25 years of live related renal transplantation in children: The Buenos Aires experience

Ruiz, Eduardo; Ferraris, Jorge R.

doi:10.4103/0970-1591.36720

Cited by 7 publications

(5 citation statements)

References 31 publications

(50 reference statements)

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“…In the most severe cases, this type of renal injury ultimately results in progressive renal tubular atrophy and interstitial fibrosis, with loss of nephrons [4]. Hence, OU accounts for 23% of pediatric cases of renal insufficiency and 50% of pediatric patients with end-stage renal disease undergoing renal transplantation [5].…”

Section: Introductionmentioning

confidence: 99%

Effects of nicorandil on renal function and histopathology in rats with partial unilateral ureteral obstruction

Öztürk

Fırat

Tekçe

et al. 2017

The Kaohsiung J of Med Scie

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To evaluate the effects of nicorandil in a rat kidney model of partial unilateral ureteral obstruction (PUUO). Thirty male rats were randomly divided into three groups as follows: (1) Group 1 (Sham-control), ureters of the rats were manipulated but not ligated; (2) Group 2 (PUUO-untreated), PUUO was performed with two-thirds of the left ureter embedded in the psoas muscle; and (3) Group 3 (PUUO-nicorandil treated). After PUUO was established, nicorandil (15 mg/kg/day) was administered by gastric lavage for 21 days to determine its effects on PUUO-induced histopathological-, functional-, and oxidative stress-induced changes. The serum levels of blood urea nitrogen and creatinine were reduced in Group 3. The level of urinary albumin and the ratio of urinary protein/creatinine were increased in the kidneys of Group 2 but decreased in Group 3. Malondialdehyde value was decreased in Group 3 compared with Group 2. Antioxidant enzyme activities (catalase, superoxide dismutase, and glutathione peroxidase) were decreased in Group 2. Nicorandil treatment caused an increase in these enzyme activities. In Group 3, leukocyte infiltration and tubular dilatation were significantly reduced. Other parameters, such as degeneration of tubular epithelium and fibrosis, also showed a marked improvement in Group 3. Expression of inducible nitric oxide synthase in Group 2 and expression of endothelial nitric oxide synthase in Group 3 were significantly elevated. Nicorandil can inhibit renal tubular damage and tubulointerstitial fibrosis by reducing the effects of oxidative stress after PUUO.

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Section: Introductionmentioning

confidence: 99%

Effects of nicorandil on renal function and histopathology in rats with partial unilateral ureteral obstruction

Öztürk

Fırat

Tekçe

et al. 2017

The Kaohsiung J of Med Scie

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“…For example, a large transplantation group in Argentina describes renal inversion in a review of their cases over a long period of time. Ruiz et al mention their preference for inversion in patients receiving a right allograft, but provide little specific data on the number of patients or outcomes . They briefly mention the need to dissect the renal pelvis from the lower pole to avoid ureteral kinking, a surgical step that was not performed in the present study.…”

Section: Discussionmentioning

confidence: 84%

“…We describe long-term assessment of six inverted renal trans- Ruiz et al mention their preference for inversion in patients receiving a right allograft, but provide little specific data on the number of patients or outcomes. 10 They briefly mention the need to dissect the renal pelvis from the lower pole to avoid ureteral kinking, a surgical step that was not performed in the present study. In our series, this was not done as this area is known for containing critical blood supply to the ureter (part of the "golden triangle"), care, yet the delivery has been harmonized by protocols generated by the senior anesthetic consultant in this paper (KT).…”

Section: Discussionmentioning

confidence: 97%

“Inverted” positioning of renal allograft during kidney transplantation in children and adolescents: A single‐institution comparative analysis

Ramesh

Taylor

Koyle

et al. 2019

Pediatric Transplantation

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Renal transplantation is the treatment of choice in children with end‐stage renal failure. Limitations in patient anatomy or a short donor renal vein may necessitate intraoperative inversion of the kidney. There is little evidence to support the use of this surgical technique, and no evidence in the pediatric population. This study identifies the perioperative and post‐operative outcomes of inverted renal transplants in pediatric patients. We reviewed all patients having a renal transplant between January 2012 and December 2016 and collected short‐ and long‐term outcomes of patients who received an inverted allograft. Early graft function was defined as the time to reach creatinine nadir. During this time, our hospital performed 81 transplants, and 50 (62%) were from deceased donors, including the 6 (12%) patients who received inverted renal grafts. Half (3/6) were female, 5/6 (83%) were dialysis‐dependent, and the median age at surgery was 13 years (range 9‐16 years). There was no significant difference in mean creatinine nadir values (P = 0.518) and the time to creatinine nadir mean values (P = 0.190) between the upright and inverted renal transplant groups. There were also no significant differences in rates of post‐operative complications between the upright and inverted allograft recipients. Inversion of renal allografts in pediatric patients is a viable surgical technique to compensate for shortcomings in patient anatomy or in special cases of renal transplantation involving a short donor renal vein. Future research should focus on outcomes of a larger group of pediatric inverted renal transplant patients.

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“…Congenital disease was the most common cause of CKD in our study population (76.92 %). RT has become the treatment of choice for pediatric patients with chronic renal conditions [1]. A multidisciplinary intervention during each operative stage (preoperative, intraoperative and postoperative) is essential to achieve a successful transplantation.…”

Section: Discussionmentioning

confidence: 99%

“…Before 1980, adolescents and children with CKD were rarely candidates for transplantation and few were selected to undergo dialysis. After that decade, a gradual increase in pediatric transplantation was reported with specific pediatric anesthetic requirements and with more complex surgical techniques [1,2].…”

Section: Introductionmentioning

confidence: 99%

Pediatric Renal Transplantation in Children with Weight 20kg or Less: A Single-Center Experience

Urquijo¹,

A²

2019

IJAR

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Background: Renal transplantation (RT) is the treatment of choice for children with Chronic Kidney Disease (CKD). This technique benefits survival and quality of life. Long-term outcomes in pediatric transplantation have significantly improved over the past 20 years; however, children less than 5 years of age weighing 20 kg or less still remain a considerable challenge, with higher mortality rate and graft loss. Methods: In this article, we present the pediatric RT experience at Hospital Universitario de Cruces, the main center for transplants in Spain. Children who underwent RT within the period of January 2012 -January 2017 were retrospectively reviewed to identify those with weight less than 20 Kg. The following parameters were collected: pre-transplant characteristics, surgical technique, anesthesia characteristics, intra-operative and post-operative surgical or medical complications, pre and post-transplant creatinine levels, renal graft survival, and late post-operative complications. Results: Within a period of 5 years, a total of 13 pediatric patients (weight ≤ 20kg) underwent RT at Hospital Universitario de Cruces. The patient sample represented 37.14 % of the 35 renal transplants performed on pediatric patients at this institution. All 13 patients received a standard surgical and anesthetic perioperative management. Post-transplant creatinine levels significantly decrease after surgery during the early postoperative period from 6.45 mg/dl preoperatively (range, 1.90 -12.26) to 0.59 mg/dl postoperatively (range, 0.27 -1.27). The mean follow-up period was 1.5 year (range, 1 -3) with 12 patients out of 13 (92.31%) presenting with 1-year graft survival. Conclusions: A multidisciplinary collaboration, including surgeons, nephrologists, and anesthesiologists specialized in handling transplants for underweight children should be a priority. Close intraoperative monitoring of vital signs and optimal fluid therapy is essential for anesthetic management due to the possible perioperative hemodynamic changes.

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25 years of live related renal transplantation in children: The Buenos Aires experience

Cited by 7 publications

References 31 publications

Effects of nicorandil on renal function and histopathology in rats with partial unilateral ureteral obstruction

Effects of nicorandil on renal function and histopathology in rats with partial unilateral ureteral obstruction

“Inverted” positioning of renal allograft during kidney transplantation in children and adolescents: A single‐institution comparative analysis

Pediatric Renal Transplantation in Children with Weight 20kg or Less: A Single-Center Experience

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