ABSTRACT
AIM: To define the effect of donor and recipient gender on the results of kidney transplantation from living related donor. MATERIAL AND METHODS: Group of 271 patients who underwent kidney transplantation from living related donor was analyzed. There were 115 women and 156 men. Age varied from 1 to 63 years (mean 21.30±12.32). There were 127 children aged 1-18 years (mean 11.28±4.63) and 144 adults aged 19-63 years (mean 29.81±11.24). Donors included 162 women and 109 men. Overall survival was calculated using Kaplan-Mayer. Mortality and incidence of transplants failure were determined using Fisher's exact test. RESULTS: All patients were divided into 2 groups depending on recipients' gender and then into 4 subgroups depending on gender of donors and recipients. Comparative statistical analysis showed that transplants survival was higher in women vs. men (T=2.7, p=0.007). Survival of patients was similar in both groups. Moreover it was the best in subgroup of recipients-women with kidneys from donors-men. Difference was statistically significant (T=2.16, p=0.03). There was no significant difference in all other cases. CONCLUSION: The results of kidney transplantation are better in recipients-women than in men.
Subject(s)
Delayed Graft Function , Graft Rejection , Kidney Failure, Chronic/surgery , Kidney Transplantation , Living Donors , Adolescent , Adult , Age Factors , Child , Delayed Graft Function/etiology , Delayed Graft Function/prevention & control , Female , Graft Rejection/etiology , Graft Rejection/prevention & control , Graft Survival , Humans , Kaplan-Meier Estimate , Kidney/pathology , Kidney/surgery , Kidney Transplantation/adverse effects , Kidney Transplantation/methods , Kidney Transplantation/mortality , Living Donors/classification , Living Donors/statistics & numerical data , Male , MoscowABSTRACT
AIM: To clarify whether cytomegalovirus (CMV) infection can affect the results of living related donor kidney transplantation. SUBJECTS AND METHODS: A study group included 17 (7.27%) patients (10 men and 7 women; 8 children and 9 adults) aged 3 to 51 years who had developed resistant CMV infection. For comparative analysis, a control group was formed from 113 patients (61 men and 52 women; 40 children and 73 adults) aged 1 to 61 years, whose CMV polymerase chain reaction (PCR) had always been negative, i.e. CMV DNA was absent. The duration of CMV infection episodes was 44 to 232 days. RESULTS: The patients were given valganciclovir in a dose of 450 mg/day. CMV PCR was negative in all the patients at the end of therapy. None of the patients died; one graft was lost. In the control (negative CMV PCR) group, 6 grafts were lost in 113 patients lost and 4 patients died. Statistical analysis showed that the results of related donor kidney transplantation were virtually equal. CONCLUSION: Suppression of resistant CMV infection can be achieved with the longer use of valganciclovir or its higher dose. CMV infection fails to affect the results of related donor kidney transplantation.
Subject(s)
Cytomegalovirus Infections , Cytomegalovirus/drug effects , Ganciclovir/analogs & derivatives , Kidney Failure, Chronic/surgery , Kidney Transplantation , Living Donors , Adolescent , Antiviral Agents/administration & dosage , Child, Preschool , Cytomegalovirus/isolation & purification , Cytomegalovirus Infections/drug therapy , Cytomegalovirus Infections/etiology , Cytomegalovirus Infections/mortality , DNA, Viral/analysis , Disease Resistance/immunology , Dose-Response Relationship, Drug , Female , Ganciclovir/administration & dosage , Humans , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/adverse effects , Kidney Transplantation/adverse effects , Kidney Transplantation/methods , Male , Middle Aged , Postoperative Complications/drug therapy , Postoperative Complications/mortality , Postoperative Complications/virology , Russia/epidemiology , Time Factors , Transplantation, Homologous , Treatment Outcome , ValganciclovirABSTRACT
AIM: To investigate the nature of microflora causing an infectious-inflammatory complications in recipients of related kidney in the early postoperative period and to substantiate the effectiveness of antibiotic prophylaxis and antibiotic therapy depending on pathogen type with the determination of its sensitivity to antimicrobial agents. MATERIAL AND METHODS: The medical records of 255 patients who underwent kidney transplantation from a living related donor from 2007 to 2014 were analyzed. Foci of infection were sanitized preoperatively to prevent infectious complications in post-transplantation period. Immunosuppression induction was achieved using 2-fold administration of Kempas or Simulect. Corticosteroids, ciclosporin, prograf, advagraf, myfortic, neoral, sertican were used for routine immunosuppression. Complications after kidney transplantation were detected in 65 (25.5%) patients including 38 (14.9%) infectious and 27 (10.6%) non-infectious complications. The material for microbiological examination included blood, urine, sputum, wound discharge, bronchial lavage. Extraction and identification of microorganisms were carried out according to conventional techniques as well as using automatic Vitec-2 Compact analizer («BioMeriex¼, France). Sensitivity to antibiotics was determined using Vitek-2 Compact analyzer. The functional aspects of transplanted kidney were studied in 255 patients. Normal and decreased function of kidney was observed in 221 (86.6%) and 30 (11.8%) cases respectively. Transplantant did not function in 4 (1.57%) patients. RESULTS: The probability of infection is highest in the early postoperative period. Risk factors were inadequate and prolonged antibiotic therapy, unrecognized infection postoperatively. The main problem in renal transplant recipients is urinary tract infection (90% of patients).
Subject(s)
Anti-Bacterial Agents/therapeutic use , Antibiotic Prophylaxis/methods , Immunosuppression Therapy/adverse effects , Kidney Transplantation/adverse effects , Postoperative Complications , Urinary Tract Infections , Adult , Child , Female , Humans , Immunosuppression Therapy/methods , Infant , Kidney Failure, Chronic/surgery , Kidney Transplantation/methods , Male , Microbial Sensitivity Tests/methods , Middle Aged , Moscow , Outcome Assessment, Health Care , Postoperative Complications/diagnosis , Postoperative Complications/microbiology , Postoperative Complications/prevention & control , Postoperative Complications/virology , Postoperative Period , Risk Factors , Time Factors , Urinary Tract Infections/diagnosis , Urinary Tract Infections/microbiology , Urinary Tract Infections/prevention & control , Urinary Tract Infections/virologyABSTRACT
The aim of investigation is analysis of factors forecasting the results of kidney transplantation from living-related donors. This research is based on the analysis of 272 kidneys' transplantation from living-related donors. It was analyzed such parameters as recipients' age, donors' age, donors' sex, degree of relationship between donor and recipient, degree of HLA-compatibility, type of inductive immunosuppression (monoclonal antibodies, corticosteroids, polyclonal antibodies), recipient's sex, presence or absence of rejection episodes for whole postoperative period. We recognized that far not all above-mentioned parameters could predict the results of kidney transplantation from living-related donors.
Subject(s)
Graft Rejection/prevention & control , Immunosuppression Therapy/methods , Kidney Transplantation , Living Donors , Risk Assessment/methods , Adolescent , Adult , Age Factors , Child , Child, Preschool , Female , Graft Rejection/epidemiology , Graft Survival , Humans , Incidence , Infant , Kidney Failure, Chronic/surgery , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Factors , Russia/epidemiology , Survival Rate/trends , Young AdultABSTRACT
AIM: To clarify whether vaccination provokes renal graft rejection. SUBJECTS AND METHODS: A total of 131 vaccinations were performed in 92 patients with chronic kidney failure (CKF), including 7 and 85 patients vaccinated before and in different periods after kidney transplantation, respectively. The patients were examined using needle graft biopsy, measurement of proteinuria, and estimation of changes in blood creatinine levels and glomerular filtration rate. RESULTS: Vaccination was not fount to provoke rejection, as suggested by the results of needle biopsy of renal allografts and examination of their function. CONCLUSION: Vaccination is safe for patients with CKF as it causes no rejection episodes.
Subject(s)
Graft Rejection/immunology , Kidney Failure, Chronic/immunology , Kidney Failure, Chronic/surgery , Kidney Transplantation , Vaccination/adverse effects , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Graft Rejection/etiology , Humans , Male , Middle Aged , Postoperative Period , Young AdultABSTRACT
To understand whether the presence of cytomegalovirus in blood influences the results of kidney transplantation from live relative donors, we analysed materials from 258 recipients divided into 2 groups. Group 1 included 113 patients with negative results of PCR for cytomegalovirus, group 2 contained 139 patients with positive PCR. We evaluated lethality, the loss of transplanted kidneys, frequency of rejection and infectious complications. Statistical treatment of the data obtained included Kaplan-Meier survival analysis, the Wilcoxon test showing the cumulative hazard risk, and comparative analysis by Fisher's and Student's tests. It was shown that cytomegalovirus present in blood increases lethality and the frequency of infectious complications in recipients of transplanted kidneys but does not influence their rejection. The cumulative survival rate was significantly higher and cumulative risk lower in group 1 than in group 2.
