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1.
Transplant Direct ; 10(9): e1671, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39131237

ABSTRACT

Background: Robotic-assisted kidney transplant (RAKT) has proven to be a successful approach for patients with morbid obesity and more centers are encouraged to apply robotic approach also for deceased donor kidney transplantation. Prolonged cold ischemia time (CIT) is accompanied by delayed graft function (DGF) and early graft loss after traditional open kidney transplant (OKT). This study examines the impact of CIT after robotic kidney transplantation on settings of deceased donation. Methods: We present a single-center retrospective analysis of 115 cases of RAKT and 128 cases of OKT from deceased donors performed from deceased donor from 2009 to July 2022. Cohort was divided in 3 groups based on CIT ("high" CIT > 15 h, n = 43; "medium" CIT 11-15 h, n = 38; "low" CIT< 11 h, n = 40). The subgroup analysis of DGF and CIT was performed. Results: The median CIT in the cohort was 13.46 (7) h, and overall rate of DGF was 30.6%. The correlation between CIT and DGF was statistically significant (P = 0.008), and DGF negatively correlated with 1-y graft survival (P = 0.04). The rate of DGF was significantly different between the groups (P = 0.05). Conclusions: Results from our study demonstrate that the effect of CIT on DGF in settings of RAKT follows a similar pattern as in traditional OKT.

2.
Transpl Int ; 37: 12690, 2024.
Article in English | MEDLINE | ID: mdl-38957660

ABSTRACT

Current scientific literature is deficient in detailing the optimal timing for conducting bariatric surgery in relation to kidney transplantation. In this study, we performed a retrospective evaluation of kidney transplant recipients with BMI >35 kg/m2. It aimed to provide data on those who received both sleeve gastrectomy (SG) and kidney transplantation (KT) simultaneously, as well as on patients who underwent SG and KT at different times, either before or after. In addition, the acceptance levels of the bariatric surgery among different scenarios were assessed. Our findings demonstrated that combined KT and SG led to successful weight loss, in contrast to undergoing kidney transplant alone, while maintaining comparable rates of graft and patient survival. Weight loss was similar between recipients who had a combined operation and those who underwent SG following the transplant. Additionally, over a median time frame of 1.7 years, patients who underwent SG before KT exhibited a statistically significant reduction in BMI at the time of the transplant. Notably, our study highlights that patients offered the combined procedure were significantly more likely to undergo SG compared to those for whom SG was presented at a different operative time than the transplant.


Subject(s)
Bariatric Surgery , Body Mass Index , Gastrectomy , Kidney Transplantation , Weight Loss , Humans , Kidney Transplantation/methods , Gastrectomy/methods , Retrospective Studies , Female , Male , Middle Aged , Adult , Bariatric Surgery/methods , Time Factors , Graft Survival , Obesity, Morbid/surgery , Treatment Outcome , Operative Time
3.
Gastroenterol Clin North Am ; 53(2): 245-264, 2024 06.
Article in English | MEDLINE | ID: mdl-38719376

ABSTRACT

Consensus remains elusive in the definition and indications of multivisceral transplantation (MVT) within the transplant community. MVT encompasses transplantation of all organs reliant on the celiac artery axis and the superior mesenteric artery in different combinations. Some institutions classify MVT as involving the grafting of the stomach or ascending colon in addition to the jejunoileal complex. MVT indications span a wide spectrum of conditions, including tumors, intestinal dysmotility disorders, and trauma. This systematic review aims to consolidate existing literature on MVT cases and their indications, providing an organizational framework to comprehend the current criteria for MVT.


Subject(s)
Celiac Artery , Organ Transplantation , Humans , Celiac Artery/surgery , Organ Transplantation/methods , Viscera/transplantation , Abdomen/pathology , Neoplasms/surgery , Wounds and Injuries/surgery
4.
Mol Cell Endocrinol ; 493: 110471, 2019 08 01.
Article in English | MEDLINE | ID: mdl-31163202

ABSTRACT

The purpose of this review is to highlight recent developments in small molecules and peptides that block the binding of coactivators to steroid receptors. These coactivator binding inhibitors bind at the coregulator binding groove, also known as Activation Function-2, rather than at the ligand-binding site of steroid receptors. Steroid receptors that have been targeted with coactivator binding inhibitors include the androgen receptor, estrogen receptor and progesterone receptor. Coactivator binding inhibitors may be useful in some cases of resistance to currently prescribed therapeutics. The scope of the review includes small-molecule and peptide coactivator binding inhibitors for steroid receptors, with a particular focus on recent compounds that have been assayed in cell-based models.


Subject(s)
Peptides/pharmacology , Receptors, Steroid/metabolism , Small Molecule Libraries/pharmacology , Binding Sites/drug effects , Humans , Models, Molecular , Peptides/chemistry , Protein Binding/drug effects , Protein Conformation , Receptors, Androgen/chemistry , Receptors, Androgen/metabolism , Receptors, Estrogen/chemistry , Receptors, Estrogen/metabolism , Receptors, Progesterone/chemistry , Receptors, Progesterone/metabolism , Receptors, Steroid/chemistry , Small Molecule Libraries/chemistry
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