Transplantation proceedings
-
Faced with a shortage of organs for liver transplantation, the use of grafts from older donors is justified. However, there remains little consensus on how this use impacts the graft and patient outcomes after transplantation from these older donors. The aim of the present analysis was to assess the graft and patient outcomes after liver transplantation from deceased donors >60 years of age. ⋯ A more advanced age of a donor should not be a contraindication for liver transplantation. The present analysis shows that liver grafts from donors >60 can be used safely in older recipients who presented with relatively low MELD scores. Analyses also indicate that high MELD obtained before transplantation may be an important prognostic factor for graft and patient survival.
-
Recently, research has focused on the association of neutrophil gelatinase-associated lipocalin (NGAL) with acute and/or active kidney injury. However, it should be remembered that NGAL is involved in iron metabolism and antimicrobial defense mechanisms. ⋯ Plasma and urine NGAL levels are strongly correlated not only with kidney function parameters, but also with red and white blood cell parameters and patient's age and sex.
-
Estimation of glomerular filtration rate (eGFR) after renal transplantation is performed with the use of methods that are standardized for a population of nontransplantation patients with chronic kidney disease. The aim of the study was to compare the performance of GFR estimation formulas in renal transplant recipients. ⋯ Measured and estimated creatinine clearance overestimate values of eGFR calculated by the MDRD or CKD-EPI formula in a population of kidney transplant recipients, especially in subjects with obesity and worse renal function. Accuracy of analyzed GFR estimation formulas decreases with deterioration of renal graft function.
-
In Poland as well as in other European countries, the number of organs from deceased donors is too small to meet the needs of transplantation therapy. ⋯ The employment of hospital transplant coordinators in Malopolskie Province has a global impact on the increase of the number of actual organ donors in that region and improvement of organ donation rates, but it is effective only in half of the hospitals with coordinators. It indicates that other measurements should also be undertaken to run donation programs.
-
Obesity and disturbances of adipokine concentrations are often recognized in kidney transplant recipients (KTRs). Leptin plays a key role in regulating energy intake and expenditure, including appetite and hunger, metabolism, and behavior. Adiponectin modulates certain metabolic processes, including glucose regulation and fatty acid oxidation, and exerts some weight-reduction effects. Visfatin has various functions, including the promotion of vascular smooth muscle cell maturation and inhibition of neutrophil apoptosis. It also activates insulin receptors and has insulin-mimetic effects, lowering blood glucose and improving insulin sensitivity. The aim of this study was to evaluate the prevalence of leptin, adiponectin, and visfatin and nutritional status abnormalities in stable KTRs. ⋯ Despite high BMI, mild malnutrition was present in one-third of KTRs. Increased BMI, abdominal obesity, and high leptin concentration were aggravated by time from transplantation and deterioration of graft function. Overweight/obesity and incorrect leptin-to-adiponectin ratio could increase cardiovascular risk in KTRs.