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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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Tissue Transplantation01:24

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Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
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The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
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Kidney Transplantation From Elderly Donor.

S Tekin1, H A Yavuz2, Y Yuksel3

  • 1General Surgery and Transplantation Unit, Medical Park Hospital, Kemerburgaz University, Antalya, Turkey.

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Kidneys from donors over 65 offer good graft and patient survival, increasing transplantation rates. Careful evaluation of these expanded criteria organs is crucial for successful renal transplantation.

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Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Geriatric Medicine

Background:

  • Increasing organ donor shortage necessitates utilizing organs from older donors.
  • Acceptance of elderly living-kidney donors is debated due to potential comorbidities and surgical risks.

Purpose of the Study:

  • To evaluate graft function and patient survival in kidney transplant recipients receiving organs from donors aged 65 years or older.
  • Compare outcomes between recipients of older donor kidneys and younger donor kidneys.

Main Methods:

  • Retrospective comparison of 294 patients receiving grafts from donors ≥ 65 years old versus 2339 patients receiving grafts from donors < 65 years old.
  • Data collected from December 2008 to December 2013.
  • Kaplan-Meier survival estimator and multivariate analysis were used for survival analysis.

Main Results:

  • No significant differences in sex, dialysis time, or cold ischemia time between groups.
  • Patient survival at 1, 2, and 3 years was comparable, though slightly lower in the older donor group (91.1%, 89.1%, 88.5% vs. 96.7%, 95.9%, 95.0%).
  • Graft survival rates at 1, 2, and 3 years were similar (97.6%, 96.4%, 94.1% vs. 97.5%, 96.8%, 95.2%). Donor age, time on dialysis, HLA-DR mismatches, and delayed graft function were associated with patient and graft survival.

Conclusions:

  • Utilizing kidneys from donors over 65 can increase renal transplantation rates by 15-20 per million population.
  • Good graft and patient survival rates are achievable with proper macroscopic and microscopic evaluation protocols for expanded criteria organs.
  • This approach expands the donor pool while maintaining acceptable transplant outcomes.