A prospective controlled study of kidney donors: baseline and 6-month follow-up.

Background: Most previous studies of living kidney donors have been retrospective and have lacked suitable healthy controls. Needed are prospective controlled studies to better understand the effects of a mild reduction in kidney function from kidney donation in otherwise healthy individuals.

Study Design: Prospective, controlled, observational cohort study.

Recipient outcomes of dual and multiple renal arteries following 1000 consecutive laparoscopic donor nephrectomies at a single institution.

Purpose: We examined outcomes of kidney transplant recipients from allografts harvested via laparoscopic donor nephrectomy (LDN) with various arterial anatomies. We examined the risk of slow graft function, delayed graft function (DGF), and postoperative urological complications in recipients of multi-vessel allografts.

Methods: Donor and recipient records for 1000 consecutive LDN were reviewed (1996-2005).

Antibody-mediated allograft rejection: morphologic spectrum and serologic correlations in surveillance and for cause biopsies.

Background: Subclinical antibody-mediated allograft rejection (AMR) has been characterized in serial biopsies from presensitized recipients but has not been systematically studied in conventional renal transplants.

Methods: We evaluated 1101 consecutive kidney transplant biopsies (400 surveillance biopsies [SBx] and 701 for cause biopsies [FCBx]) with concurrent donor-specific antibody (DSA) studies, C4d staining, and ultrastructural examination.

Results: A comparison of AMR-related features (DSA and DSA class, C4d staining, and microvascular injury) demonstrated that these were qualitatively and quantitatively associated with each other and with graft dysfunction.

Anemia after kidney transplantation; its prevalence, risk factors, and independent association with graft and patient survival: a time-varying analysis.

Introduction: Posttransplant anemia and its association with transplant outcomes have not been properly studied.

Methods: We examined 530 renal allograft recipients transplanted at our center and followed up for 31.0±14.

Glomerular inflammation in renal allografts biopsies after the first year: cell types and relationship with antibody-mediated rejection and graft outcome.

Background: Antibody-mediated rejection manifests with glomerular and peritubular capillary inflammation and transplant glomerulopathy (TG). The role of glomerular inflammation (GI) components in the development of TG and their impact on outcome are incompletely understood.

Methods: GI was quantified on hematoxylin-eosin, CD3, CD20, and CD68 stains on biopsies from 240 patients with grafts functioning more than or equal to 1 year.

A study of renal outcomes in obese living kidney donors.

Background: Little is known about the long-term outcomes of obese living kidney donors (OLKDs). We undertook this study to describe renal outcomes of OLKDs several years after donation.

Methods: We invited 101 OLKDs for follow-up health evaluation.

Cigarette smoking, kidney function, and mortality after live donor kidney transplant.

Background: The role of smoking as a risk factor for adverse renal outcomes after kidney transplant has not been well studied. We therefore undertook this investigation to assess the association of smoking with transplant outcomes.

Study Design: Retrospective cohort study.

A study of renal outcomes in African American living kidney donors.

Background: Little is known about the long-term outcomes of African American living kidney donors (AALKDs). We undertook this study to describe renal outcomes of AALKDs several years after donation.

Methods: We invited 107 AALKDs to come for follow-up health evaluation.

The independent association between serum uric acid and graft outcomes after kidney transplantation.

Background: Improving long-term outcomes of kidney transplantation depends on identifying novel risk factors that lead to poor outcomes. We sought to evaluate the predictive value of mean uric acid (UA) level during the first 6 months posttransplant for graft survival and function.

Methods: Two hundred twelve recipients of living donor kidneys transplanted during January 2000 to December 2001 were included.

Pancreas transplant alone as an independent risk factor for the development of renal failure: a retrospective study.

Background: Pancreas transplant alone (PTA) is a controversial procedure. Without clearly demonstrated patient survival, recipients report improved quality of life. Nephrotoxic immunosuppression (IS) may exacerbate diabetic renal injury post-PTA.

A single center comparison of long-term outcomes of renal allografts procured laparoscopically versus historic controls procured by the open approach.

We have previously reported that renal allografts procured by the laparoscopic live donor nephrectomy (lapNx) demonstrate worse early renal outcomes but noninferior 1-year renal function as compared to those procured by the standard open nephrectomy (openNx). We undertook this study to examine whether the apparent early dysfunction will impair long-term renal allograft survival. We retrospectively updated the status of the first 132 consecutive adult left lapNx recipients at our center and the preceding 99 adult openNx recipients.

Transplant recipient renal function is donor renal mass- and recipient gender-dependent.

The effect of both donor renal mass and gender on renal function, in both gender recipients, was examined. Qualifying consecutive living-donor renal transplants (n = 730) were stratified into 4 donor-recipient groups: female-female (n = 177), male-female (n = 151), female-male (n = 240), male-male (n = 162). Groups were equivalent in age, race, body mass index (BMI), match, ischemia time, operative time, and estimated glomerular filtration rate (eGFR).

The unique character of cardiovascular disease in chronic kidney disease and its implications for treatment with lipid-lowering drugs.

Although the risk for cardiovascular disease (CVD) is high in individuals with chronic kidney disease (CKD), there are very limited data to guide the use of lipid-lowering drugs (LLDs) in this population because the major trials of LLDs in the general population have included very few individuals with CKD. The pathophysiologic and epidemiologic differences of CVD in the CKD population suggest that the study findings derived in the general population may not be directly applicable to those with CKD, and the few trials that have been directed at patients with kidney disease have not shown clear clinical benefits of LLDs. The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (K/DOQI) Work Group has provided consensus-based guidelines for managing dyslipidemias in individuals with CKD and after renal transplantation.

Polyomavirus BK versus JC replication and nephropathy in renal transplant recipients: a prospective evaluation.

Background: JC virus (JCV) viruria is more common than BK virus (BKV) viruria in healthy individuals but in kidney transplants (KT), polyomavirus nephropathy (PVAN) is primarily caused by BKV. Few cases of PVAN have been attributed to JCV. Systematic studies on JCV replication in KT are lacking.

Histological patterns of polyomavirus nephropathy: correlation with graft outcome and viral load.

Polyomavirus-associated nephropathy (PVAN) is a significant cause of allograft loss. The diagnosis requires allograft biopsy, but the impact of the histological features on diagnosis and outcome has not been described. We studied the distribution and extent of PVAN in 90 patients.

Histologic features of mycophenolate mofetil-related colitis: a graft-versus-host disease-like pattern.

Mycophenolate mofetil (MMF) is widely used for maintenance immunosuppression in solid organ transplantation. Gastrointestinal toxicity, usually manifested as diarrhea, is the most common side effect of MMF. We evaluated colonic biopsies from 20 renal transplant patients with MMF-related diarrhea.