Publications by authors named "Durlik M"

: The best treatment for end-stage chronic kidney disease (ESKD) is kidney transplantation (KT). As a result of an aging population, each year more kidney transplants in older adults are performed. Nevertheless, older recipients, characterized by more comorbidities and frailty, raise concerns about the outcomes, potential complications, and the general approach.

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  • Many kidney transplant patients are classified as having no rejection after biopsy, but some may actually have undetected rejection activities.
  • A study of over 5,000 biopsies found that more than half were marked as no rejection, yet many showed signs of subthreshold T cell-mediated rejection (TCMR) and antibody-mediated rejection (ABMR).
  • Patients with these hidden rejection activities are at increased risk of future graft issues, as higher levels of TCMR and ABMR correlate with worse kidney function and higher chances of rejection in subsequent biopsies.
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: Robotic-assisted nephrectomy for living kidney-donation (RANLD) has the potential of becoming the leading technique of harvesting kidney, if expertise is available. The aim of this work is to present our initial experience with robotic technique with additional hand-assistance. : We initiated RANLD at our clinic using the DaVinci System in September 2022, since then harvesting six kidneys, four left and two right; in two cases, multiple arteries existed.

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Background: Pneumocystis jirovecii pneumonia (PJP) is an opportunistic fungal infection that, in immunocompromised patients, can progress to respiratory failure and death. Since trimethoprim/sulfamethoxazole (TMP/SMX) chemoprophylaxis has become a standard management, the prognosis has improved. However, there are patients with a history of TMP/SMX intolerance who cannot receive chemoprophylaxis.

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Background: Long-lasting diabetes mellitus type 1 and end-stage renal disease induce severe metabolic and immunologic deterioration. Pretransplant C-reactive protein (CRP) and albumin (ALB) levels impact kidney transplantation. We evaluated the effects of preoperative CRP, ALB, neutrophils (NEU), and platelet (PLT) counts on 1- and 5-year recipient survival after simultaneous pancreas and kidney transplantation (SPK).

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Background: The number of women treated with immunosuppressants is increasing. Often, these women are of childbearing age. Consequently, they must face the decision of whether to breastfeed when they do have a child.

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Unlabelled: Nutritional assessment is used to implement early nutritional interventions and reduce complications associated with malnutrition, which plays a crucial role in improving postoperative outcomes for patients undergoing pancreas and/or kidney transplantation.

Objective: The aim of this study was to analyze the nutritional status (NS) in patients eligible for kidney transplantation (KTx) and simultaneous kidney-pancreas transplantation (SPKTx).

Methods: We analyzed the database of hospitalized patients from 2020 to 2023 to identify preoperative parameters of NS in patients eligible for KTx and SPKTx.

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Introduction: Sleep plays a crucial role in maintaining health. Transplant patients are exposed to numerous stressors and are at risk of sleep disturbances. The aim of this study was to assess the sleep patterns of transplant patients.

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Metabolic syndrome (MS) constitutes an important source of cardiovascular- and cancer-related morbidity and mortality in the general population. Limited information is available on whether these findings can be directly extrapolated to liver recipients. This study aimed to investigate the impact of post-transplant MS present 1 year after liver transplantation on survival rates, risk of major cardiovascular events (CVEs), and de novo malignancies.

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Background: Metabolic complications are a recognized health concern in liver transplant recipients that result in inferior patient-reported outcomes. Patients with MASH are known to be disproportionately affected by metabolic diseases compared to other indications for transplantation.

Purpose: The aim of this study was to investigate the incidence of metabolic abnormalities in liver recipients with specific focus on differences between patients transplanted for MASH and non-MASH-causes.

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  • DRESS syndrome is a rare and serious hypersensitivity reaction that affects the skin and internal organs, especially the kidneys, typically occurring 2 to 8 weeks after starting certain medications, including antiepileptics and allopurinol.
  • Two case reports highlight patients experiencing severe symptoms, including kidney injury and skin lesions, following drug use; both improved after stopping the medications and starting steroid treatment.
  • Diagnosis of DRESS can be challenging due to its varied symptoms, making thorough evaluation of symptoms, drug history, and lab results crucial for effective treatment.
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Introduction: Not much is known about the significance of nutritional status and support in transplant surgery, least of all in simultaneous pancreatic and kidney transplantation. Malnutrition in the context of simultaneous pancreatic-kidney transplantation seems to be complex and a still poorly investigated problem. Since SPKTX is highly qualified and also has a small volume procedure, it is difficult to obtain data from large cohorts of patients.

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  • Protocol biopsies can identify early subclinical issues in kidney transplant patients which may lead to graft dysfunction, but their routine use varies across transplant centers.* -
  • In a study of 61 patients, those with mild inflammatory lesions and BK virus nephropathy showed improved long-term outcomes after treatment adjustments following protocol biopsies.* -
  • Overall, protocol biopsies appear valuable for early detection of problems in transplants, helping to maintain stable kidney function and potentially preventing graft failure.*
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  • Chemokines are small proteins involved in processes like inflammation and are being studied for their role in transplant medicine, specifically in predicting outcomes after renal transplants.
  • * This study focused on urinary chemokines CCL2 and CXCL10 to assess their effectiveness in forecasting 5-year graft failure and mortality in kidney transplant patients after a one-year biopsy.
  • * Results indicated that higher levels of urinary CCL2 correlated with increased risk of graft failure and death, suggesting that CCL2 could serve as a valuable biomarker in the context of personalized medicine.
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  • IgA nephropathy (IgAN) is a serious kidney disease linked to IgA buildup, and a large study identified 30 genetic risk factors associated with it.
  • Fourteen new loci were discovered that suggest a connection between genetic influences and abnormal IgA levels.
  • The research highlights inflammation-related pathways and potential drug targets, revealing that higher genetic risk scores are tied to earlier kidney failure.
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Background: The chronic kidney disease (CKD) population, including kidney transplant recipients (KTRs) and subjects on renal replacement therapy, is particularly vulnerable to unfavorable outcomes from chronic hepatitis C (CHC). Currently, there are oral direct-acting antiviral agents (DAAs) available to eradicate the virus with favorable short-term outcomes; however, their long-term effects are lacking. The aim of the study is to assess the long-term efficacy and safety of DAA therapy in the CKD population.

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The post-transplant evolution of antihuman leukocyte antigen donor-specific antibodies (anti-HLA DSAs) includes three clinical patterns: resolved preformed DSAs, persistent preformed DSAs, and de novo DSAs. The aim of this retrospective study was to analyze the impact of resolved preformed, persistent preformed, and de novo anti-HLA-A, -B, and -DR DSAs in kidney transplant recipients on long-term renal allograft outcomes. This is a post hoc analysis of the study conducted in our transplant center.

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  • - Onco-nephrology is an emerging medical field that explores the relationship between kidney issues in cancer patients and cancer occurrences in those with kidney diseases.
  • - The focus is on understanding acute kidney injury (AKI), chronic kidney disease (CKD), and related complications like electrolyte imbalances in the context of cancer treatment.
  • - The article discusses how assessing kidney function can help optimize chemotherapy and highlights the potential of new cancer therapies, including immunotherapy, for patients with transplants.
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Chronic hepatitis C (CHC) is prevalent in the hemodialysis-dependent population. Currently, all patients with CHC should be considered for treatment; however, many hemodialysis-dependent patients are still left untreated. Following HCV cure, accurate surveillance is mandatory to reduce liver-related mortality and prevent reinfection.

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This paper is an update of the diagnostic and therapeutic recommendations of the National Consultant for Gastroenterology and the Polish Society of Gastroenterology from 2013. It contains 49 recommendations for the diagnosis and treatment, both pharmacological and surgical, of ulcerative colitis in adults. The guidelines were developed by a group of experts appointed by the Polish Society of Gastroenterology and the National Consultant in the field of Gastroenterology.

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Background: Amyloidosis is a very heterogeneous disease. Correct diagnosis is extremely important because of the various treatment options for different types of amyloidosis. This study presents a case report and literature review of the misdiagnosis of fibrinogen Aα-chain amyloidosis (AFib amyloidosis).

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Post-transplant antihuman leukocyte antigen donor-specific antibodies (anti-HLA DSAs) monitoring in kidney transplant recipients remains unclear and is currently under investigation. The pathogenicity of anti-HLA DSAs is determined by antibody classes, specificity, mean fluorescent intensity (MFI), C1q-binding capacity, and IgG subclasses. The aim of this study was to investigate the association of circulating DSAs and their characteristics with renal allograft long-term outcomes.

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Antiphospholipid syndrome (APS) is a devastating autoimmune disease and in renal transplant recipients may result in allograft thrombosis or in extra-renal manifestation, mostly venous thromboembolism. There are many non- and immune risk factors affecting renal allograft in recipients with APS. However, renal allograft outcome in recipients with APS without APS nephropathy remains unknown.

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  • Tacrolimus is a key immunosuppressive medication for kidney transplant patients, with two main prolonged-release options: Advagraf® and Envarsus®; however, they aren’t bioequivalent.
  • A study was conducted to compare the safety and efficacy of Envarsus® and Advagraf® in 115 kidney transplant recipients, monitoring patient health over two years.
  • The results showed no significant difference in patient survival or kidney function between the two formulations, but the LCPT group had a higher C/D ratio, and sepsis occurred more frequently in the Advagraf® group.
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