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« Last post by Clark on July 13, 2023, 01:25:06 PM »
https://www.renalandurologynews.com/home/conference-highlights/era-edta-congress/hypertension-in-living-kidney-donors-ups-proteinuria-risk/Hypertension in Living Kidney Donors Ups Proteinuria RiskNatasha PersaudHypertension in living kidney donors increases the risk for proteinuria, investigators reported at the 60th European Renal Association Congress in Milan, Italy.Using the Korean Organ Transplantation Registry (KOTRY), investigators identified 642 hypertensive and 4848 normotensive living kidney donors. Hypertensive donors had a significant 1.8-fold increased risk for proteinuria compared with normotensive donors, Hyeon Seok Hwang, MD, of Severance Hospital, Yonsei University College of Medicine, and colleagues reported. Proteinuria risk tended to increase even after 4-5 years, they noted.Both before and after nephrectomy, hypertensive living donors had lower estimated glomerular filtration rates (eGFR) than normotensive donors. They had no greater risk of developing chronic kidney disease, however. The risk of eGFR falling below 60 or 45 mL/min/1.73 m2 did not differ significantly between groups.“Careful monitoring for proteinuria is required in hypertensive donors after nephrectomy,” Dr Hwang’s team concluded.ReferenceKim JH, Lee YH, Yoon SY, et al. Comparisons of clinical outcomes between hypertensive and normotensive living kidney donors: a nationwide prospective cohort study. Presented at: ERA 2023 Congress; June 15-18; Milan, Italy. Poster 4343.
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« Last post by Clark on July 13, 2023, 01:23:14 PM »
https://www.cureus.com/articles/168113-improving-surgical-safety-in-living-donor-renal-transplantation-with-antiseptic-skin-preparation-bladder-irrigation-corner-saving-vascular-anastomosis-dj-stenting-and-extravesical-ureteroneocystostomy-modifications-a-comprehensive-approach#!/Singh S, Wani M S, Bhat A H, et al. (July 10, 2023) Improving Surgical Safety in Living Donor Renal Transplantation With Antiseptic Skin Preparation, Bladder Irrigation, Corner-Saving Vascular Anastomosis, DJ Stenting, and Extravesical Ureteroneocystostomy Modifications: A Comprehensive Approach. Cureus 15(7): e41635. doi:10.7759/cureus.41635AbstractIntroductionThe antiseptic skin preparation, bladder irrigation, corner-saving vascular anastomosis, DJ stenting, and extravesical ureteroneocystostomy (ABCDE) approach encompasses a range of modifications applied during different stages of the surgical procedure in renal transplantation. These modifications include the following: A, antiseptic skin preparation sequentially with cetrimide 3.35%, chlorhexidine scrub 4%, spirit, and povidone-iodine 10%; B, bladder irrigation with amikacin and betadine solution; C, corner-saving end-to-side vascular anastomosis; D, DJ stenting with early postoperative removal within three weeks; and E, extravesical ureteroneocystostomy using our institute's modified Lich-Gregoir technique.MethodsThis prospective observational study was conducted at our institution between March 2021 and May 2023. Data were collected from the patients' medical records and analyzed using Statistical Package for the Social Sciences (SPSS) (IBM SPSS Statistics, Armonk, NY, USA). Statistical tests, including t-test, Mann-Whitney test, chi-square test, and Fisher's exact test, were used for analysis. The study assessed various recipient, donor, intraoperative, and post-transplant factors, as well as surgical complications and stent-related factors.ResultsOut of 72 renal transplantations, 12 (16.6%) had the following surgical complications: urinary (n = 4; 5.5%), wound-related (n = 3; 4.1%), and lymphocele (n = 5; 6.9%). The most common complications were lymphocele (n = 5; 6.9%) and urinary leak (n = 4; 5.5%). Surgical complications were more common in male recipients (91.6% versus 8.3%), as well as in recipients with longer dialysis duration (24 ± 17 versus 11.0 ± 7 months) and had extended hospitalization time (16.4 ± 8.6 versus 8.0 ± 2.9 days) (p < 0.05). Wound infection correlated with longer surgeries (>300 minutes) and other complications. Lymphocele patients had higher drain output (>500 mL) on day 1 and longer hospital stays (>15 days). Urinary tract infections (UTIs) were linked to dialysis duration (>24 months), diabetes, and longer indwelling times of DJ stents and urinary catheters. Early DJ stent removal (<3 weeks) reduced UTI incidence and symptoms (p < 0.05). All complications were categorized as minor (3a or less), according to the Clavien-Dindo classification.ConclusionThe modified ABCDE surgical approach in renal transplantation decreased the complications, showing favorable outcomes compared to those in the literature.
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« Last post by Clark on July 13, 2023, 12:36:44 PM »
https://www.wavy.com/news/virginia-law-requiring-companies-to-give-employees-time-off-to-donate-organs-takes-effect-july-1/Virginia law requiring companies to give employees time off to donate organs takes effect July 1by: Tyler EnglanderA new law is set to go into effect in Virginia with the hopes of convincing more people to donate organs. The law will require employers with over 50 employees to give employees 60 days off unpaid if they donate an organ or 30 days unpaid if they donate bone marrow. According to Donate Life Virginia, 2,400 Virginians are awaiting a life-saving organ donation.Lara Malbon, Executive Director of Donate Life Virginia, said live donors can donate a kidney or part of their liver. “Most people waiting are Virginians in need of a kidney,” Malbon said. “We all have the opportunity right now and living donors to donate a kidney.” David Bruno, interim chair of the Transplant Department at VCU Health Hume-Lee Transplant Center, said last year that the department did around 500 kidney and liver transplants. “When I’m talking to family members about encouraging their friends and family members to be donors, they often will kind of dig through a list and say, ‘He’s working, or he’s the only person in the house working,” Bruno said. Bruno added that time off is needed to travel to appointments before the transplant and to recover. “It really helps you heal faster, so instead of 9-12 weeks of recovery, you are looking at 6-8 weeks of recovery, and that’s for a strenuous job,” said Bruno. Bruno added that although some non-profit organizations do pay organ donors for the time they take off, if lawmakers really wanted to make a difference, they would mandate paid time off. “We don’t want to burden them with a financial disincentive to donate,” said Bruno. “We want to encourage this.” To be eligible, donors must have worked at that company for at least a year and provide written documentation from a doctor.
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« Last post by Clark on July 03, 2023, 09:28:49 AM »
Best wishes to all remembering past milestones this month, be they successes in our shared adventures in altruistic action, or grief at tragedy that unfortunately accompanies us on our journeys. In July we particularly think of all those listed here. We are in awe of Barbara who donated fifty years ago! We cry, again, at the memory of Patti who never woke up from her donation surgery, and her husband/recipient staying with her daily, singing, for nearly four years. Finally, we wonder about folks in the past eight years. Are social media media posts really sufficient memorial to the extraordinary acts we are party to? Please consider requesting we add your anniversary to our calendar at https://livingdonorsonline.org/donor-experiences/donation-anniversaries/. Looking forward to hearing from you!Take care, all!Fiftieth anniversary:Barbara Outz Johnson donated a kidney to her brother on July 5th, 1973Forty-sixth anniversary:Kathleen Mahoney donated a kidney to her brother when she was 20 and he was 14, on July 11th, 1977Thirty-third anniversary:Joan Schurman donated a kidney to her son on July 8th, 1990Twenty-eighth anniversary:Mare Medernach donated a kidney to her brother, Mark, on July 19th, 1995Twenty-seventh anniversary:David Scott donated a kidney to his sister, Gail Haisley, on July 10th, 1996Twenty-third anniversary:Laura Hawes donated part of her liver to her mother on July 25th, 2000Patti McRoberts, a living kidney donor to her husband on July 31st, 2000, never woke up, and died on July 29th, 2004 Twenty-second anniversary:Jenny Lee donated a kidney to her daughter on July 9th, 2001Lisa Steele donated a kidney to an unrelated recipient on July 12th, 2001Stephanie Ritchon donated a kidney to her sister on July 16th, 2001Twenty-first anniversary:Jess Coleman donated part of his liver to his wife on July 3rd, 2002Gerda A. Coakley donated a kidney to her brother on July 10th, 2002Margaret donated part of her liver to her mother on July 12th, 2002Michaela Robertson donated a kidney to her father, Calder Robertson, on July 16th, 2002Ted Whitehead donated part of his liver to his brother on July 19th, 2002Julie Michaels donated a kidney to a friend on July 24th, 2002Tim Hurley donated a kidney to his son on July 24th, 2002Twentieth anniversary:Steven Seidner donated a kidney to his father on July 8th, 2003Tom Falsey donated a kidney to a stranger on July 15th, 2003Patricia donated a kidney to a stranger on July 22nd, 2003Zell Kravinsky donated a kidney to a stranger on July 22nd, 2003Donna Vogelgesang donated a kidney to her father on July 30th, 2003Karen Kennedy donated a kidney to her mother on July 30th, 2003Linda Marshall donated a kidney to her mom on July 30th, 2003 Nineteenth anniversary:Gary W. donated a kidney to his father on July 7th, 2004Lisa Quinn donated a kidney to her mother-in-law on July 7th, 2004Susan Kuhn donated a kidney to her husband on July 9th, 2004Kimberly Moity donated a kidney to her husband on July 13th, 2004Mike donated a kidney to his uncle on July 20th, 2004Barbara Romine donated a kidney to her daughter on July 28th, 2004Sherry donated a kidney to her husband on July 28th, 2004Sixteenth anniversary:Irismer donated a kidney to her cousin on July 2nd, 2007Kevin Vericker donated a kidney to his brother on July 5th, 2007Ellen Sweeney donated part of her liver to her sister, Susan, on July 12th, 2007Tristan Smith donated a kidney to his 11 year old cousin on July 12th, 2007Tanya Moder donated a kidney to a stranger on July 17th, 2007Charissa Cook donated a kidney to her father, Joseph DiBeneditto, on July 18th, 2007Matt Jones donated a kidney to an unrelated person on July 18th, 2007Laurie Fosburg Carlo donated a kidney to her sister-in-law on July 20th, 2007Joyce Hennes donated a kidney to a friend on July 24th, 2007Fifteenth anniversary:Breann Dobben donated a kidney to her boyfriend on July 7th, 2008Marilyn (Moe) Shea donated a part of her liver to her employer on July 1st, 2008Jonas Read donated a kidney to his childhood friend, Austin Pierce, on July 31st, 2008Fourteenth anniversary:Anne Caldwell donated a kidney to a friend from church on July 7th, 2009Jody Clement donated a kidney to her best friend, Faye, on July 8th, 2009Macey Leigh donated a kidney to her cousin, Marc, on July 10th, 2009Cathy Hopkins donated a kidney to her uncle on July 16th, 2009Jordan Brough donated a kidney to a stranger (and then friend) on July 16th, 2009Laurie Stuart donated a kidney to her ex-husband, Paul, on July 22nd, 2009Thirteenth anniversary:Nicki Hayes became a non-directed kidney donor on July 13th, 2010Rasula Rashid donated a kidney to her daughter, Firoza, on July 13th, 2010Tom O'Driscoll donated a kidney to Carolyn Branson, suggested by Chaya Lipschutz, on July 23rd, 2010Nina Brown donated 60% of her liver to her sister-in-law's best friend, Lynn Deal, on July 15th, 2010Dawn made a non-directed kidney donation on July 26th, 2010Betty (Bryant) Shelton made a non-directed kidney donation on July 27th, 2010Sara Guzman donated a kidney to her husband, Julian, on July 27th, 2010, after he received a liver transplant. He died on November 1st, 2010 due to other complications.Jeanne Blackburn donated a kidney to an unidentified unrelated person on July 28th, 2010Twelfth anniversary:Jeremy Hunsicker donated a kidney to his sister, Naomi Schlaner, on July 7th, 2011Rebecca Kelley donated a kidney to her ex-husband, Frank, on July 7th, 2011David Frazier donated a kidney to his co-worker, Kristen Adams, on July 12th, 2011Donna Reed Foster donated a kidney to Kerry Anthony Conrad, no relation, on July 13th, 2011 Patrick Liam O'Connor donated a kidney to his uncle, Francis Nolan, on July 14th, 2011Julie donated a kidney to her adopted sister on July 15th, 2011Leticia Rodriguez donated a kidney to her friend, Elizabeth Lopez, on July 20th, 2011John Milligan donated a kidney to his wife, Jane, on July 22nd, 2011Eleventh anniversary:Robin donated a kidney to Toby, her son, on July 5th, 2012Shelli Hudson-Altringer donated a kidney to her brother, Jim Hudson, on July 17th, 2012Annie Wright donated a kidney to a co-worker as part of a chain on July 19th, 2012Tenth anniversary:Peggy Williams donated a kidney to an unrelated person on July 3rd, 2013Maurice Bryant donated a kidney to his father, Alvin, on July 9th, 2013Nancy B Ross donated a kidney on July 10th, 2013Jessica Kuhn donated a kidney on July 30th, 2013Sharon Topai donated a kidney to a dear friend on July 31st, 2013Ninth anniversary:Shipra Singh donated a kidney to his mother, Santosh Singh, on July 7th, 2014Lynn Bakiares donated a kidney to her husband, Jeffrey, on July 9th, 2014Randy Browder donated a kidney to his friend, Ronnie Scott, on July 10th, 2014Ashley Hoyng donated a kidney to an unrelated person on July 22nd, 2014Yanira Santos donated a kidney to her mother, Carmen Urena, on July 22nd, 2014Susan Clark donated a kidney to an unrelated person, Yennifer Guitterez, on July 24th, 2014
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« Last post by Clark on June 15, 2023, 12:12:51 PM »
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2805570June 5, 2023Characterization of Transplant Center Decisions to Allocate Kidneys to Candidates With Lower Waiting List PriorityKristen L. King, MPH1,2; S. Ali Husain, MD, MPH, MA1,2; Miko Yu, MA1,2; et alJoel T. Adler, MD, MPH3; Jesse Schold, PhD, MStat, MEd4,5; Sumit Mohan, MD, MPH1,2,6JAMA Netw Open. 2023;6(6):e2316936. doi:10.1001/jamanetworkopen.2023.16936Key PointsQuestion How often do kidney transplant centers skip candidates with the highest priority to place kidneys with recipients with lower-ranked allocation prioritization?Findings This cohort study of 26 579 organ offers from 3136 donors to 4668 recipients found that at 11 geographically isolated transplant centers, kidneys were placed further down the match-run than the candidate with the highest priority 68% of the time. Lower-quality kidneys were statistically significantly more likely to be placed with candidates further down the list than higher-quality kidneys.Meaning These findings suggest that transplant centers frequently skip over candidates to place kidneys with recipients with lower allocation priority, with limited oversight and transparency.AbstractImportance Allocation of deceased donor kidneys is meant to follow a ranked match-run list of eligible candidates, but transplant centers with a 1-to-1 relationship with their local organ procurement organization have full discretion to decline offers for higher-priority candidates and accept them for lower-ranked candidates at their center.Objective To describe the practice and frequency of transplant centers placing deceased donor kidneys with candidates who are not the highest rank at their center according to the allocation algorithm.Design, Setting, and Participants This retrospective cohort study used 2015 to 2019 organ offer data from US transplant centers with a 1-to-1 relationship with their local organ procurement organization, following candidates for transplant events from January 2015 to December 2019. Participants were deceased kidney donors with a single match-run and at least 1 kidney transplanted locally and adult, first-time, kidney-only transplant candidates receiving at least 1 offer for a locally transplanted deceased donor kidney. Data were analyzed from March 1, 2022 to March 28, 2023.Exposure Demographic and clinical characteristics of donors and recipients.Main Outcomes and Measures The outcome of interest was kidney transplantation into the highest-priority candidate (defined as transplanted after zero declines for local candidates in the match-run) vs a lower-ranked candidate.Results This study assessed 26 579 organ offers from 3136 donors (median [IQR] age, 38 [25-51] years; 2903 [62%] men) to 4668 recipients. Transplant centers skipped their highest-ranked candidate to place kidneys further down the match-run for 3169 kidneys (68%). These kidneys went to a median (IQR) of the fourth- (third- to eighth-) ranked candidate. Higher kidney donor profile index (KDPI; higher score indicates lower quality) kidneys were less likely to go to the highest-ranked candidate, with 24% of kidneys with KDPI of at least 85% going to the top-ranked candidate vs 44% of KDPI 0% to 20% kidneys. When comparing estimated posttransplant survival (EPTS) scores between the skipped candidates and the ultimate recipients, kidneys were placed with recipients with both better and worse EPTS than the skipped candidates, across all KDPI risk groups.Conclusions and Relevance In this cohort study of local kidney allocation at isolated transplant centers, we found that centers frequently skipped their highest-priority candidates to place kidneys further down the allocation prioritization list, often citing organ quality concerns but placing kidneys with recipients with both better and worse EPTS with nearly equal frequency. This occurred with limited transparency and highlights the opportunity to improve the matching and offer algorithm to improve allocation efficiency.
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« Last post by Clark on June 13, 2023, 08:44:20 PM »
https://www.breakinglatest.news/news/shorten-waiting-times-and-increase-chances-of-survival-through-living-donations/Shorten waiting times and increase chances of survival through living donationsIn view of the long waiting lists for donor organs, experts at the University Hospital Dresden want to focus more on living donations. “In order to give as many patients as possible the chance of a donor organ, the organ donation figures, which have been extremely low in recent years and have continued to decrease in comparison to other European countries, must improve significantly,” warned Medical Director Michael Albrecht on Saturday.According to the German Foundation for Organ Transplantation, the number of organ donations in Saxony in 2022 fell again last year after two years of positive trends. Nationwide, there were 869 so-called postmortem organ donors last year, a drop of almost 7 percent compared to 2021. According to the foundation, 8,500 people in Germany would be waiting for a life-saving transplant.Hundreds of patients’ health deteriorates so dramatically every year that a transplant is no longer possible or they die while waiting because a suitable organ cannot be found in time. In the past, 74 heart patients, 47 lung patients and 324 kidney patients who were on the waiting list died.Around 6,600 people alone need a new kidney. That is four times as many patients as transplants could be placed in Germany in the course of the year. In total, even a hundred thousand people are dependent on dialysis. Some of these patients can no longer be put on the waiting list because they have no hope.
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« Last post by Clark on June 13, 2023, 08:40:00 PM »
https://www.renalandurologynews.com/home/conference-highlights/american-transplant-congress/high-kdpi-kidneys-still-underused/High KDPI Kidneys Still UnderusedNatasha PersaudUse of high Kidney Donor Profile Index (KDPI) kidneys with a score greater than 85 remained “modest” during 2010-2019, despite national efforts to increase it, investigators reported at the 2023 American Transplant Congress in San Diego, California.Of 106,448 recipients of kidney transplants during 2010-2019 who were identified using the 2010-2019 United Network for Organ Sharing’s Organ Procurement and Transportation Network (UNOS-OPTN) database, only 6.8% received grafts with a KDPI score higher than 85, Ashesh P. Shah, MD, of Thomas Jefferson University in Philadelphia, Pennsylvania, reported on behalf of his team.Age trends remained the same. Nearly a quarter (23.8%) of high KDPI transplantations were performed in recipients aged 70 years or older, 45.5% in those aged 60-69 years, 30.2% in those aged 30-59 years, and 0.5% in those younger than 30 years.The likelihood of receiving a high KDPI kidney was a significant 30-fold higher for patients aged 70 years or older compared with those younger than 30 years. Patients with diabetes had significant 1.2-fold increased odds of accepting a high KDPI kidney. Black and Hispanic adults both had significant 1.3-fold increased odds of receiving a high KDPI kidney compared with White adults. Women and patients with glomerulonephritis or congenital rare familiar disease, however, had lower likelihood of receiving a high KDPI kidney.“Pressures, such as outcomes reporting and perceived inadequate risk adjustment, disincentivize transplant programs from using high KDPI kidneys,” Dr Shah explained in an interview. “Older patients who have shorter expected post-transplant survival would probably be best served by receiving high KDPI allografts. These patients have the worst survival on the transplant list due to their age and comorbidities and would gain the most by being transplanted early.” According to the Organ Procurement & Transplantation Network, high KDPI kidneys last more than 5.5 years.Dr Shah suggested conducting a national clinical trial to better understand high KDPI kidneys, identify optimal candidates, and standardize practice. Transplant programs and patients should opt in to participate in such a national clinical trial and be exempt from punitive national reporting, he noted.“We need to clearly establish best practices for evaluation of these organs and patient care after transplantation,” Dr Shah added. “The field needs more information about these kidneys, in terms of pulsatile pump perfusion parameters, biopsy rapid permanent section histology and, perhaps, novel biomarkers. The KDPI score also probably needs to be updated, such as the hepatitis C penalty.”References1. Shah A, Litvintchouk A, Amaefule A, et al. 10 Year trends and patterns of kidney transplantation according to KDPI score and factors associated with allocation of higher KDPI score. Presented at: ATC 2023; June 3-7, San Diego, California. Abstract B143.2. Kidney Donor Profile Index (KDPI) guide for clinicians. OPTN. Accessed on May 19, 2023.
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« Last post by Clark on June 13, 2023, 08:37:58 PM »
https://www.goalcast.com/tina-turner-erwin-bach-kidney-donation/Tina Turner’s Husband Donated His Kidney to Her Six Years Before She Died So She Could Live LongerBy Carl Wordsworth Actions speak louder than words…In May 2023, American icon Tina Turner passed away.She had been battling a worsening kidney condition brought on by hypertension, which developed into renal failure.She had penned an open letter for “Show Your Kidneys Love” — an awareness group concerning kidney health. In the letter, she shared that her husband actually donated his own kidney to her in 2017 — an act of selflessness and love — that saved her life.Turner admitted in the letter that she long ignored the severity of her condition, which originated with a diagnosis of hypertension many years ago.This developed over the years, worsening until it caused a stroke in 2009.After the stroke, she learned that her kidneys had lost a considerable amount of function, and she began to come to terms with the seriousness of her situation.She was placed on a prescription to monitor her blood pressure, but wrote, “with time I developed a fatal dislike of these pills.” She opted instead to see a homeopathic doctor, considering it an alternative to the medication.However, this decision would prove to be pivotal, as she admitted: “I had not known that uncontrolled hypertension would worsen my renal disease and that I would kill my kidneys by giving up on controlling my blood pressure. I never would have replaced my medication by the homeopathic alternatives if I had had an idea how much was at stake for me.”Faced with a life-or-death situation, she began a treatment called dialysis, which requires being hooked up to machinery for hours at a time to replace the typical function of one’s kidneys. At this point, her “kidney function had reached its all-time low.”“In order to survive, I had to start dialysis,” she wrote. “It was my only option, but it was depressing to be connected to a machine for hours. For the next nine months, all my life was about dialysis.” At one point, she even considered medically assisted suicide.How And When Tina Tuner’s Husband Stepped InTurner met Erwin Bach in 1986– a decade after her infamous divorce from Ike Turner. Bach is a German music executive, who met the American star when he was tasked with picking her up from the Dusseldorf Airport.Turner was 16 years older than him at the time but remembers feeling love at first sight. The two dated for 27 years before ultimately tying the knot in 2013.
They remained fiercely committed to each other, and Bach made the huge decision to donate one of his kidneys to her in 2017, the first step in a complex procedure.She describes that he “shocked me by saying that he wanted to give me one of his kidneys,” adding that she was “overwhelmed by the enormity of his offer.”In her open letter to raise awareness around her condition, she describes the time after her kidney transplant as “a never-ending up and down.”“From time to time my body tried to reject the donor kidney as it frequently happens after transplantation. Every so often this required more hospital admissions. I kept feeling nauseous and dizzy, forgot things, and was scared a lot.”However, the procedure was a success and helped extend Turner’s life by years.Erwin did not want to lose his wife and was willing to give everything he could to keep her healthy. As the saying goes, actions speak louder than words, and Bach truly put his money where his mouth was by stepping up to donate a kidney.According to Donate Life, more than 90,000 people in the U.S. are waiting for a kidney donation, and it can take an average of three to five years to receive a kidney from a deceased donor.
Bach’s decision to go under the knife for his wife seriously lessened this waiting time, which is typically the hardest part of the transplant procedure.Though her condition ultimately claimed her life this past month, Bach’s decision to donate his kidney marks a bold move of selfless love. Humans have a tremendous capacity for empathy, and stories such as this can remind us how powerful a bond between two people can be.When we truly do not want to lose someone, we are willing to go to any length. Erwin Bach’s decision to donate a kidney captures an unwavering kind of love that can inspire us all to step up for those we cherish.
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« Last post by Clark on June 13, 2023, 08:34:27 PM »
https://www.renalandurologynews.com/home/conference-highlights/american-transplant-congress/cvd-diabetes-ups-hospitalization-risk-for-living-kidney-donors/CVD, Diabetes Ups Hospitalization Risk for Living Kidney DonorsNatasha PersaudLiving kidney donors may have increased risks for end-stage kidney disease (ESKD) following nephrectomy. New study findings presented at the 2023 American Transplant Congress in San Diego, California, add that living kidney donors with diabetes or cardiovascular disease — risk factors for ESKD and its sequelae — are more likely to be hospitalized after donation.Amy Chang, MD, of Johns Hopkins University School of Medicine in Baltimore, Maryland, and colleagues studied post-donation hospitalization records from 2265 living kidney donors who underwent nephrectomy from 1968 to 2019. Median age at donation was 46 years.Hospitalization within a median 7 years affected 42% of donors. The most common reasons for hospitalization were surgery (59%), cardiovascular causes (16%), and urologic problems (6%). The investigators predicted that up to half of living kidney donors would eventually experience hospitalization following nephrectomy.After adjusting for clinical characteristics, cardiovascular and diabetes history in the donor were significantly associated with 1.5- and 2.2-fold increased odds of hospitalization, the investigators reported. Hospitalization was not associated with patient sex, smoking history, education level, or income.Hospitalization of living kidney donors may be “a sentinel event” for adverse outcomes, according to Dr Chang and colleagues.“Since diabetes is the leading cause of [ESKD] in this population and cardiovascular disease is the leading cause of death in an [ESKD] population, hospitalization in donors presents a crucial opportunity to avert the most adverse long-term outcomes described in this population.”ReferenceChang A, Phung A, Mehta S, et al. All-cause hospitalization among live kidney donors after nephrectomy. Presented at: ATC 2023; June 3-7, San Diego, California. Abstract 480.
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« Last post by Clark on June 13, 2023, 08:31:42 PM »
https://www.renalandurologynews.com/home/conference-highlights/american-transplant-congress/living-kidney-donation-barriers-facilitators-identified/Living Kidney Donation Barriers, Facilitators IdentifiedJody CharnowInterventions that raise awareness of living kidney donation (LKD), ease fears about donation surgery, and eliminate related medical expenses could increase willingness to be a living donor, investigators concluded based on public opinion survey findings they reported at the 2023 American Transplant Congress in San Diego, California.The survey, conducted in June 2021 using an online platform, included 802 US adults aged 25 to 65 years. Respondents with greater knowledge about LKD were more likely to be White, female, older, and willing to consider LKD, Katya Kaplow, MPH, of NYU Langone Health in New York, and colleagues reported. Exposure within the past 12 months to content about LKD was reported by 22.2% of respondents and was associated with a greater willingness to donate.Based on survey responses LKD barriers include concerns about health impact (76.3% of respondents) and medical expenses (65.7%) related to donation. Facilitators of LKD included information about the safety of the operation (78.7%), information that would lessen worries about health after donation (76.7%), and not having to pay for any medical expenses (76.3%).ReferenceKaplow K, Ruck J, Thomas A, et al. National attitudes towards living kidney donation in the United States: Results of a public opinion survey. Presented at: ATC 2023, San Diego, California, June 3-7. Abstract C117.
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