The influence of socioeconomic deprivation on outcomes in transplant patients infected with SARS-CoV-2 in Wales.

Introduction: SARS-CoV-2 infection has had a significant impact on vulnerable individuals including transplant patients. Socioeconomic deprivation negatively affects outcomes of many health conditions. The aim of this study was to evaluate the effect of socioeconomic deprivation on the incidence and severity of SARS-CoV-2 infection among Welsh transplant patients.

Thymoglobulin Versus Alemtuzumab Versus Basiliximab Kidney Transplantation From Donors After Circulatory Death.

Introduction: The Campath, Calcineurin inhibitor (CNI) reduction, and Chronic allograft nephropathy (3C), a study comparing alemtuzumab versus basiliximab induction immunosuppression in kidney transplants, has found lower acute rejection rate with alemtuzumab but same graft survival. The aim of the current study is to evaluate the effect of induction immunosuppression (thymoglobulin, alemtuzumab, basiliximab) on the outcome of kidneys of donors after circulatory death (DCD).

Methods: Data of the 274 DCD patients of the 3C obtained from the sponsor were compounded with the 140 DCD patients who received thymoglobulin in a single center with the same entry criteria as the 3C, giving 414 patients on 3 induction regimes.

SARS-CoV-2 Infection Can Lead to an Increase in Tacrolimus Levels in Renal Transplant Patients: A Cohort Study.

The aim of this study is to evaluate the effect of SARS-CoV-2 infection on serum tacrolimus levels. Tacrolimus levels of 34 transplant patients diagnosed with SARS-CoV-2 in 2020 were compared with their pre-infection values and those of a control group with alternative infections. 20 out of 34 (59%) had high levels.

An Analysis of Serological Response and Infection Outcomes Following Oxford-AstraZeneca (AZD1222) and Pfizer-BioNTech (mRNA BNT162b2) SARS-CoV-2 Vaccines in Kidney and Kidney-pancreas Transplants.

Background: Severe acute respiratory syndrome coronavirus 2 is associated with high mortality among transplant recipients. Comparative data that define humoral responses to the Oxford-AstraZeneca (AZ) and BNT162b2 (Pfizer-BioNTech) vaccines are limited.

Methods: We recruited 920 kidney transplant patients receiving at least 1 dose of severe acute respiratory syndrome coronavirus 2 vaccine, excluding patients with virus pre-exposure.

Alemtuzumab in renal transplantation. Reviews of literature and usage in the United Kingdom.

Kidney transplantation has evolved over the years from transplants between identically matched donors and recipients to successfully transplanting allografts across virtually any degree of donor-recipient human leukocyte antigen mismatch and ABO-incompatibility. Integral to these improved outcomes has been the development and deployment of a range of immunosuppressive agents. The addition of monoclonal and polyclonal antibodies as a standard part of overall immunosuppression has led to the improved outcomes by providing a robust and focused protection during the first few months of transplantation when allografts are most vulnerable to immune-mediated injury.

Laterality in laparoscopic hand assisted donor nephrectomy - Does it matter anymore? Outcomes of a large retrospective series.

This retrospective study was performed to analyse if laterality of the retrieved living donor kidney had any effect on donor and recipient outcomes after hand assisted laparoscopic donor nephrectomy (HALDN). 739 donors who underwent HALDN between January 2006 and January 2018 at a large tertiary transplant centre in the United Kingdom were included. Donor outcomes in individuals undergoing right versus left HALDN were compared with respect to conversion rates, morbidity, warm and cold ischaemia times and recipient failure rates, vascular and ureteric complications.

Pancreas Donor Risk Index and Preprocurement Pancreas Suitability Score for Prediction of Pancreas Transplant Outcomes.

Objectives: The Pancreas Donor Risk Index and Preprocurement Pancreas Suitability Score were designed to assist in the evaluation of pancreases for transplant. Preprocurement Pancreas Suitability Score <17 and PancreasDonor Risk Index ≤1.57 were deemed ideal.

Staggered Dual Kidney Transplantation.

We describe a case where a patient received a successful dual kidney transplantation in a staggered fashion. Two kidneys from a deceased donor were accepted for 2 separate primary intended recipients, however, due to unforeseen circumstances, both kidneys were eventually transplanted in a staggered fashion into an alternate single recipient. The intention behind this method was to enhance the patient's renal function and to prevent the wastage of a kidney.

Induction with ATG in DCD kidney transplantation; efficacy and relation of dose and cell markers on delayed graft function and renal function.

Aim: We aimed to analyse the efficacy of the Thymoglobulin dose used for induction in controlled DCD kidneys, and its initial impact on blood cell and CD3 count, as predictors of efficacy.

Methods: 140 DCD patients who received ATG induction, were analysed. Intended dose was 1.

SARS-CoV-2 in Kidney Transplant and Waitlisted Patients During the First Peak: The Welsh Experience.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) global pandemic has led to many health care services, including transplantation, being temporarily suspended. For transplantation to safely recommence, there is a need to understand the effects of SARS-CoV-2 in transplant and waitlist patients. We identified 21 patients with proven SARS-CoV-2 infection (13 transplant; 8 waitlist) during the first peak of coronavirus disease 2019 in Wales.

Monthly variance in UK renal transplantation activity: a national retrospective cohort study.

Objective: To identify whether renal transplant activity varies in a reproducible manner across the year.

Design: Retrospective cohort study using NHS Blood and Transplant data.

Setting: All renal transplant centres in the UK.

The influence of socioeconomic deprivation on outcomes in pancreas transplantation in England: Registry data analysis.

Socioeconomic deprivation is associated with poorer outcomes in chronic diseases. The aim of this study was to investigate the effect of socioeconomic deprivation on outcomes following pancreas transplantation among patients transplanted in England. We included all 1270 pancreas recipients transplanted between 2004 and 2012.

The impact of distance from transplant unit on outcomes following kidney transplantation.

Background: Following transplantation, many patients travel long distances for follow-up care. Many studies have examined the influence of distance from transplant centre on access to transplantation, but few have examined post-transplant outcomes.

Materials And Methods: Distance from transplant centre was calculated for all kidney transplant recipients transplanted over a 5-year period.

The role of nutritional assessment and early enteral nutrition for combined pancreas and kidney transplant candidates.

Background: Early post-operative enteral nutrition is an important part of perioperative management and is strongly supported by ESPEN Guidelines. However, there is limited evidence into the use of Early Enteral Nutrition (EEN) after combined Pancreas and Kidney Transplantation (PKT). We know malnutrition in type-1 diabetics with end stage renal failure (ESRF) is a common problem and a significant risk factor.

The influence of socioeconomic deprivation on outcomes in pancreas transplantation.

Socioeconomic deprivation is an important factor in determining poor health and is associated with a higher prevalence of many chronic diseases including diabetes and renal failure, with poorer outcomes of their treatments. The influence of deprivation on outcomes following pancreas transplantation has not previously been reported. The Welsh Index of Multiple Deprivation was used to assess the influence of socioeconomic deprivation on outcomes for 119 consecutive pancreas transplant recipients from a single center in the United Kingdom, transplanted between 2004 and 2013.

Impact of expanded criteria variables on outcomes of kidney transplantation from donors after cardiac death.

Introduction: To expand the donor pool, kidney transplants are being performed using donors who were previously considered unacceptable. We applied the United Network for Organ Sharing criteria to define expanded criteria donors (ECD) within the donation after cardiac death (DCD) and donation after brain stem death (DBD) cohorts. We compared outcomes of DCD and DBD transplants with and without (standard criteria donor [SCD]) the ECD criteria.

Campath, calcineurin inhibitor reduction and chronic allograft nephropathy (3C) study: background, rationale, and study protocol.

Background: Kidney transplantation is the best treatment for patients with end-stage renal failure, but uncertainty remains about the best immunosuppression strategy. Long-term graft survival has not improved substantially, and one possible explanation is calcineurin inhibitor (CNI) nephrotoxicity. CNI exposure could be minimized by using more potent induction therapy or alternative maintenance therapy to remove CNIs completely.

Influence of delayed graft function and acute rejection on outcomes after kidney transplantation from donors after cardiac death.

Background: Delayed graft function (DGF) and acute rejection (AR) exert an adverse impact on graft outcomes after kidney transplantation using organs from donation after brain-stem death (DBD) donors. Here, we examine the impact of DGF and AR on graft survival in kidney transplants using organs from donation after cardiac death (DCD) donors.

Methods: We conducted a single-center retrospective study of DCD and DBD donor kidney transplants.

High frequency of ulcers, not associated with Helicobacter pylori, in the stomach in the first year after kidney transplantation.

Background: Although gastrointestinal (GI) symptoms are very frequent in organ transplant patients, there is a paucity of data about the endoscopic findings of kidney recipients.

Methods: Two thousand one hundred and thirty-five kidney transplants were performed between 1994 and 2007. During that period, 672 gastroscopies were performed in 543 of those patients.

Multidisciplinary insights into optimizing adherence after solid organ transplantation.

Background: Nonadherence to medical treatment in transplant recipients is a major risk factor for graft rejection episodes, and it has significant financial implications. Despite its importance, there is a lack of common understanding across the disciplines involved of the key issues driving nonadherence.

Methods: A qualitative study, comprising a multidisciplinary workshop, followed by a consultation exercise to validate its outcomes, was initiated to gain further insight into nonadherence behavior and to identify priorities for optimizing adherence to posttransplantation regimens.

Increased nitric oxide production during acute rejection in kidney transplantation: a useful marker to aid in the diagnosis of rejection.

Background: The diagnosis of acute rejection (AR) relies on biopsy (Bx), with all the noninvasive tests failing to show satisfactory predictive value. Nitric oxide (NO) has been shown to play a role in AR. The aim of this study is to analyze the relationship between NO and (1) biopsy-proven allograft rejection and (2) other reasons of allograft dysfunction.