Effect Of Renal Transplantation Research Articles

Effect of renal transplantation on pulmonary artery hypertension: a single-center study

Effect of renal transplantation on pulmonary artery hypertension: a single-center study

Effect of Renal Transplantation on Gonadal Hormones in Male Patients with End Stage Renal Disease

Effect of Renal Transplantation on Gonadal Hormones in Male Patients with End Stage Renal Disease

The Effect of Renal Transplantation on Female Sexual Function: An Age-Matched Pair Analysis

To evaluate female sexual function (FSF) after renal transplantation (RT) and compare it to an age-matched normal females (control). The study included 100 sexually active RT females in child-bearing period. Sexual function was evaluated with Female Sexual Function Index (FSFI). We compared the mean scores of all domains of FSFI to an age-matched sexually active normal females. Also, we compared the current FSFI to the pre-transplant status in 54 married females before RT. Factors affecting the FSF after RT were assessed. In comparison to control group, RT group had statistically significant lower sexual desire (P <.001) with no significant differences as regard arousal, lubrication, orgasm, satisfaction, pain, and total FSFI score (P >.05). Among RT-females, 83% had normal sexual function, and 83.7% of the control had normal sexual function (P=.8). After RT, the FSFI score increased significantly from 20.7 ± 5.4 to 27.8 ± 3.1 (P <.001), and 85.2% had normal sexual function compared to 22.2% before RT (P <.001) with statistically significant improvement in all domains (P <.001) except for pain score (P=.8). Female circumcision was the only identified factor associated with FSD (P=.02). Successful RT significantly improves female sexual function of ESRD patients. The sexual function after RT is comparable to healthy control except for lower sexual desire.

Renal transplantation in patients with an augmentation cystoplasty.

BackgroundThe effects of renal transplantation in patients with augmentation cystoplasty are still controversial. We retrospectively analyzed nine patients who underwent renal transplantation after augmentation cystoplasty.MethodsA total of nine patients who underwent augmentation cystoplasty prior to renal transplantation between January 1990 and May 2020 were reviewed. Basic information on augmentation cystoplasty, transplant procedures, and long-term outcomes of renal transplantation were analyzed.ResultsThe bowel segments utilized for augmentation cystoplasty were the stomach in two patients (one patient needed revision using the ileum), the ileum in four patients, the ileocolic pouch in one patient, the sigmoid in one patient, and the ureter in one patient. All the cystoplasties were performed prior to renal transplantation. The mean follow-up period after transplantation was 161 months (range, 2–341 months). Two patients had an episode of acute rejection each; however, their graft functions were well-maintained. Five patients had recurrent urinary tract infections, and three of these patients progressed to allograft failure. One patient died from bladder cancer with a functioning graft. Five of nine patients showed well-maintained graft function.ConclusionsRenal transplantation after bladder augmentation surgery is a major operation requiring a high level of surgical skill. Based on our long-term experiences, we recommend diligent postoperative monitoring for urinary tract infections, optimal catheter use, and use of appropriate antibiotic prophylaxis to avoid severe complications.

Effects of Renal Transplantation on Cardiac Morphology and Function Luis Vernaza Hospital, Guayaquil, Ecuador: Kidney Transplant and Morphology and Cardiac Function

Introduction: Structural heart disease is a frequent complication of advanced chronic kidney disease and the leading cause of death in patients with renal replacement therapy, mainly in those on dialysis. There is sufficient evidence to demonstrate a regression of left ventricular hypertrophy and improvement of ventricular function after a successful renal transplant. The objective of this study is to describe the experience regarding the effects of renal transplantation on cardiac remodeling and function and thus corroborate with local data the benefits of renal transplantation on the left ventricular mass index (LVMI grs), Left Ventricle Ejection Fraction (LVEF %), Left Atrium Diameter (LAD mm), Left Ventricle Diastolic Diameter (LVDD mm), Left Ventricle Systolic Diameter (LVSD mm), Posterior Wall (PW mm) and Interventricular Septum (IVS mm). Materials and Methods: This is a quantitative, observational, descriptive and retrospective study. A database was constructed whose information was tabulated and subsequently analysed by the statistical program SPSS 13 to perform the statistical analysis. The results of the nominal variables were expressed in percentages and of the numerical variables in average ± standard deviation (SD) and confidence interval. The study included all adults over18 years with a diagnosis of chronic renal failure who underwent renal transplantation at Luis Vernaza Hospital between January 2009 to December 2016 and who had pre and post-transplant transthoracic echocardiography. Results: Of the 132 adults undergoing renal transplantation, 74 patients who met the inclusion criteria were identified, their average age was 35.2 years DS (+/- 11.7 years), forty-eight patients (64%) were male. All patients were dependent on dialysis, whose average time was 5 years and 88% of the population underwent intermittent hemodialysis weekly. The pre-transplant and post-transplant echocardiographic measurements were: LVEF (%) 60.89 ± 1,175 vs. 66.81 ± 0.685 (&lt;0.0001); LVMI (grs) 242.54 ± 11.92 vs. 184.62 ± 7,591 (&lt;0.0001); LAD (mm) 35.9 ± 0.772 vs. 34.8 ± 0.602 (0.215); LVDD (mm) 47.97 ± 0.756 vs. 44.98 ± 0.927 (0.003); LVDS (mm) 29.85 ± 0.897 vs. 26.68 ± 0.681 (0.004); PW (mm) 11.86 ± 0.270 vs. 10.92 ± 0.208 (0.002); IVS (mm) 12.12 ± 0.348 vs. 10.95 ± 0.253 (0.002) respectively. Conclusion: In this study, was observed a favorable overall impact of renal transplantation on the structure and function of the heart, with a significant reduction in LVH and LVMI and systolic and diastolic function of the left ventricle, thus reducing the risk of associated death to cardiovascular events.

P1632IMPACT OF RENAL TRANSPLANTATION ON THE FUNCTIONAL STATUS OF PATIENTS WITH END-STAGE RENAL FAILURE IN TACROLIMUS ERA

Abstract Background and Aims Survival after renal transplantation has improved significantly over the past 20 years. On the contrary, surprisingly little is known about the functional status post-transplant. A fundamental understanding of the functional status of patients surviving renal transplantation is of primary importance to clinicians and families alike, who often pursue renal transplantation with a principal hope that functional status will improve. The aim of our study is to assess the effect of renal transplantation on functional status of the patients in tacrolimus era Method Using data from the United States organ procurement and transplantation network, all renal transplant patients maintained on tacrolimus-based immunotherapy and had functional assessment at time of transplant and five-years post-transplant were retrospectively reviewed. Data including age, sex, gender, ethnicity, functional status, diabetes, body mass index, cold ischemia time, number of previous transplants, panel reactive antibodies, donor type, donor age, HLA-mismatches, number of acute rejection episodes, induction therapies, maintenance immunotherapy on discharge were collected. Functional status was defined according to Karnofsky score measurements. Descriptive analysis was used to assess effect of renal transplantation on functional status. Outcome measured was functional status five-years post-transplant. Multiple logistic regression analysis was used to assess factors affecting functional status post-transplant. Results 19704 patients were included in the study. Among patients with mild impairment at time of transplant, only 13.55% showed worsening of functional status. Among patients with moderate impairment at time of transplant, 65.5% showed improvement of functional status while only 3.92% showed worsening of functional status. Among patients with severe impairment at time of transplant, 88.56% showed improvement in functional status (64.57% showed improvement to mild impairment and 23.99% showed improvement to moderate impairment). Multiple logistic regression analysis showed that steroid withdrawal protocol is associated with improvement in functional status (OR=1.24, P=0.007, CI ranges from 1.06 to 1.45), while dialysis maintenance before transplantation was associated with abnormal functional status post-transplant (OR=0.73, P=0.003, CI ranges from 0.59 to 0.89). Conclusion This study revealed that renal transplantation is associated with substantial improvement in functional status of the patients. Steroid withdrawal protocols is associated with significant improvement in functional status while maintenance dialysis before transplantation is associated with worse outcomes. This study recommends using steroid withdrawal protocols and performing transplantation for the patients at the pre-dialysis state. Functional status at time of transplant shouldn’t be a hindrance to performing transplantation.

Effects of Renal Transplantation and Hemodialysis on Patient’s General Health Perception and Oral Health–Related Quality of Life: A Single-Center Cross-Sectional Study

BackgroundPatients with end-stage renal disease have a lower quality of life compared to the general population. Oral health–related quality of life (OHRQoL) is of particular interest as good oral health could influence general health. This study aimed to compare dental and periodontal health status, OHRQoL, and general health perception of renal transplant (TX) and hemodialysis patients (HD) with that of healthy controls. MethodsThe study included 64 TX, 63 HD, and 61 healthy patients. TX patients were also grouped according to the time elapsed after transplantation and currently use of immunosuppressive agents. The numbers of decayed, missing, and filled teeth were recorded as DMFT, and periodontal health status was evaluated. Patients’ general health perceptions and OHRQoL were assessed using Short Form-36, Oral Health Impact Profile-14, and OHRQoL-United Kingdom questionnaires. ResultsThe HD groups presented significantly higher DMFT scores and periodontal scores than TX and control groups. OHRQoL-United Kingdom total scores of TX and HD groups were lower than controls (P < .05). Oral Health Impact Profile-14 total scores revealed that HD groups' OHRQoL was significantly lower than TX and control groups (P < .05). Perceptions of general health of TX patients were higher than in the HD group. ConclusionsRenal transplantation has shown to increase quality of life and OHRQoL compared to hemodialysis therapy. Neither the immunosuppressive agent nor the time elapsed after transplantation were observed to be significant factors affecting OHRQoL.

CORONARY ARTERY CALCIFICATION IN RENAL TRANSPLANT RECIPIENTS

Abstract:Background: Vascular calcification is as active process in dialysis patients, It remains unclear if calcification related to dialysis is ameliorated after renal transplantation or not. Multi-detector computed tomography remain as a gold standard for noninvasively determine the quantity of CAC. Our aim is to study the effect of renal transplantation on vascular calcification occurred among hemodialysis patients and the risk factors for development of vascular calcification and its progression after kidney transplantation. Methods: Transplant registry in Mansoura Urology and Nephrology Center was reviewed for kidney transplant recipients with pre-transplant non-contrast spiral CT chest. So, 149 recipients were included and they were divided according to the presence of vascular calcification into 2 groups. Group I: 58 KTRs with pre-transplant vascular calcification, Group II: 91 KTRs without pre-transplant vascular calcification.Results: Pre-transplant vascular calcification was predominant among old age, males with high pre-transplant intact PTH levels. After kidney transplantation, the number of patients with vascular calcification slightly increased but the severity of vascular calcification significantly increased. High pre-transplant calcium score, longer hemodialysis duration and high intact PTH levels are associated with post-transplant vascular calcification progression.Conclusion: it is better to courage pre-emptive kidney transplantation or to decrease the incidence of post-transplant vascular calcification. Also, candidates for renal transplantation should keep PTH within accepted level to decrease the chance for vascular calcification.

The Effect of Renal Transplantation on Cardiac Functions.

Chronic renal failure is a well-known risk factor for cardiovascular poor outcome. Despite advances in dialysis and renal transplantation, these patients still have high cardiovascular morbidity and mortality. The aim of our study was to evaluate the changes in blood parameters and echocardiographic parameters of patients undergoing renal transplantation in our center. One hundred and eighty-three patients who underwent renal transplantation between September 2012 and January 2016 were included in the study. Pre- and postoperative hemoglobin values, lipid profiles, ejection fractions, presence of left ventricular hypertrophy, presence of diastolic dysfunction, and valve pathologies were retrospectively scanned. Data were obtained from all patients in terms of blood parameters, but we compared 92 patients' echocardiographic data because of lack of both pre- and postoperative echocardiography records. In our study, 124 patients (67.8%) were male, and the mean age was 42.6 ± 14.4 years. Hemoglobin levels (11.2 ± 1.98, 12.7 ± 2.2 mg/dL, P <0.001) and high-density lipoprotein (HDL) values (37.6 ± 10.5, 46.6 ± 13.6 mg/dL, P <0.001) were found to be different significantly. In echocardiographic evaluation, there was no difference between pre- and postoperative ejection fractions in 92 patients. However, patients with preoperative ejection fraction <50% had a significant increase in postoperative ejection fraction (40.1 ± 6.2, 48.4% ± 9.4%, P = 0.012). Renal transplantation can improve left ventricle ejection fraction in patients with basal ejection fraction less than 50% and also provide a significant increase in hemoglobin and HDL levels in all patients. This suggests that renal transplantation may reverse the process for dilated cardiomyopathy and may improve cardiac function in patients with low ejection fraction. However, transplantation should be performed as early as possible in these patients.

The effect of renal transplantation on left ventricular function, electrocardiography, and mechanical synchrony by gated myocardial perfusion imaging

BackgroundDepressed left ventricular ejection fraction (LVEF), LV mechanical dyssynchrony (LVMD), and prolonged QTc interval predict poor outcomes in end-stage renal disease (ESRD). Renal transplantation improves mortality in ESRD patients but the effects of transplantation on these indices remain undefined. MethodsWe identified patients with myocardial perfusion imaging (MPI) before and after renal transplantation. A control group consisted of ESRD patients who underwent 2 MPIs but did not receive a transplant. Changes in LVEF, LVMD indices [phase standard deviation (SD) and bandwidth (BW)] by MPI, and electrocardiogram (ECG) indices were determined. ResultsThe study population consisted of 32 ESRD patients (53% male, 50 ± 11 years, 59% African American, 65% diabetic). The second MPI was performed 31 months (13-59 months) after renal transplantation. LVEF (72 ± 10% vs. 67 ± 10%, P < 0.001) but not SD (22 ± 15° vs. 22 ± 11°, P = 0.9) or BW (58 ± 35° vs. 57 ± 29°, P = 0.9) improved after transplantation. There were no changes in these indices in the control group. QTc (425 ± 30 ms vs. 447 ± 32 ms, P = <0.001) but not QRS (90 ± 21 ms vs. 90 ± 21 ms, P = 0.9) improved significantly after renal transplantation. ConclusionsLVEF and QTc improved after renal transplantation but LVMD indices and QRS did not change, which suggests that LVMD and electrical dyssynchrony may be irreversible in ESRD.

The Effect of Renal Transplantation in End-Stage Renal Failure Patients Undergoing Total Hip Replacement.

Background:Patients with end-stage renal failure (ESRF) undergoing elective orthopedic surgery generally have higher postoperative morbidity and mortality compared to the general population. Studies on the outcome of ESRF patients undergoing total hip replacement (THR), especially those with a functioning renal transplant, are conflicting. We aim to evaluate the impact of renal transplantation on functional outcome and postoperative complications in patients with ESRF undergoing THR.Materials and Methods:A total of 29 primary THRs were performed in 25 patients with ESRF between 1999 and 2013. There were 12 patients with 14 THRs who had a functioning renal transplant at the time of surgery (transplant group), and 13 patients with 15 THRs who were dialysis dependent with either no or failed prior transplant (nontransplant group). Functional outcome was evaluated with the Oxford Hip Score (OHS) and Western Ontario and McMaster Universities Osteoarthritis Index. Clinical records and followup radiographs were used to evaluate postoperative complications.Results:There is lower mortality rate (P = 0.02) and lower overall complication rate in the transplant group compared to the nontransplant group (relative risk 0.60, 95% confidence interval 0.40–0.91, P = 0.008). The mean increase in OHS postoperatively was greater in the nontransplant group (nontransplant-24.7; transplant-18.7) and trended toward statistical significance (P = 0.06).Conclusion:ESRF patients who undergo THR experience improvements in functional outcome regardless of transplant status. There was no significant difference in postoperative functional outcomes between the two groups of patients, but patients with renal transplants are less likely to experience postoperative complications and have better survival.

Effect of Renal Transplantation on Health-Related Quality of Life in Patients with End-Stage Renal Disease; A Quasi-Experimental Study

Background: Renal transplantation is one of the best modalities to lengthen the life expectancy of patients with end-stage renal disease (ESRD). However, no sufficient documents exist regarding the effects of renal transplantation on the health-related quality of life (HRQOL) especially in Iranian population. Objectives: This study aimed to determine the possible influence of renal transplantation in different scales of HRQOL in southern Iran. Methods: This Quasi-experimental study was carried out with 120 patient candidate for renal transplantation (Apr 2012 - Jan 2014). Using the general SF-36 questionnaire, HRQOL of the patients 1 week before and 3 months after the transplantation was evaluated. All data were analyzed statistically using descriptive and analytical tests (α = 0.05). Results: Seventy-eight patients (65%) were male. The mean (SD) of the age was 38.92 (13.259) years. HRQOL and its eight scales were significantly different before and after the transplantation (P < 0.001). There was a significant difference between general perception of health and primary school, as well as diploma (P = 0.008). Other demographical factors such as age, gender, marital status and type of donor had no impact on HRQOL, statistically. There was no correlation between HRQOL and the length of facing the disease, except in the subgroup of role limitation due to physical problems (P = 0.01). Conclusions: The study showed that renal transplantation has sufficient credibility in improvement of HRQOL in patients with ESRD. Moreover, continuous enhancement of education level and public knowledge might be as effective as development of medical serving systems in maintaining and achieving greater improvement in HRQOL.

Effects of Renal Transplantation on Uraemic Cardiomyopathy

Effects of Renal Transplantation on Uraemic Cardiomyopathy

The Treatment of Male Infertility After Allograft Renal Transplantation: A Case Series

Background: Renal transplantation is a useful option for allowing female renal failure patients of childbearing age to achieve pregnancy. However, there have been a few reports on the effects of renal transplantation on infertility treatment in male renal failure patients. We herein report two cases in which male patients underwent infertility treatment after renal transplantation. Case Presentation: Case 1: A 51-year-old Asian (Japanese) man underwent transplantation (the donor was his wife) for renal failure due to Autosomal Dominant Polycystic Kidney Disease (ADPKD). At two years after transplantation, he visited the reproduction center in our institute due to infertility. A semen analysis revealed oligoasthenozoospermia. He ultimately failed to achieve pregnancy and gave up on infertility treatment. Case 2: A 47-year-old Asian (Japanese) man underwent renal transplantation (the donor was his sister) due to renal failure caused by diabetes mellitus. At three years after renal transplantation, he visited the reproduction center in our institute for infertility. Due to ejaculation disability and the absence of sperm in the patient’s urine after masturbation, he was diagnosed with anejaculation. Thus, testicular sperm extraction (TESE) was performed. Twenty-three motile spermatozoa were successfully retrieved by microdissection TESE (micro-TESE). ICSI was subsequently performed and a good embryo was transferred. His wife achieved pregnancy and is expected to deliver this October. Conclusion: We report two cases of male infertility treatment after renal transplantation.

Effect of renal transplantation on organochlorine pesticide (OCPS) Levels in chronic kidney disease patients (CKD-5D): A Longitudinal study

Effect of renal transplantation on organochlorine pesticide (OCPS) Levels in chronic kidney disease patients (CKD-5D): A Longitudinal study

Ultrasound Assessment of Intima-media Thickness and Diameter of Carotid Arteries in Patients Undergoing Hemodialysis or Renal Transplantation.

Renal transplant (RT) recipients have a high risk of developing cardiovascular diseases. However, the effects of renal transplantation on the development of arteriosclerosis have been controversial. The carotid intima-media thickness (СШТ) and diameter (CD) are important indicators of vascular remodeling and arteriosclerosis. In this study, 31 patients with hemodialysis (HD), 31 RT recipients and 84 age- and gender-matched control subjects were enrolled. Their CIMT and CD were measured by ultrasonic radiofrequency tracking, and the linear regression models and Z test were used to identify the progression of arteriosclerosis and the risk factors. Compared with HD group, RT group had significantly lower CIMT and CD. CIMT was found to be associated with age, body weight, resistance index and diastolic velocity, while CD was associated significantly with age, body weight, pulsatility index, end diastolic velocity and diastolic blood pressure (DBP), respectively. The correlation curves between CIMT and age showed the slopes of curves were decreased successively in control, RT and HD groups, and the curves between CD and age showed the slopes were decreased in order of RT > control > HD groups. It was concluded that CIMT and CD were significantly correlated with age in RT and moderately with age in HD patients. RT could reduce the progress of arteriosclerosis in patients with end-stage renal disease.

Correction to: Effect of renal transplantation on cognitive function in hemodialysis patients: a longitudinal study.

In the original publication, the second author's affiliation was incorrectly published as "Department of Physiology, RAK College of Medical Sciences, Ras Al Khaimah, UAE". The correct affiliation should read as "Visiting Academic, Basic Medical Sciences Department, College of Medicine, University of Sharjah (UAE)".

Effects of Renal Transplantation on Female Sexual Dysfunction: Comparative Study With Hemodialysis and a Control Group

ObjectivesSexual dysfunction occurs commonly in individuals with end-stage renal disease. Chronic renal failure as well as the treatments used for it generally has a negative impact on sexual function with a subsequent increase in the risk of depression. There is scarcity of published data on female sexual dysfunction and the degree of improvement in patients on hemodialysis (HD) and transplant (Tx) recipients. The aim of this study was to compare the sexual function and degree of depression in HD and Tx patients with control group. For this purpose, we used the validated Female Sexual Function Index (FSFI) and Beck Depression Inventory (BDI). Materials and MethodsA total of 23 renal Tx, 29 HD, and 30 control patients were enrolled in the study. HD patients were required to be undergoing HD for ≥6 months, and for renal Tx recipients, the Tx had to be performed ≥6 months before study entry. All women underwent a general and urogynecologic examination. Demographic and clinical variables were documented. FSFI and BDI scale scores were compared among groups. ResultsThe rates of female sexual dysfunction were 56.7%, 89.7%, and 73.9% in the control, HD, and Tx, patients respectively. Total FSFI scores in HD group were significantly lower than those in Tx and control patients (P < .05). FSFI scores improved significantly in the Tx group. BDI scores in HD and control subjects were 23.24 and 14.17, respectively, with a significant difference between the 2 groups (P < .005). BDI score in the Tx group was 16.65 and the difference was statistically insignificant. ConclusionsThis preliminary study documented that successful Tx may positively affect sexual life in women with chronic renal failure. A diagnosis of female sexual dysfunction should be made routinely in patients with chronic renal failure.

The effect of renal transplantation on quality of sleep in former dialysis patients.

Data on sleep quality in renal transplanted (RTX) patients are scarce, and longitudinal studies are lacking. The purpose of this study was to assess the prevalence of sleep complaints in RTX patients and identify variables associated with improvement in sleep quality. In a longitudinal study, 301 dialysis patients were followed for up to 5.5 years, during which time 142 were transplanted. Out of the transplanted patients, a total of 110 were eligible for inclusion. Sleep quality and depression were assessed with the validated questionnaires Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI), and data were collected during dialysis and after RTX. Based on PSQI scores, 59% were characterized as poor sleepers after RTX compared to 75% when in dialysis (P = 0.016). A total of 46% experienced a clinical relevant improvement in overall sleep quality, while 21% experienced a clinical relevant deterioration. In multivariable analyses, clinical meaningful change in sleep quality was not associated with either depressive symptoms assessed with BDI or other clinical variables. Sleep quality improved after RTX in nearly half of the patients, but poor sleep quality was prevalent in RTX patients. Therefore, sleep quality should routinely be assessed in RTX patients.

Short-term effects of renal transplantation on coronary artery calcification: A prospective study.

Cardiovascular disease is a leading cause of mortality in renal transplant recipients. Coronary artery calcification (CAC) has been found to have good correlation with atherosclerosis and cardiovascular morbidity. The objective of our study was to assess the prevalence of CAC and the long-term effects of renal transplantation on CAC and carotid intima-medial thickness (CIMT) in Indian renal transplant recipients. Twenty-eight renal transplant recipients were included in this prospective study. Dual-source computed tomography and calcium scoring using Agatston's method and CIMT measurement were performed at the time of transplant and then repeated at six and 12 months after transplantation. The prevalence of CAC in our study patients was low (32%), probably because they were young, had been on dialysis for a short duration and had undergone live-related renal transplant. An overall improvement in biochemical parameters was observed after transplantation. Patients with zero baseline calcium score did not show progression. Patients with baseline calcium score more than zero showed initial progression at 6 months and no further progression afterwards. There was good correlation between CIMT and CAC score. Our study suggests that renal transplantation does not reverse the calcification but appears to decrease the rate of progression in the long term.