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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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In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
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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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In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
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Kidney Transplant III: Nursing Management01:16

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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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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Related Experiment Video

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Microdissection of Primary Renal Tissue Segments and Incorporation with Novel Scaffold-free Construct Technology
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Optimizing clinical utilization and allocation of older kidneys.

Christian Denecke1, Matthias Biebl, Johann Pratschke

  • 1Department of General, Visceral and Transplantation Surgery, Charite Virchow Clinic, Berlin, Germany.

Current Opinion in Organ Transplantation
|July 1, 2015
PubMed
Summary

Optimizing marginal kidney grafts involves strategies like the Eurotransplant Senior Program and minimizing cold ischemic times. These approaches aim to reduce organ discard and increase kidney transplantation rates.

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Area of Science:

  • Nephrology
  • Transplantation Medicine
  • Organ Allocation

Background:

  • Persistent organ shortages and high discard rates necessitate improved strategies for marginal kidney grafts.
  • The Eurotransplant Senior Program (ESP) exemplifies an 'old-for-old' allocation system focused on optimizing marginal graft utilization.

Purpose of the Study:

  • To review and highlight methods for optimizing the outcome and allocation of marginal kidney grafts.
  • To address the urgent need for increased renal transplantation by reducing organ discard rates.

Main Methods:

  • Review of the Eurotransplant Senior Program's allocation system.
  • Analysis of strategies including brief cold ischemic times, novel preservation techniques, and dual kidney transplantation.
  • Consideration of donation after cardiac death (DCD) kidneys from elderly donors.

Main Results:

  • The ESP prioritizes short ischemic times for marginal grafts.
  • Several factors contribute to increased renal transplant supply: refined allocation, brief cold ischemia, new preservation methods, quality assessment, dual kidney transplants, and DCD kidneys from elderly donors.
  • Age-adapted immunosuppression and improved patient selection enhance outcomes with marginal kidneys.

Conclusions:

  • Significant potential exists to increase marginal graft utilization and reduce discard rates.
  • Dual kidney transplantation and novel preservation methods are key to expanding the donor pool.
  • Optimized allocation, preservation, and patient management are crucial for maximizing the use of marginal organs.