Living Donor Kidney Transplantation

Rodrigue, James R.; Rudow, Dianne LaPointe; Hays, Rebecca

doi:10.2215/cjn.00800115

Cited by 19 publications

(12 citation statements)

References 10 publications

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“…Evaluation guidelines and acceptance criteria for all living donors have been developed to reduce the risk of poor medical and/ or psychosocial outcomes. [24][25][26] Additional NDD guidelines have been developed to further assess motivation, psychological stability, and possible risk factors for unrealistic expectations from donation. 1,27,28 To date, studies suggest that NDDs have outcomes similar to those of traditional directed donors.…”

Section: Discussionmentioning

confidence: 99%

Long-term psychosocial outcomes after nondirected donation: A single-center experience

Jacobs

Berglund

Wiseman

et al. 2019

American Journal of Transplantation

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Short‐term studies have demonstrated that nondirected donors (NDDs) have psychosocial outcomes that are similar to donors who donate directly, but long‐term studies have not been done. NDDs at our center were surveyed regarding motivation; support during donation; stress related to donation; regret; financial resources used for donation; preferences about communication with the recipient; and cost reimbursement. Of 100 NDDs who donated at our center in the last 20 years, 95 remain in contact with us, and 77 responded to our survey (mean ± standard deviation [SD] 6.7 ± 4 years postdonation). The most common motivation for donation was the desire to help another (99%). Many NDDs received support from family, friends, and employers. NDDs voiced stress about the possibility of recipient kidney rejection, physical consequences to themselves, and financial burden. Only one donor expressed regret. Almost half wanted some recipient information at donation; 61% preferred routine recipient status updates; 56% believed meeting the recipient should occur at any mutually agreeable time; and 55% endorsed reimbursement for expenses. Stressors for NDDs are analogous to those of directed donors; NDDs prefer having some information about the recipient and prefer to be given a choice regarding the timing for communication with the recipient. NDDs supported donation being financially neutral.

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Section: Discussionmentioning

confidence: 99%

Long-term psychosocial outcomes after nondirected donation: A single-center experience

Jacobs

Berglund

Wiseman

et al. 2019

American Journal of Transplantation

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“…During the last 20 years, the two main policies attempting to achieve this purpose were living donation and expanded criteria donors [ 5 – 8 ]. These donors are presumed to provide a worse outcome than conventional donors and many research protocols have been developed to reduce preservation injury (PI) and PI-related complications [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Strategies to Restore Adenosine Triphosphate (ATP) Level After More than 20 Hours of Cold Ischemia Time in Human Marginal Kidney Grafts

et al. 2018

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BackgroundThe persisting organ shortage in the field of transplantation recommends the use of marginal kidneys which poorly tolerate ischemic damage. Adenosine triphosphate (ATP) depletion during cold ischemia time (CIT) is considered crucial for graft function. We tested different strategies of kidney perfusion before transplantation in the attempt to improve the technique.Material/MethodsTwenty human discarded kidneys from donors after brain death and with at least 20 hours of CIT were randomized to the following experimental groups (treatment time three-hours at 4°C): a) static cold storage (CS); b) static cold hyperbaric oxygenation (Hyp); c) hypothermic perfusion (PE); d) hypothermic perfusion in hyperbaric oxygenation (PE-Hyp); and e) hypothermic oxygenated perfusion (PE-O2).ResultsHistological results showed that perfusion with or without oxygen did not produce any endothelial damage. A depletion of ATP content following the preservation procedure was observed in CS, PE, and Hyp, while PE-Hyp and PE-O2 were associated with a net increase of ATP content with respect to baseline level. In addition, PE-Hyp was associated with a significant downregulation of endothelial isoform of nitric oxide synthase (eNOS) gene expression and of hypoxia inducible factor-1α (HIF-1α).ConclusionsHyperbaric or normobaric oxygenation with perfusion improves organ metabolic preservation compared to other methods. This approach may prevent the onset of delayed graft function, but clinical trials are needed to confirm this.

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“…The American Society of Transplantation recommends providing culturally tailored community-based LDKT education to patients earlier in the transplantation referral process, in modules, with transplantation liaisons in dialysis clinics. 15 Supplementary education provided directly to dialysis patients over a longer time frame may enhance current KT education in dialysis centers. Text-messaging interventions 16,17 could be used because these have been shown to promote behavior change.…”

mentioning

confidence: 99%

Direct Delivery of Kidney Transplant Education to Black and Low-Income Patients Receiving Dialysis: A Randomized Controlled Trial

Waterman

Peipert

McSorley

et al. 2019

American Journal of Kidney Diseases

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Living Donor Kidney Transplantation

Cited by 19 publications

References 10 publications

Long-term psychosocial outcomes after nondirected donation: A single-center experience

Long-term psychosocial outcomes after nondirected donation: A single-center experience

Strategies to Restore Adenosine Triphosphate (ATP) Level After More than 20 Hours of Cold Ischemia Time in Human Marginal Kidney Grafts

Direct Delivery of Kidney Transplant Education to Black and Low-Income Patients Receiving Dialysis: A Randomized Controlled Trial

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