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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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Kidney Transplant II: Surgical Procedure01:26

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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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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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Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

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In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
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Acute Kidney Injury III: Clinical Manifestations01:29

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Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Using a Chemical Biopsy for Graft Quality Assessment
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Kidney Biopsies May Help Predict Renal Function After Liver Transplantation.

Raimund H Pichler1, Janna Huskey, Jolanta Kowalewska

  • 11 Departments of Medicine, Pathology and Surgery, University of Washington, Seattle, WA.

Transplantation
|August 2, 2016
PubMed
Summary
This summary is machine-generated.

Renal biopsies are safe and useful for liver transplant candidates with kidney problems. They help determine transplant type and predict kidney function, avoiding unnecessary kidney transplants in 70% of cases.

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Area of Science:

  • Nephrology
  • Hepatology
  • Transplantation Medicine

Background:

  • Renal biopsy is proposed for end-stage liver disease patients to assess renal failure causes and reversibility.
  • Its utility in kidney allocation for liver transplant candidates requires further validation.

Purpose of the Study:

  • Evaluate the utility of renal biopsies in liver transplant candidates with renal impairment.
  • Analyze pathological diagnoses, patient outcomes, and biopsy result predictability for renal recovery.

Main Methods:

  • Retrospective analysis of 59 liver transplant candidates with renal impairment.
  • Evaluation of transjugular and percutaneous renal biopsy complication rates.
  • Correlation of histological findings with post-transplant kidney function and outcomes.

Main Results:

  • Low complication rates for renal biopsies (2.9% transjugular, 4.2% percutaneous).
  • Common diagnoses: membranoproliferative glomerulonephritis, IgA nephropathy, acute tubular injury.
  • Biopsy criteria avoided kidney allocation for 70% of patients; predicted post-transplant kidney function.

Conclusions:

  • Renal biopsy is safe and elucidates renal failure etiology in liver transplant candidates.
  • Biopsies predict post-liver transplant alone (LAT) kidney function and aid kidney allocation.
  • Biopsy findings help guide decisions between simultaneous liver-kidney transplantation (SLK) and LAT.