Publications by authors named "Jane Long"
Purpose: In October 2018, the OPTN changed adult heart transplant (HT) allocation policy, increasing the number of adult candidates that had higher priority than pediatric candidates, potentially disadvantaging pediatric waitlist registrants.
Methods: To understand the impact of this policy change, we used SRTR data to identify 1469 pre-policy (7/2016-9/2018) and 2901 (10/2018-12/2022) post-policy pediatric (< 18 years) HT registrants. We quantified mortality and transplant risks using weighted cause-specific hazard models, and then using weighted competing risks regression.
Introduction: Heart failure with reduced ejection fraction (HFrEF) guidelines recommend 'four pillars' of medical therapy and device therapy if left ventricular ejection fraction (LVEF) remains ≤35% after 3 months optimum medical therapy.We conducted the first study to examine the effects of optimisation to contemporary medical therapy on cardiac reverse remodelling, as demonstrated by cardiac magnetic resonance imaging (CMR).We hypothesised a proportion of patients would undergo beneficial remodelling and LVEF improvement above the threshold for complex device prescription after 6 months.
View Article and Find Full Text PDFBackground: Pretransplant functional, motor, cognitive, and academic deficits are common in pediatric patients requiring heart transplantation (HT); some persist post-HT. We assessed the association between these quality of life (QoL) deficits and post-HT outcomes.
Methods: Using SRTR data 2008-2023, we evaluated the functional, motor, cognitive, and academic status of pediatric HT recipients from listing to 15 years post-HT.
Background: Kidney transplant (KT) candidates often experience hospitalizations, increasing their delirium risk. Hospitalizations and delirium are associated with worse post-KT outcomes, yet their relationship with pre-KT outcomes is less clear. Pre-KT delirium may worsen access to KT due to its negative impact on cognition and ability to maintain overall health.
View Article and Find Full Text PDFIntroduction: Dietary restrictions for patients with end-stage kidney disease (ESKD) are burdensome. Kidney transplantation (KT) candidates who lack neighborhood resources and are burdened by dietary restrictions may have decreased access to KT.
Methods: In our two-center prospective cohort study (2014-2023), 2471 ESKD patients who were evaluated for KT (candidates) reported their perceived burden of dietary restrictions (not at all, somewhat/moderately, or extremely bothered).
Sexual bother and sexual activity before and after kidney transplantation.
Am J Transplant
February 2025
Article Synopsis
- Post-transplant, sexual bother tends to decrease over the first three years, with a significant improvement in sexual activity, especially peaking one year after transplantation.
- It's important to address sexual health during kidney transplantation management, as it greatly influences the quality of life for patients both before and after the procedure.
Article Synopsis
- - The study evaluated the safety and effectiveness of semaglutide, a diabetes and weight loss medication, in patients with advanced chronic kidney disease (CKD) stages 4 and 5, as well as those on dialysis, due to limited existing research in this area.
- - Data from 76 patients (mostly males with a mean age of 66.8) was analyzed over approximately five years, showing significant weight loss (avg. drop of 4.9 kg) and decreased hemoglobin A1c levels (avg. drop from 8.0% to 7.1%).
- - While 63.1% reported no adverse effects, the most common issues leading to discontinuation were nausea, vomiting,
Article Synopsis
- Adults living in deprived neighborhoods face socioeconomic challenges that reduce their chances of receiving live-donor and preemptive kidney transplants, with a significant impact based on race and ethnicity.
- A study analyzing over 403,000 kidney transplant candidates found that higher neighborhood deprivation correlated with lower transplant rates, particularly affecting Black candidates.
- Key socioeconomic factors, like income and education, were linked to higher chances of receiving transplants, highlighting the need for targeted efforts to address these disparities.
Sleep Disorders and Dementia Risk in Older Patients with Kidney Failure: A Retrospective Cohort Study.
Clin J Am Soc Nephrol
October 2024
Article Synopsis
- - Older patients with kidney failure who have sleep disorders are at a significantly increased risk for various types of dementia, including vascular dementia, with over 50% of these patients experiencing sleep issues.
- - A study involving over 216,000 older patients revealed that 26.3% were diagnosed with sleep disorders, leading to higher incidences of dementia within five years compared to those without sleep issues.
- - For patients specifically diagnosed with obstructive sleep apnea, positive airway pressure (PAP) therapy appears to lower the risk of developing dementia, highlighting a potential intervention for this vulnerable group.
Article Synopsis
- Older adults with chronic kidney disease (CKD) have a higher risk of dying, and traditional factors don’t accurately predict this risk, which led researchers to explore frailty and cognitive impairment as predictors.
- The study analyzed data from individuals aged 60 and above to understand how frailty and cognitive function relate to CKD and whether these factors could enhance mortality risk predictions.
- Results showed that frailty significantly worsened cognitive function, and while it improved mortality predictions for those with CKD, cognitive impairment did not add any predictive value.
Article Synopsis
- * The risk of dementia is even higher for older adults living in minority-dominant neighborhoods, which is 2.19 times greater compared to White individuals in predominantly White neighborhoods.
- * The study analyzed over 901,000 older adults from 2003 to 2019 and found that racial and ethnic segregation plays a critical role in the increased risk of dementia among minoritized adults with kidney failure.
Article Synopsis
- * A study of 1,406 ILDKT recipients revealed that older patients showed increased mortality risk (hazard ratio: 2.07) but similar rates of delayed graft function (DGF) and length of stay (LOS) compared to younger counterparts.
- * The effects of age on transplant outcomes were consistent across both ILDKT and compatible living donor kidney transplant (CLDKT) groups, suggesting that age should not disqualify older patients from receiving ILDKT.
The impact of bariatric surgery (BS) on kidney transplantation (KT) outcomes in patients with obesity remains controversial. We systematically searched MEDLINE, EMBASE, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials for studies reporting outcomes of KT recipients that underwent prior BS. Common/random effects meta-analyses were performed to obtain summary ratios of the postoperative outcomes.
View Article and Find Full Text PDFArticle Synopsis
- * In the study, researchers used digital imaging software (DIS) to analyze liver biopsies from transplant patients, finding that traditional assessments often overestimate MaS compared to DIS, especially at higher values.
- * The study showed that DIS-measured MaS correlated with certain posttransplant liver enzyme levels and early complications, suggesting DIS could standardize MaS definitions and improve outcomes for transplant candidates.
Article Synopsis
- A minimally invasive technique for partial hepatectomy employs transvaginal specimen extraction, which has been shown to be safe and feasible.
- This method may lead to better cosmetic results, reduced need for pain medications after surgery, and shorter hospital stays for patients.
- The text discusses the initial experiences of using this innovative approach in surgical practice.
Article Synopsis
- - The study examined the complications of kidney transplants in incompatible living donor recipients (ILDKTr) who have donor-specific antibodies (DSA) compared to compatible living donor recipients (CLDKTr), focusing on the risks of delayed graft function (DGF) and acute rejection (AR).
- - Results showed that AR rates were significantly higher in ILDKTr groups with stronger DSA, while DGF rates were slightly elevated but had no greater mortality impact when compared to CLDKTr groups.
- - The findings suggest that healthcare providers need to assess these risks during pre-surgery discussions and implement strategies to minimize complications in ILDKTr patients.
Article Synopsis
- Steatotic donor livers (SDLs) are often turned down for transplant due to higher risks of graft loss, despite candidates facing long wait times for organs.
- A study compared outcomes of 759 candidates who accepted an SDL transplant versus 13,362 candidates who declined, revealing that those who accepted had a brief but significant risk period post-surgery but overall a much lower long-term mortality risk.
- Results indicate that selected SDLs can reduce waiting times and offer considerable long-term survival benefits for liver transplant candidates.
Background: Donor livers with ≥30% macrosteatosis (steatotic livers) represent a possible expansion to the donor pool, but are frequently discarded as they are associated with an increased risk of mortality and graft loss. We hypothesized that there are certain recipient phenotypes that would tolerate donor steatosis well, and are therefore best suited to receive these grafts.
Methods: Using national registry data from the Scientific Registry of Transplant Recipients between 2006 and 2017, we compared 2048 liver transplant recipients of steatotic livers with 69 394 recipients of nonsteatotic (<30%) livers.
Article Synopsis
- Older donors (age ≥50 years) contributing kidneys after cardiac death (DCD50) are often overlooked due to concerns about poorer transplant outcomes, leading patients to hesitate in accepting these offers.
- A study of kidney transplant candidates showed that those who accepted DCD50 kidneys had a 49% lower risk of mortality compared to those who declined such offers, with statistics indicating a significant survival advantage.
- Even kidneys from donors aged ≥60 still provided similar benefits, highlighting the importance of considering DCD50 offers in the decision-making process for both healthcare providers and patients.
Article Synopsis
- Infections after kidney transplantation (KT) are a significant concern, with a cumulative incidence of 36.9% at 3 months, 53.7% at 1 year, and 78.0% at 5 years, highlighting their prevalence.
- The most frequently observed infections include urinary tract infections (46.8%) and pneumonia (28.2%), both of which contribute to elevated health risks.
- Kidney transplant recipients who develop infections face a notably higher risk of mortality (24.9% vs. 7.9%) and graft failure (20.6% vs. 10.1%), emphasizing the need for targeted monitoring in those at risk.
Article Synopsis
- Desensitization protocols for HLA-incompatible living donor kidney transplantation (ILDKT) differ among transplant centers, but their effects on patient outcomes are not well understood.
- A study involving 1,358 ILDKT recipients across 25 centers aimed to analyze variations in post-transplant mortality and graft loss, finding minimal differences attributable to the centers themselves.
- Results showed that only a few centers had notably different outcomes, leading to the conclusion that ILDKT practices across diverse centers appear effective without significant negative impact on patient outcomes.