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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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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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Kidney Structure01:45

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The kidneys are two large bean-shaped organs located in the upper abdomen. They filter the blood several times a day to remove toxins and rebalance water and electrolytes of the circulatory system via the renal veins. The kidneys receive blood directly from the heart via the renal arteries. These arteries enter the kidney at the hilum, the concave surface of the bean, where they branch and divide into smaller vessels and capillaries.
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Liver Histology01:27

Liver Histology

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The microscopic anatomy of the liver is a complex and intricate system that comprises numerous structural units known as liver lobules, each of which is comparable in size to a sesame seed. These hexagonal structures consist of plates of liver cells or hepatocytes, which are characterized by their versatility and abundance of cellular apparatus like rough and smooth ER, Golgi apparatus, peroxisomes, and mitochondria.
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The liver, an essential organ in the human body, performs over 200 vital functions that can be broadly categorized into metabolic, hematological, endocrine regulation, and bile production.
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Robot-Assisted Kidney Transplantation
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Simultaneous liver kidney transplantation.

Ashwani K Singal1, Song Ong2, Sanjaya K Satapathy3

  • 1Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, AL, USA.

Transplant International : Official Journal of the European Society for Organ Transplantation
|December 15, 2018
PubMed
Summary
This summary is machine-generated.

Simultaneous liver-kidney transplantation improves outcomes for patients with end-stage liver disease and kidney failure. Better tools are needed to allocate kidneys and predict recovery in acute kidney injury patients undergoing liver transplant.

Keywords:
cirrhosisdialysisend-stage renal diseaseoutcomessimultaneous liver kidney

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Area of Science:

  • Nephrology
  • Hepatology
  • Transplantation

Background:

  • Kidney injury is common in end-stage liver disease.
  • Simultaneous liver-kidney (SLK) transplantation offers better outcomes than liver transplantation (LT) alone for select patients.
  • The Model for End-Stage Disease (MELD) score has increased SLK use since 2002.

Purpose of the Study:

  • To review current literature on SLK transplant criteria and outcomes.
  • To identify unmet needs in managing kidney injury in liver disease patients.
  • To evaluate the effectiveness of current organ allocation policies.

Main Methods:

  • Literature review of simultaneous liver-kidney transplantation.
  • Analysis of SLK allocation criteria for different kidney injury etiologies.
  • Assessment of current organ procurement and transplant network policies.

Main Results:

  • SLK allocation criteria are consistent for end-stage renal disease and chronic kidney disease in cirrhotic patients.
  • Criteria are heterogeneous for acute kidney injury (AKI) due to difficulty differentiating causes (hepatorenal vs. intrarenal).
  • There is a need for urine biomarkers and clinical models to stratify AKI and predict renal recovery.

Conclusions:

  • Accurate stratification of AKI etiology and prediction of renal recovery are crucial for optimal SLK allocation.
  • Current organ allocation policies' ability to conserve donor kidneys and optimize SLK use remains to be determined.
  • Further research into biomarkers and predictive models is essential for improving patient outcomes and resource utilization in liver disease with kidney injury.