77 research outputs found
Association of microsatellite markers on chromosomes 6q27 region and 10p15 region with end-stage renal disease in a UK renal transplant population
Has the UK living kidney donor population changed over time? A cross-sectional descriptive analysis of the UK living donor registry between 2006 and 2017
Patterns of hospitalisation before and following initiation of haemodialysis: a 5 year single centre study
Investigating the Solubility and Cytocompatibility of CaO-Na2O-SiO2/TiO2 Bioactive Glasses
This study aims to investigate the solubility of a series of titanium (TiO2)-containing bioactive glasses and their subsequent effect on cell viability. Five glasses were synthesized in the composition range SiO2-Na2O-CaO with 5 mol % of increments TiO2 substituted for SiO2. Glass solubility was investigated with respect to (1) exposed surface area, (2) particle size, (3) incubation time, and (4) compositional effects. Ion release profiles showed that sodium (Na+) presented high release rates after 1 day and were unchanged between 7 and 14 days. Calcium (Ca2+) release presented a significant change at each time period and was also composition dependent, where a reduction in Ca2+ release is observed with an increase in TiO2 concentration. Silica (Si4+) release did not present any clear trends while no titanium (Ti4+) was released. Cell numbers were found to increase up to 44%, compared to the growing control population, with a reduction in particle size and with the inclusion of TiO2 in the glass composition
Hyperamylasemia post living donor nephrectomy does not relate to pain
Introduction
The aetiology of pain after laparoscopic donor nephrectomy remains unclear. Given the
proximity of the left kidney to the tail of the pancreas, we aimed to assess whether mobilisation
and retrieval of the left kidney might inflame the pancreas, leading to pain and
hyperamylasaemia in the post-operative period.
Patient and methods
In the present study, 16 consecutive live kidney donors were analysed in the same three months
period. Amylase levels were measured on days 1 and 2. For each 24-hour period postoperatively
analgesia consumption was recorded, as well as pain scores at rest on a visual
analogue scale (VAS).
Results
Three out of 16 donors presented hyperamylasemia. A multiple regression analysis found
levobupivacaine dose, propofol dose, transversus abdominis plane block and day 1 amylase did
not significantly predict pain scores. Interestingly, body mass index significantly correlated
with increased pain scores (p = 0.041). Also, increasing CO2 insufflation pressure and use of
local anaesthetic infusion catheters predicted a decreased deep pain score (p = 0.036 and p =
0.037).
Conclusion
There was no correlation of amylase levels and pain scores. Pancreatitis is a rare complication
of nephrectomy and no overt cases were seen in the case of donor nephrectomy
Comprehensive Investigation of the Caveolin 2 Gene: Resequencing and Association for Kidney Transplant Outcomes
Caveolae are plasma membrane structures formed from a complex of the proteins caveolin-1 and caveolin-2. Caveolae interact with pro-inflammatory cytokines and are dysregulated in fibrotic disease. Although caveolae are present infrequently in healthy kidneys, they are abundant during kidney injury. An association has been identified between a CAV1 gene variant and long term kidney transplant survival. Chronic, gradual decline in transplant function is a persistent problem in kidney transplantation. The aetiology of this is diverse but fibrosis within the transplanted organ is the common end point. This study is the first to investigate the association of CAV2 gene variants with kidney transplant outcomes. Genomic DNA from donors and recipients of 575 kidney transplants performed in Belfast was investigated for common variation in CAV2 using a tag SNP approach. The CAV2 SNP rs13221869 was nominally significant for kidney transplant failure. Validation was sought in an independent group of kidney transplant donors and recipients from Dublin, Ireland using a second genotyping technology. Due to the unexpected absence of rs13221869 from this cohort, the CAV2 gene was resequenced. One novel SNP and a novel insertion/deletion in CAV2 were identified; rs13221869 is located in a repetitive region and was not a true variant in resequenced populations. CAV2 is a plausible candidate gene for association with kidney transplant outcomes given its proximity to CAV1 and its role in attenuating fibrosis. This study does not support an association between CAV2 variation and kidney transplant survival. Further analysis of CAV2 should be undertaken with an awareness of the sequence complexities and genetic variants highlighted by this study
Living donor kidney transplantation in older individuals : an ethical legal and psychological aspects of transplantation (ELPAT) view
Donor autonomy and self-sacrifice in living organ donation : an ethical legal and psychological aspects of transplantation (ELPAT) view
Clinical teams understandably wish to minimise risks to living kidney donors undergoing surgery, but are often faced with uncertainty about the extent of risk, or donors who wish to proceed despite those risks. Here we explore how these difficult decisions may be approached and consider the conflicts between autonomy and paternalism, the place of self-sacrifice and consideration of risks and benefits. Donor autonomy should be considered as in the context of the depth and strength of feeling, understanding risk and competing influences. Discussion of risks could be improved by using absolute risk, supra-regional MDMs and including the risks to the clinical team as well as the donor. The psychological effects on the donor of poor outcomes for the untransplanted recipient should also be taken into account. There is a lack of detailed data on the risks to the donor who has significant co-morbidities
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