Commercial renal transplantation: A risky venture? A single Canadian centre experience

Kapoor, Anil; Kwan, Kevin; Whelan, J. Paul

doi:10.5489/cuaj.11018

Cited by 9 publications

(7 citation statements)

References 23 publications

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“…Kidney transplantation is considered the treatment of choice for patients with end-stage renal disease (ESRD) and has been shown to improve quality of life and survival rate for most patients compared to those maintained on dialysis[5,6]. AF occurs in over 7% of kidney transplant recipients in the first 3 years after transplantation and is associated with reduced graft and patient survival[7].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of non-vitamin K antagonist oral anticoagulants post-kidney transplantation

Bukhari¹,

Altheaby²,

Tawhari³

et al. 2019

WJT

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BACKGROUNDNovel oral anticoagulants (NOACs) were developed as alternatives to vitamin K antagonists, primarily warfarin, as they do not require routine monitoring and have limited drug-drug and drug-food interactions. However, the efficacy and safety of these agents in kidney transplantation are not well studied.AIMTo assess the profile and safety of NOACs for patients who had kidney transplantation, and to provide recommendations and guidelines on therapeutic strategies in these patients.METHODSThis was a retrospective study carried out among adult patients who were actively on the following NOACs (apixaban, rivaroxaban or dabigatran) in our renal transplantation program from December 2015 to December 2016. The patients were identified primarily through electronic medical record system (patient data linkage). Data on the clinical and laboratory profile of the patients were retrieved and analyzed with SPSS 22.0.RESULTSComplete data on 42 renal transplant patients were retrieved: 59.5% males, 90.5% were whites and 66.7% were older than 60 years old. The mean duration since renal transplantation of the patients was 8.8 ± 7.4 years. The most common risk factors for the development of end-stage renal disease in the subjects were hypertension (19.0%), polycystic kidney disease (19.0%), followed by diabetic nephropathy (16.7%) and chronic glomerulonephritis (16.7%). The main indications for NOACs use in the cohort were atrial fibrillation in 25 patients (59.5%) and venous thromboembolism in 10 patients (23.8%). Overall, 29 patients (69%) were treated with apixaban, 10 patients (23.8%) with rivaroxaban and 3 patients (7.14%) with dabigatran. No (0%) thromboembolic events were observed during the one-year period, but 3 (7.1%) bleeding events occurred in the cohort consisting of 1 patient treated with rivaroxaban 15 mg daily and 2 patients who received apixaban 2.5 mg twice daily. There were no significant changes in serum tacrolimus level three days after the initiation of NOACs among patients treated with tacrolimus (pre- and post-NOACs tacrolimus levels were 7.2516 and 7.8867 ng/mL, P = 0.55, respectively). Also, after one-year of treatment with NOACs there were no significant changes in the pre- and post-NOACs serum creatinine level (P = 0.772) and estimated glomerular filtration rates (P = 0.232).CONCLUSIONNo thromboembolic events or significant changes in renal profile were observed in our cohort of kidney transplant recipients who were treated with NOACs for at least a year. However, a few bleeding events were observed. This calls for further well-planned randomized controlled trials to assess the efficacy and safety of NOACs among renal transplant recipients.

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Section: Introductionmentioning

confidence: 99%

Efficacy and safety of non-vitamin K antagonist oral anticoagulants post-kidney transplantation

Bukhari¹,

Altheaby²,

Tawhari³

et al. 2019

WJT

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“…The authors have unequivocally shown that recipient mortality and morbidity rates are unacceptably high, likely as a result of cost-cutting and limited expertise in the practice of commercial transplantation. 1 The fact that a sister renal transplant group in Ontario has published similar data indicate that this phenomenon is highly relevant to Canadian transplant centres.…”

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confidence: 68%

Organ trafficking in Canada: Is it relevant to the urologist?

Luke

Möser

2013

CUAJ

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“…Information that patients brought back about their transplantations abroad was commonly unavailable or inadequate, in particular the details and circumstances surrounding donor selection . The variations in terminology and inadequate documentation make it difficult, if not impossible, to assess whether a commercial transaction was involved.…”

Section: Resultsmentioning

confidence: 99%

On Patients Who Purchase Organ Transplants Abroad

Ambagtsheer

Jong

Bramer

et al. 2016

American Journal of Transplantation

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The international transplant community portrays organ trade as a growing and serious crime involving large numbers of traveling patients who purchase organs. We present a systematic review about the published number of patients who purchased organs. With this information, we discuss whether the scientific literature reflects a substantial practice of organ purchase. Between 2000 and 2015, 86 studies were published. Seventy-six of these presented patients who traveled and 42 stated that the transplants were commercial. Only 11 studies reported that patients paid, and eight described to what or whom patients paid. In total, during a period of 42 years, 6002 patients have been reported to travel for transplantation. Of these, only 1238 were reported to have paid for their transplants. An additional unknown number of patients paid for their transplants in their native countries. We conclude that the scientific literature does not reflect a large number of patients buying organs. Organ purchases were more often assumed than determined. A reporting code for transplant professionals to report organ trafficking networks is a potential strategy to collect and quantify cases.

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Commercial renal transplantation: A risky venture? A single Canadian centre experience

Cited by 9 publications

References 23 publications

Efficacy and safety of non-vitamin K antagonist oral anticoagulants post-kidney transplantation

Efficacy and safety of non-vitamin K antagonist oral anticoagulants post-kidney transplantation

Organ trafficking in Canada: Is it relevant to the urologist?

On Patients Who Purchase Organ Transplants Abroad

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