Recommendations for living donor kidney transplantation

Frutos, M.Á.; Crespo, Marta; Valentín, María de la Oliva; Alonso-Melgar, Ángel; Alonso, J. Blasco; Fernández, Constantino; García-Erauzkin, Gorka; González, Esther; González-Rinne, Ana; Guirado, Lluís; Gutiérrez-Dalmau, Álex; Huguet, J.; Moral, José Luis; Musquera, Mireía; Paredes, David; Redondo, Dolores; Revuelta, Ignacio; Hofstadt, Carlos J. van-der; Alcaraz, Antonio; Alonso-Hernández, Ángel; Alonso, Manuel; Bernabeu, Purificación; Bernal, Gabriel; Breda, Alberto; Cabello, Mercedes; Caro-Oleas, José Luis; Cid, Joan; Diekmann, Fritz; Espinosa, Laura; Facundo, Carme; García, Mercé; Gil-Vernet, S.; Lozano, Miquel; Mahíllo, Beatriz; Martínez, María José Busto; Miranda, Blanca; Oppenheimer, Federico; Palou, Eduard; Pérez‐Sáez, María José; Peri, Lluís; Rodríguez, Ó.; Santiago, Carlos; Tabernero, Guadalupe; Hernández, Domingo; Domínguez‐Gil, Beatriz; Pascual, Julio

doi:10.1016/j.nefroe.2022.07.001

Cited by 2 publications

(1 citation statement)

References 686 publications

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“…These factors could negatively impact the initial graft function and contribute to subsequent complications. Additionally, living donor kidney transplantation allows for a higher degree of compatibility between the donor and recipient due to controlled donor selection and better matching [ 13 ]. This reduces the risk of immune-mediated complications and increases the odds of successful graft integration.…”

Section: Discussionmentioning

confidence: 99%

Graft survival and mortality outcomes after kidney transplant in patients with lupus nephritis: a systematic review and meta-analysis

Jiang,

Xu,

Yin

2024

Renal Failure

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To explore the effect of lupus nephritis (LN) on graft survival in renal transplant patients. Literature search was conducted in PubMed, EMBASE and Scopus database for randomized controlled trials (RCTs), cohort, and case-control studies. The target population of interest was adult patients (aged >18 years) with end-stage renal disease (ESRD) and no history of previous renal transplants. Primary outcomes of interest were graft survival and patient survival. Pooled effect estimates were calculated using random-effects models and reported as hazard ratio (HR) with 95% confidence intervals (CI). A total of 15 studies were included. Compared to patients with ESRD due to other causes, patients with LN undergoing kidney transplant had lower patient survival rate (HR 1.15, 95% CI: 1.01, 1.31; N = 15, I 2 =34.3%) and worse graft survival (HR 1.06, 95% CI: 1.01, 1.11; N = 16, I 2 =0.0%), especially when studies with deceased donor were pooled together. Studies with a larger sample size (>200) showed that LN was strongly associated with lower graft and patient survival rates. Elevated risk of mortality in LN patients was detected in case-control studies, but not RCTs. On the other hand, RCTs, but not case-control studies, showed an increased risk of poor graft survival in LN patients. The findings suggest that the presence of LN might have a negative impact on both the graft survival and the overall patient survival of post-transplant ESRD patients. Further studies that account for factors such as study methodology, donor characteristics, and sample size are needed to reach definitive conclusions. Renal transplant patients with LN should undergo regular follow-up examinations.

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Section: Discussionmentioning

confidence: 99%

Graft survival and mortality outcomes after kidney transplant in patients with lupus nephritis: a systematic review and meta-analysis

Jiang,

Xu,

Yin

2024

Renal Failure

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Vascular closure devices in living‐donor nephrectomy: a much‐needed systematic review and meta‐analysis focusing on safety

et al. 2023

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ObjectiveTo assess the safety of vascular closure devices in living‐donor nephrectomy (LDN), as staplers and non‐transfixion techniques (polymer locking and metal clips) are the methods employed to secure the renal vessels during laparoscopic and robotic LDN, but the use of clips has come into question since the United States Food and Drug Administration and manufacturers issued a contraindication.MethodsA systematic review and meta‐analysis were conducted to assess the safety of vascular closure devices (International Prospective Register of Systematic Reviews [PROSPERO] registration: CRD42022364349). The PubMed, Scopus, the Excerpta Medica dataBASE (EMBASE), and the Literatura Latino‐Americana e do Caribe em Ciências da Saúde (LILACS) databases were searched in September 2022. For comparative and non‐comparative studies, incidence estimates and odds ratios (ORs), respectively, for the main variables regarding safety of vascular closure devices were pooled by using random effects meta‐analyses. Quality assessment of the included comparative studies was conducted using the Risk Of Bias In Non‐randomised Studies of Interventions (ROBINS‐I) tool.ResultsOf the 863 articles obtained, data were retrieved from 44 studies, which included 42 902 patients. In non‐comparative studies, the pooled estimate rates for device failure, severe haemorrhage rate, conversion to open surgery, and mortality were similar for both clips and staplers. Regarding the meta‐analyses for comparative studies (three studies), there were no significant differences between the two groups for the severe haemorrhage rate (OR 0.57, 95% confidence interval [CI] 0.18–1.75; P = 0.33), conversion to open surgery (OR 0.35, 95% CI 0.08–1.54; P = 0.16), or death rate (OR 3.64, 95% CI 0.47–28.45; P = 0.22). Based on weak evidence, device failure was lower in the polymer clip group (OR 0.41, 95% CI 0.23–0.75; P = 0.00).ConclusionsThis study has confirmed that there is no evidence for the superiority of any vascular closure device in terms of safety in LDN. Standardised recommendations for vascular control in this context should be carefully designed and prospectively evaluated.

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Recommendations for living donor kidney transplantation

Cited by 2 publications

References 686 publications

Graft survival and mortality outcomes after kidney transplant in patients with lupus nephritis: a systematic review and meta-analysis

Graft survival and mortality outcomes after kidney transplant in patients with lupus nephritis: a systematic review and meta-analysis

Vascular closure devices in living‐donor nephrectomy: a much‐needed systematic review and meta‐analysis focusing on safety

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