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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

849
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

Kidney Transplant II: Surgical Procedure

955
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

Kidney Transplant III: Nursing Management

647
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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Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

548
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
548

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Kidney Transplant Function in Recipients from Deceased Donors with COVID-19.

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Elevations in Donor-Derived Cell-Free DNA and Allograft Outcomes in Kidney Transplantation.

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The Demographic Tide: How Aging and Comorbidity are Reversing Hard-won Gains in Kidney Allograft Survival.

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Related Experiment Video

Updated: May 5, 2026

Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation
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How do we increase deceased donor kidney utilization and reduce discard?

Venkatesh K Ariyamuthu1, Abd A Qannus, Bekir Tanriover

  • 1Division of Nephrology, University of Arizona, COM, Tucson, Arizona, USA.

Current Opinion in Organ Transplantation
|February 13, 2025
PubMed
Summary

Expanding the deceased donor kidney pool involves using marginal organs from donors with acute kidney injury (AKI), hepatitis C virus (HCV), and hepatitis B virus (HBV). Advanced preservation techniques improve outcomes and increase kidney transplant access.

Keywords:
acute kidney injuryallocationdeceased donor kidney transplantationdiscardhepatitis B virushepatitis C virusmachine perfusionnon-use

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Area of Science:

  • Nephrology
  • Transplantation
  • Organ Preservation

Background:

  • The United States faces a critical shortage of deceased donor kidneys, leading to high discard rates of viable organs.
  • Suboptimal and high-risk kidneys, including those from donors with acute kidney injury (AKI), hepatitis C virus (HCV), and hepatitis B virus (HBV), are often underutilized.

Purpose of the Study:

  • To review strategies for expanding the deceased donor kidney pool.
  • To reduce the discard rates of viable kidneys in the US.
  • To explore the use of marginal and high-risk donor kidneys.

Main Methods:

  • Review of advances in organ preservation techniques, including hypothermic and normothermic machine perfusion.
  • Analysis of normothermic regional perfusion (NRP) for donation after cardiac death (DCD) donors.
  • Examination of outcomes for kidneys from donors with AKI, HCV, and HBV.

Main Results:

  • Hypothermic and normothermic machine perfusion improve outcomes for marginal and extended-criteria kidneys.
  • NRP enhances organ utilization and graft viability in DCD donors.
  • Kidneys from AKI and HCV-positive donors show comparable long-term outcomes to standard transplants with appropriate protocols.
  • HBV-positive donor kidneys offer potential for expanded transplant access with antiviral prophylaxis.

Conclusions:

  • Optimizing deceased donor kidney utilization requires a multi-faceted approach.
  • Advancements in preservation technologies and evidence-based decision-making for high-risk organs are crucial.
  • Policy innovations are needed to address organ shortage and enhance transplant access.