Download or read book Early Versus Late Ureteric Stent Removal After Kidney Transplantation written by Emily Thompson and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction: Kidney transplantation is the treatment of choice for patients with end-stage kidney disease. In a previous review we concluded routine ureteric stenting in kidney transplantation reduces the incidence of major urological complications (MUCs). Unfortunately, this reduction appears to lead to a concomitant rise in urinary tract infections (UTI). For kidney recipients UTI is now the commonest post-transplant complication. This represents a considerable risk to immunosuppressed transplant recipients. There are a number of different approaches taken to ureteric stenting which are associated with varying degrees of morbidity and hospital cost. This review aimed to look at the benefits and harms of early versus late removal of the ureteric stent in kidney transplant recipients.Methods: We searched the Cochrane Kidney and Transplant Specialised Register using terms relevant to this review. All RCTs and quasi-RCTs were included in our meta-analysis. Two authors reviewed the identified studies. Early removal was considered as stent removal before day 15 post-op or during the index transplant admission. The primary outcome of interest was the incidence of MUCs. Secondary outcomes were UTI, idiosyncratic stent-related complications, hospital related costs and adverse events. A subgroup analysis was performed examining complications reported in different ureteric stenting techniques; bladder indwelling (BI) vs per-urethral (PU). Statistical analyses were performed using the random effects model and results expressed as relative risk (RR) with 95% confidence intervals (CI).Results: Five RCTs (1097 patients) were included in our analysis. There was no significant difference in the incidence of MUCs in early vs late removal; RR 1.65 95% CI [0.57, 4.83], p=0.36. The incidence of UTI was significantly reduced in the early removal group; RR 0.60 95% CI [0.41, 0.87], p=0.007. UTIs were significantly less likely to occur if a BI stent was used, RR 0.45 95% CI [0.29, 0.70], p=0.0004, compared with PU stents; RR 0.81 95% CI [0.51, 1.27] p=0.36. Discussion: Early removal of ureteric stents following kidney transplantation significantly reduces the incidence of UTI and is not associated with a higher risk of MUC. Bladder indwelling stents are the optimum method for achieving this benefit.

Download or read book P121 Timing of Ureteric Stent Removal and Occurrence of Urological Complications After Kidney Transplantation A Systematic Review and Meta analysis written by Jeffrey Anthony Lafranca and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction: Implanting a ureteric stent during ureteroneocystostomy reduces the risk of leakage and ureteral stenosis after kidney transplantation (KTx), but it may also predispose to urinary tract infections (UTI). The aim of this study is to determine a more definite moment for ureteric stent removal after KTx. Methods: Searches were performed in EMBASE, MEDLINE Ovid, Cochrane CENTRAL, Web of science and Google scholar. For this systematic review all aspects of the Cochrane Handbook for Interventional Systematic Reviews are followed and it is written based on the PRISMA-statement. Articles discussing JJ-stents and their time of removal in relation to outcomes were included. Studied outcome measures were UTI, urinary leakage, ureteral stenosis and re-intervention. Results: 1043 articles were identified, of which 14 articles were included. Meta-analysis showed a significant reduction of UTI when stents were removed earlier than three weeks (OR 0.49, p = 0.0009). Regarding incidence of urinary leakage, there is no significant difference between early ( three weeks) and late stent removal ( three weeks) (OR 0,60, p= 0,16). No meta-analysis could be performed on the outcome of ureteral stenosis, because of the lack data. Conclusion: Based on our results, earlier stent removal after KTx ( three weeks) is associated with a decreased incidence of UTI and does not show a higher incidence of urinary leakage compared to later removal ( three weeks). We recommend that the routine removal of ureteric stents implanted during KTx should be performed around three weeks postoperatively.

Download or read book Timing of Ureteric Stent Removal and Occurrence of Urological Complications After Kidney Transplantation written by Jeffrey Anthony Lafranca and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction: Implanting a ureteric stent during ureteroneocystostomy reduces the risk of leakage and ureteral stenosis after kidney transplantation (KTx), but it may also predispose to urinary tract infections (UTI). The aim of this study is to determine a more definite moment for ureteric stent removal after KTx. Methods: Searches were performed in EMBASE, MEDLINE Ovid, Cochrane CENTRAL, Web of science and Google scholar. For this systematic review all aspects of the Cochrane Handbook for Interventional Systematic Reviews are followed and it is written based on the PRISMA-statement. Articles discussing JJ-stents and their time of removal in relation to outcomes were included. Studied outcome measures were UTI, urinary leakage, ureteral stenosis and re-intervention. Results: 1043 articles were identified, of which 14 articles were included. Meta-analysis showed a significant reduction of UTI when stents were removed earlier than three weeks (OR 0.49, p = 0.0009). Regarding incidence of urinary leakage, there is no significant difference between early ( three weeks) and late stent removal ( three weeks) (OR 0,60, p= 0,16). No meta-analysis could be performed on the outcome of ureteral stenosis, because of the lack data. Conclusion: Based on our results, earlier stent removal after KTx ( three weeks) is associated with a decreased incidence of UTI and does not show a higher incidence of urinary leakage compared to later removal ( three weeks). We recommend that the routine removal of ureteric stents implanted during KTx should be performed around three weeks postoperatively.

Download or read book Novel Stent Removal Technology in Kidney Transplantation written by Amy Nagle and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction:Ureteric stents should be routinely used in kidney transplantation to reduce major urological complications. Standard practice is stent removal with flexible cystoscopy six weeks post-transplant. Increased rates of urinary tract infection (UTI) are associated with longer time transplant stents remain. Magnetic stents and Isiris single use technology allow outpatient portable removal. We aimed to investigate if the use of these technologies are feasible in kidney transplant patients and whether removal times could be reduced and outcomes improved.Methods:A prospective study of transplant stent removal in 181 patients who underwent either kidney transplant (KT) or simultaneous pancreas kidney transplantation (SPK) between 08/11/2017 and 12/08/2018. The type of stent, method of removal, location, time to removal and any procedure complications were recorded. 21 female patients had a 15cm magnetic stent inserted. All other patients had a standard 16cm stent.Results185 stent removal procedures were performed for 179 patients. 6 (3.3%) patients required two procedures to achieve stent removal. 47 (25.4%) removals used Isiris single use technology; performed in transplant outpatient clinic or occasionally on inpatient wards. 3 (6.5%) attempted Isiris removals required standard outpatient flexible cystoscopy to remove the stent. 107 (57.8%) used standard flexible cystoscopy. 10 (5.4%) stent removals were done in theatre under general anaesthetic or sedation. 14/21 (67%) magnetic stents were removed in transplant outpatient clinic. 4/21 (19%) magnet stents fell out early; 3/21 (6.5%) magnet stents required Isiris for removal. The mean time to stent removal (TtR) for all patients was 43.5 days (range 4 to 184 days). Mean Isiris TtR was 44 days. Mean magnet stent TtR was 29 days.DiscussionIsiris and magnetic stent technologies are feasible after kidneytransplantation. This has allowed for stent removal before discharge or during outpatient clinics. Both technologies have potential to reduce administration time, patient hospital visits and associated costs.

Download or read book P142 Novel Stent Removal Technology in Kidney Transplantation written by Amy Nagle and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction:Ureteric stents should be routinely used in kidney transplantation to reduce major urological complications. Standard practice is stent removal with flexible cystoscopy six weeks post-transplant. Increased rates of urinary tract infection (UTI) are associated with longer time transplant stents remain. Magnetic stents and Isiris single use technology allow outpatient portable removal. We aimed to investigate if the use of these technologies are feasible in kidney transplant patients and whether removal times could be reduced and outcomes improved.Methods:A prospective study of transplant stent removal in 181 patients who underwent either kidney transplant (KT) or simultaneous pancreas kidney transplantation (SPK) between 08/11/2017 and 12/08/2018. The type of stent, method of removal, location, time to removal and any procedure complications were recorded. 21 female patients had a 15cm magnetic stent inserted. All other patients had a standard 16cm stent.Results185 stent removal procedures were performed for 179 patients. 6 (3.3%) patients required two procedures to achieve stent removal. 47 (25.4%) removals used Isiris single use technology; performed in transplant outpatient clinic or occasionally on inpatient wards. 3 (6.5%) attempted Isiris removals required standard outpatient flexible cystoscopy to remove the stent. 107 (57.8%) used standard flexible cystoscopy. 10 (5.4%) stent removals were done in theatre under general anaesthetic or sedation. 14/21 (67%) magnetic stents were removed in transplant outpatient clinic. 4/21 (19%) magnet stents fell out early; 3/21 (6.5%) magnet stents required Isiris for removal. The mean time to stent removal (TtR) for all patients was 43.5 days (range 4 to 184 days). Mean Isiris TtR was 44 days. Mean magnet stent TtR was 29 days.DiscussionIsiris and magnetic stent technologies are feasible after kidneytransplantation. This has allowed for stent removal before discharge or during outpatient clinics. Both technologies have potential to reduce administration time, patient hospital visits and associated costs.

Download or read book Challenges in Pediatric Kidney Transplantation written by Katherine E. Twombley and published by Springer Nature. This book was released on 2021-06-26 with total page 429 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a comprehensive overview of the unique challenges inherent in pediatric kidney transplantation. The text reviews the problems faced during each stage of the kidney transplantation process, including the occurrence of infections during the pre-transplant stage, surgical challenges during the actual transplantation, and medication issues during the post-transplant stage. The book also features high-yield case presentations of typical pediatric transplant scenarios, from the pre-transplant management of a child with CAKUT to the evaluation and treatment of antibody mediated rejection in children. Written by experts in the field, Challenges in Pediatric Kidney Transplantation: A Practical Guide is a valuable resource for clinicians, practitioners, and trainees who manage or are interested in this challenging group of patients.

Download or read book Evidence Based Nephrology 2 Volume Set written by Jonathan C. Craig and published by John Wiley & Sons. This book was released on 2022-11-14 with total page 2903 pages. Available in PDF, EPUB and Kindle. Book excerpt: Das Werk Evidence-based Nephrology bietet Studenten der Nephrologie und praktizierenden Ärzten eine bequeme zentrale Quelle für medizinische Daten, die einen evidenzbasierten Filter durchlaufen sind. Die vollständig überarbeitete zweite Auflage enthält wichtige neue Daten, aktualisierte Methoden der Forschungssynthese sowie einen verstärkten Fokus auf die Einbindung eines größeren Publikums in die Bewertung und Behandlung von Nierenerkrankungen. Das überarbeitete Lehrwerk umfasst zwanzig neue Kapitel und drei neue Abschnitte, in denen die Themen unterstützende Pflege, patientenzentrierte Pflege und Behandlungserfolge besprochen werden. Zusätzlich wurden alle Kapitel aus der ersten Auflage umfassend aktualisiert. In der neuen Auflage werden die folgenden Themen behandelt: Epidemiologie, akute Nierenverletzungen, primäre Nierenerkrankungen, sekundäre Nierenerkrankungen, chronische Nierenerkrankungen und deren Komplikationen, Hämodialyse, chronische Nierenerkrankungen im Stadium 5, Peritonealdialyse, unterstützende Pflege, Transplantation, Elektrolyt- und Säure-Basen-Störungen sowie die patientenzentrierte Pflege und Behandlungsergebnisse bei Patienten im Kindes- und Erwachsenenalter. Durch den neuen Mitherausgeber und zahlreiche neue Autoren und Herausgeber der einzelnen Kapitel und Abschnitte erhalten die Leser mit dem Werk Evidence-based Nephrology nun ein noch besseres Fachbuch. Die Themen jedes einzelnen Kapitels werden systematisch aufgebaut und durch die besten derzeit verfügbaren Daten belegt. In der neuen Auflage werden die verfügbaren Daten noch umfassender behandelt und wichtige klinische Fragen zum Thema Behandlung und Versorgung von Patienten in allen Stadien chronischer Nierenerkrankungen angesprochen. Dies betrifft auch Patienten, die unterschiedliche Formen der Dialyse erhalten (Hämodialyse oder Peritonealdialyse), sowie Patienten, bei denen einen Nierentransplantation erforderlich ist, und pädiatrische Patienten. Die zweite Auflage von Evidence-based Nephrology ist ein wichtiges Referenzwerk für Ärzte, die sich mit evidenzbasierter Nephrologie befassen und meist nicht genügend Zeit haben, um jede Frage, die sich in der täglichen Versorgung ihrer Patienten ergibt, gründlich zu klären.

Download or read book Urinary Tract Infection written by Tomas Jarzembowski and published by BoD – Books on Demand. This book was released on 2018-06-27 with total page 128 pages. Available in PDF, EPUB and Kindle. Book excerpt: Urinary tract infection (UTI) is a problem so common and so significant in routine clinical practice that accurate diagnostics are especially important. In particular, complicated UTI is associated with an increased rate of therapy failures, as a result of possible biofilm formation on foreign elements and antibiotic resistance, as well as the increased possibility of an infection recurrence. These are the arguments for the constant search for novel diagnostic tools and techniques. These and many other vital topics regarding UTI complications, management, and treatment, in addition to antibiotic resistance and bacterial virulence traits allowing us to mitigate or avoid antibiotic action, are presented in this book.

Download or read book Kidney Transplantation Principles and Practice E Book written by Stuart J. Knechtle and published by Elsevier Health Sciences. This book was released on 2019-08-31 with total page 752 pages. Available in PDF, EPUB and Kindle. Book excerpt: Offering practical guidance for all members of the transplant team, Kidney Transplantation, Principles and Practice, 8th Edition, provides the balanced, up-to-date information you need to achieve optimal outcomes for your patients. A global team of internationally renowned surgeons and nephrologists, many new to this edition, offers fresh perspectives on everything from applied science and surgical techniques to immunosuppressive methods, outcomes, risks, and medical considerations related to kidney transplantation, in both adults and children. Offers state-of-the-art coverage of all areas of kidney transplantation such as preservation of kidneys; mechanisms of rejection and the induction of tolerance; techniques of laparoscopic live donor nephrectomy; and immunosuppression. Contains up-to-date outcomes data and analysis of the evidence supporting current practice in the field. Includes new information on desensitization and considerable new data on the clinical use of costimulation blockade. Keeps you current with new chapters on kidney allocation policy that reflects the ethical and societal values of different countries and populations; and biomarkers of kidney injury and rejection, including the need for better monitoring tools to guide therapy and patient management. Covers hot topics such as management of chronic allograft failure, the sensitized patient and antibody-mediated rejection, and paired exchange principles. Features hundreds of superb illustrations to help you visualize key concepts and nuances of renal transplantation. Provides dynamic visual guidance with new real-time video coverage of ultrasound-guided pancreas allograft biopsy; a new animation of calcineurin inhibitor mechanism of action animation; and videos that demonstrate the formation of an immune synapse, 3-D rotational images of immune synapses, an NK cell killing its target, peritoneal dialysis-catheter insertion techniques, laparoendoscopic single site (LESS) donor nephrectomy, and more.

Download or read book Understanding the Complexities of Kidney Transplantation written by Jorge Ortiz and published by BoD – Books on Demand. This book was released on 2011-09-06 with total page 578 pages. Available in PDF, EPUB and Kindle. Book excerpt: Kidney transplantation is a complex field that incorporates several different specialties to manage the transplant patient. This book was created because of the importance of kidney transplantation. This volume focuses on the complexities of the transplant patient. In particular, there is a focus on the comorbidities and special considerations for a transplant patient and how they affect kidney transplant outcomes. Contributors to this book are from all over the world and are experts in their individual fields. They were all individually approached to add a chapter to this book and with their efforts this book was formed. Understanding the Complexities of Kidney Transplantation gives the reader an excellent foundation to build upon to truly understand kidney transplantation.

Download or read book Current Issues and Future Direction in Kidney Transplantation written by Thomas Rath and published by BoD – Books on Demand. This book was released on 2013-02-13 with total page 494 pages. Available in PDF, EPUB and Kindle. Book excerpt: The here presented book covers different areas of clinical and scientific interest, reaching from donor evaluation to newest methods in immunological diagnostics. But also aspects of daily care of transplant recipients can be found in the carefully selected chapters. Everything driven by the aim to improve the care for all of our transplanted patients.

Download or read book Pediatric Renal Transplantation written by Amir H. Tejani and published by Wiley-Liss. This book was released on 1994-08-16 with total page 576 pages. Available in PDF, EPUB and Kindle. Book excerpt: A detailed, contributed reference offering broad coverage of renal transplantation in children. Diagnosis, the patient's medical management, operative methods, surgical and medical complications, donor selection, immunosuppression, late effects on growth and development and psychosocial factors are among the topics discussed. Features a chapter on how to set up and manage a pediatric renal transplant program.

Download or read book Recent Advances and Clinical Outcomes of Kidney Transplantation written by Charat Thongprayoon and published by . This book was released on 2020-09-10 with total page 270 pages. Available in PDF, EPUB and Kindle. Book excerpt: Advances in immunosuppression and kidney transplant techniques have led to significant improvements in the short-term survival of the renal allograft. Long-term graft survival, however, has relatively lagged behind and has now become one of the main problems in kidney transplantation. In this Special Issue, we discuss the recent research developments in kidney transplants that may affect long-term allografts, as well as the survival of the patient. The latest developments in living kidney donation are also explored.

Download or read book Renal and Metabolic Disorders written by John A. Kellum and published by Oxford University Press, USA. This book was released on 2013-02-07 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book presents a road map of the interactions among metabolic, electrolyte, acid-base and endocrine problems and suggesting clear lines of action for the ICU clinician. Each chapter provides guidelines for understanding "how did we get here" and "what should we do now", as quickly and safely as possible.

Download or read book Kidney Transplantation written by Andrzej Baranski and published by Springer Nature. This book was released on 2023-04-26 with total page 495 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a practically applicable guide to the latest techniques in kidney transplantation in an easy-to-digest format. Background is provided on relevant aspects of anatomy and physiology. Detailed step-by-step procedural guidance describes how to successfully perform benching surgery, kidney transplantation and graftectomy techniques. Surgical methods of non-laparoscopic kidney procurement from deceased and living donors are also covered. Potential complications with relevant prevention and resolution strategies are discussed to assist the reader in developing a deep understanding of the methodologies presented. In this book, the author shares his knowledge and experience gained over 35 years in the field of kidney procurement, preparation and transplantation. The book is a monograph and contains many of the author's individual views on certain kidney procurement and transplantation techniques. Kidney Transplantation: Step-by-Step Surgical Techniques is a concise overview of techniques for kidney procurement, benching and transplantation. Therefore, it is a valuable resource for all practicing and trainee practitioners who encounter these patients in their day-to-day practice.

Download or read book Oxford Textbook of Urological Surgery written by Freddie C. Hamdy and published by Oxford University Press. This book was released on 2017-10-06 with total page 1201 pages. Available in PDF, EPUB and Kindle. Book excerpt: Offering a comprehensive guide, the Oxford Textbook of Urological Surgery is a practical resource mapped to the curriculum for urological training as approved by the General Medical Council (GMC), making it particularly useful in preparation for the Intercollegiate Examination. Presented in a clear and accessible way, this evidence based volume covers all major areas, including functional urology, stone disease, infection, andrology, nephrology, transplantation, uroradiology, and paediatric urology. This highly illustrated full colour textbook has an innovative and user-friendly style, including over 500 photographs, clinical images, and line drawings. Bringing together the expertise of over 100 specialist contributors in the field, the Oxford Textbook of Urological Surgery is a highly valuable source of information, and will become the standard reference text for all who study urological disease and its treatment.

Download or read book Biomaterials and Tissue Engineering in Urology written by J. Denstedt and published by CRC Press. This book was released on 2009-06-05 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: An invaluable resource for clinicians as well as for researchers in materials and biomedical devices, this text summarizes recent research on the use of biomaterials and tissue engineering in the treatment of urological disorders. Part one reviews the fundamentals including biofilms and encrustation formation. Part two then discusses recent advances in biomaterials and the design of urological devices such as metal ureteral stents, self-lubricating catheter materials, and penile implants. The final section addresses urological tissue engineering, covering artificial and natural biomaterials, nanotechnology, and placental stem cells used for the regeneration of urological tissue and organs.