Introduction: We evaluated whether nephron sparing surgery (NSS) combined with meticulous suturing of the cut stump under clamping with cooling is beneficial for oncological outcomes and also assessed the relationship between cold ischemia time and deterioration of renal function.
Methods: One hundred and six patients with renal cell carcinoma (RCC) were subjected to this procedure. Oncological outcomes and renal function according to the estimated glomerular filtration rate (eGFR) and the tubular excretion rate on renoscintigraphy before and at 12 months after surgery were evaluated.
Results: Cancer recurrences were observed in 2 patients with past history of RCC; however, no patient died of cancer. Renal function was evaluated depending on 4 different ischemia times. All groups did not show a remarkable decrease of renal function in terms of eGFR. Renoscintigraphy revealed the deterioration of the affected kidney in patients with >60 min ischemia.
Conclusion: The renoprotective procedure of NSS provided maximum preservation of renal function until 60 min of cold ischemia time.
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http://dx.doi.org/10.1159/000479037 | DOI Listing |
Exp Clin Transplant
December 2024
>From the Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Vall d'Hebron Hospital, Barcelona, Spain.
Marginal liver grafts, such as those from cardiac death donors and donors with steatotic organs, are highly vulnerable to ischemia-reperfusion injury. In addition, ex situ graft alteration, either by reduction or splitting, will prolong the static cold storage time and amplify the ischemia-reperfusion injury. Hypothermic oxygenated machine perfusion has the potential to end the oxygen deprivation during preservation and accordingly improve outcomes in some marginal grafts that have been traditionally discarded.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, 40-027 Katowice, Poland.
The results of kidney transplantation (KTx) in elderly patients are deteriorated by more frequent use of organs procured from older or extended criteria donors (ECDs). To eliminate the influence of donor factors on the transplantation results, the pair analysis method was applied. The study aimed to assess the survival, during long-term follow-up after transplantation, of recipients and transplanted kidneys, graft function, and factors influencing survival in recipients aged 60 years and older (≥60) compared to recipients aged less than 60 years (<60) who received a kidney from the same brain death donor (DBD).
View Article and Find Full Text PDFMol Med
January 2025
Center for Immunology and Inflammation, Feinstein Institutes for Medical Research, Manhasset, NY, USA.
Background: Chronic kidney disease (CKD) is a leading cause of death in the United States, and renal fibrosis represents a pathologic hallmark of CKD. Extracellular cold-inducible RNA-binding protein (eCIRP) is a stress response protein involved in acute inflammation, tissue injury and regulated cell death. However, the role of eCIRP in chronic inflammation and tissue injury has not been elucidated.
View Article and Find Full Text PDFHum Immunol
January 2025
Immunology department, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia.
Introduction: HLA matching is critical for successful kidney transplantation. This study aimed to investigate the impact of eplet mismatches and Predicted Indirectly Recognizable HLA Epitopes (PIRCHE-II) scores on the development of de novo donor-specific antibodies (dnDSA) and graft survival in a Tunisian cohort, characterized by a high prevalence of living donors and significant genetic diversity in HLA profiles.
Methods: This retrospective study included 112 adult kidney transplant recipients who underwent transplantation between 2012 and 2018.
Sci Rep
January 2025
Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Static cold storage of donor livers at 4 °C incompletely arrests metabolism, ultimately leading to decreases in ATP levels, oxidative stress, cell death, and organ failure. Hydrogen Sulfide (HS) is an endogenously produced gas, previously demonstrated to reduce oxidative stress, reduce ATP depletion, and protect from ischemia and reperfusion injury. HS is difficult to administer due to its rapid release curve, resulting in cellular death at high concentrations.
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