Kidney transplantation from donation after circulatory death using abdominal normothermic oxygenated circulation: are the outcomes equivalent?

Purpose: To increase the pool of kidneys available for transplantation, a renewed interest in donation after circulatory death (DCD) has emerged. This study aims to determine the outcomes of kidney transplantation from DCD after abdominal normothermic oxygenated circulation (ANOR) support.

Methods: From January 2016 to December 2018, 58 kidneys were implanted from uncontrolled DCD after ANOR support.

An integrated program of extracorporeal membrane oxygenation (ECMO) assisted cardiopulmonary resuscitation and uncontrolled donation after circulatory determination of death in refractory cardiac arrest.

Aim: To assess the feasibility of an integrated program of extracorporeal cardiopulmonary resuscitation (ECPR) and uncontrolled donation after circulatory determination of death (uDCDD) in refractory cardiac arrest (rCA).

Methods: Single center, prospective, observational study of selected patients with in-hospital (IHCA) and out-of-hospital (OHCA) rCA occurring in an urban area of ∼1.5 million inhabitants, between October-2016 and May-2018.

Organs transplantation - how to improve the process?

The transplant of cadaveric organs must be performed in a short period of time in order to achieve satisfactory results. In Hospital S. João (HSJ), a large Portuguese hospital, during 2008 and 2009, 65 and 61 respectively potential donors were identified, but 12 and 19 of them were not validated as such in time.

Conversion from sirolimus to everolimus in kidney transplant recipients receiving a calcineurin-free regimen.

Background: Everolimus (EVL) and sirolimus (SRL) were introduced into immunosuppressive regimens, in an attempt to replace or reduce the dose of the nephrotoxic calcineurin inhibitors (CNI). In our institution, due to an administrative decision, conversion from SRL to EVL, was carried out, providing us the opportunity to investigate the effectiveness and safety profile of both drugs and to review the practical conversion dose between them.

Methods: We retrospectively analyzed the medical records of 51 maintenance kidney transplant recipients receiving an SRL-based CNI-free regimen, who were switched to EVL.

[Metastatic calcification detected on bone scintigraphy].

Purpose: To show the value of bone scintigraphy in the diagnosis of metastatic calcification in end-stage renal insufficiency.

Material And Methods: The authors present a fifty-one-year-old male with terminal renal insufficiency of hypertensive renovascular etiology, on hemodialysis for the last 10 years, referred for a bone scan because of osteoarticular complaints, and no other associated symptoms or findings on physical examination.

Results: Whole body bone scintigraphy images (HMDP-99mTc, 925MBq), showed increased uptake in the lower half of both lungs, the stomach and renal parenchyma, compatible with metastatic calcification.

[Antiviral drug-induced nephrotoxicity].

Antiviral drug-induced kidney injury, frequently leading to acute renal failure, is increasing in incidence. We review the pathogenesis and clinical manifestations of antiviral drug-induced nephrotoxicity, as well as strategies for prevention and treatment.