Kidney Transplant

Introduction:  Asymptomatic bacteriuria (AB) during the first year post-renal transplantation has an incidence higher than 50%. Urinary tract infection (UTI) is the most frequent complication of renal transplantation; its incidence is between 30 and 70 % during the first year.  Objective:  To analyze the incidence of UTI and AB during the first year post-renal transplantation and their impact on renal function.   Methods:  Retrospective study in renal transplantation patients older than 18 between January 2006 and December 2017 in our center. Patients who had received combined renal transplantation, lost renal graft during the first year due to surgical complications (thrombosis, allograft rupture) or medical complications (rejection, underlying disease recurrence) were excluded.  Results:  A study was performed with 161 adult patients who had undergone kidney transplantation. The incidence of UTI and AB during the first year after receiving transplantation was 32% and 25%, respecti...

Background and Aims Immunosuppressant non-adherence is a leading cause of preventable renal allograft dysfunction, rejection and graft loss. The barriers to immunosuppressant adherence as well as associated risk factors of non-adherence vary across studies in different locations. This study aimed to investigate the prevalence of immunosuppressant non-adherence among adult kidney transplant recipients and identify barriers to adherence in a renal transplant cohort. Method A cross sectional survey was conducted using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS), the Immunosuppressant Therapy Barrier Scale and the Beliefs about Medicines Questionnaire. Adherence was defined according to the BAASIS, with barriers to adherence and beliefs about medicines compared between the two groups. Participants were recruited from the out-patient clinic at Zenith Medical and Kidney centre. An advert for the study was placed in consultation rooms and patients were...

Goal: To evaluate and compare the available evidence on management strategies for asymptomatic cholelithiasis, investigating the benefits, risks and challenges of expectant observation compared to cholecystectomy. Methodology: A bibliographic review was carried out using the PubMed database. Search terms included “Asymptomatic cholelithiasis” and “Conservative management,” among other relevant combinations. Nine articles were selected for detailed analysis. Results: The review pointed out that continuous monitoring of patients with asymptomatic cholelithiasis is essential due to the annual risk of developing serious complications. Selective laparoscopic cholecystectomy has been shown to be effective in high-risk subgroups of patients. An individualized approach is recommended in managing these patients, highlighting the need for additional research to refine clinical practices. Final considerations: It is crucial to prioritize continuous clinical monitoring and careful selection of patients for selective laparoscopic cholecystectomy.

Lymphoceles may occur as frequently as 16% of the time after kidney transplantation, becoming clinically evident between 18 and 180 days after surgery. The management of lymphoceles is unclear. Percutaneous needle aspiration and external drainage are associated with high recurrence and complications. Surgical intraperitoneal marsupialization of lymphocele is considered the treatment of choice, but requires hospital admission, general anesthesia, and sometimes extensive surgical dissection. We discuss our experience in the treatment of recurrent symptomatic lymphocele intraperitoneally drained using a Tenckhoff catheter in 7 consecutive patients. Clinical manifestations became evident between 26 and 90 days after transplantation. The diagnosis was obtained with abdominal ultrasound in all cases; mean lymphocele diameter was 14 +/- 6 cm. After percutaneous drainage, performed to differentiate urinoma/lymphocele and to rule out infections, the lymphocele recurred within 1 month. Therea...

Purpose: The purpose of this case study is to report on an isolated internal iliac artery aneurysm (IIIAA) with solitary kidney found during cadaveric dissection and to discuss potential clinical implications of such a variation.

Methods: IIIAA and solitary kidney were discovered during cadaveric dissection performed by six nursing graduate students at Samford University in Birmingham, Alabama. Upon discovery, a literature review was performed to consider clinical implications, patient presentation, and management strategies associated with IIIAA and solitary kidney. This is the first time the pairing of these variations has been reported and thus it is difficult to speculate whether or not this person had symptoms associated with either of these conditions.

Results: IIIAA is independently associated with bladder, ureter, rectal, iliac vein, and sciatic nerve symptoms. Solitary kidney is associated with hypertension and end-stage renal disease.

Conclusion: As this variation was discovered post-mortem, it is unknown whether this condition was symptomatic.

Adhesion interaction in the fibre-matrix interface is important in all composites used in load-bearing applications. To improve interfacial adhesion, various treatment methods of the fibre surface are applied. In this work the influence of chemical and/or mechanical treatment on the adhesion interaction of polyester (UP) resin or poly(lactic acid) (PLA) polymer composites reinforced by flax or cotton yarns was investigated by means of contact angle measurements and uniaxial tensile testing. It was obtained that the tensile strength of UP or PLA biocomposites increases when cotton and flax fibre undergo mercerisation, twisting or pre-tension, while the effect of bleaching was negligible. The combination of treatment methods is especially effective when mercerised or twisted fibres are pre-ten sioned. The investigations proved that fibre treatment creates possibilities to obtain natural fibre reinforced biocomposites with mechanical properties comparable to those of glass fibre reinfo...

Valganciclovir is used for the prophylaxis of cytomegalovirus infection in pediatric solid transplant patients. The current pediatric dose regimen resulted in large variability in drug exposure. A posterior dosage adaptation was required in children to achieve the daily target area under the curve (AUC) of 40-50 μg·h·mL(-1). However, a clinically feasible tool for valganciclovir dosage adjustment based on individual AUC is not available. The objective of this study was to develop and validate a reliable and clinically applicable limited sampling strategy using Bayesian estimation for individualizing valganciclovir dose in pediatric kidney transplant patients. The Bayesian estimator to calculate ganciclovir AUC was developed using the original pharmacokinetic dataset consisting of 28 full profiles from 22 pediatric kidney transplant patients. External validation was prospectively performed in an independent validation group consisting of 14 full pharmacokinetic profiles from 14 pedia...