Browsing by Subject "Kidney Transplantation"

Sort by: Order: Results:

Now showing items 1-13 of 13
  • Helanterä, Ilkka; Isola, Timo; Lehtonen, Taru K.; Åberg, Fredrik; Lempinen, Marko; Isoniemi, Helena (2019)
    Background: Kidney transplantation is reported to save costs compared to maintenance dialysis. We analyzed the current actual costs of kidney transplantation compared to dialysis, and analyzed risk factors for higher costs after transplantation. Material/Methods: Altogether, 338 kidney transplant recipients between 2009 and 2014 were included in this study. All individual-level cost data from specialized health care and data from all reimbursed medication and travel costs were acquired from official records. Cost data were compared before and after transplantation within the same patients starting from dialysis initiation and continued until the end of follow-up at the end of 2015. Results: Total annual costs were median 53 275 EUR per patient in dialysis, 59 583 EUR for the first post-transplantation year (P Conclusions: After the first posttransplant year the costs of a kidney transplant patient for the health care system are
  • Räihä, Juulia; Helanterä, Ilkka; Ekstrand, Agneta; Nordin, Arno; Sallinen, Ville; Lempinen, Marko (2019)
    Background: Pretransplant dialysis modality may affect outcome after simultaneous pancreas-kidney transplantation (SPKT), and it has been suspected that peritoneal dialysis (PD) is associated with more postoperative complications compared to hemodialysis (HD). The aim of this study was to evaluate whether pretransplant dialysis modality affects the risk for postoperative complications in SPKT recipients. Material/ Methods: This was a retrospective longitudinal cohort study of all patients undergoing SPKT from 2010 to 2017, during which 99 simultaneous pancreas-kidney transplantations were performed. Three pre-emptive transplantations were excluded. Patient groups receiving PD (n=59) or HD (n=37) were similar regarding baseline characteristics. All complications occurring during the first 3 months after transplantation, as well as patient and graft survival, were analyzed. Results: There were no significant differences in postoperative complications between groups, with similar rates of intraabdominal infections (8% in HD vs. 10% in PD), pancreatitis (16% in HD vs. 17% in PD), gastrointestinal bleedings (22% in HD vs. 10% in PD), and relaparotomies (27% in HD vs. 24% in PD). None of the patients had venous graft thrombosis. Past peritonitis was not associated with increased risk for postoperative complications in PD patients. Patient and graft survival were similar between PD and HD groups. Conclusions: Peritoneal dialysis is not a risk factor for postoperative complications after SPKT.
  • Vink, P.; Torrell, J.M.R.; Fructuoso, A.S.; Kim, Sung-Joo; Kim, Sang-Il; Zaltzman, J.; Ortiz, F.; Plana, J.M.C.; Rodriguez, A.M.F.; Rodrigo, H.R.; Marti, M.C.; Perez, R.; Roncero, F.M.G.; Kumar, D.; Chiang, Y.-J.; Doucette, K.; Pipeleers, L.; Morales, M.L.A.; Rodriguez-Ferrero, M.L.; Secchi, Antonio; McNeil, S.A.; Campora, L.; Di Paolo, E.; El Idrissi, M.; López-Fauqued, M.; Salaun, B.; Heineman, T.C.; Oostvogels, L. (2020)
    Background. The incidence of herpes zoster is up to 9 times higher in immunosuppressed solid organ transplant recipients than in the general population. We investigated the immunogenicity and safety of an adjuvanted recombinant zoster vaccine (RZV) in renal transplant (RT) recipients ≥18 years of age receiving daily immunosuppressive therapy. Methods. In this phase 3, randomized (1:1), observer-blind, multicenter trial, RT recipients were enrolled and received 2 doses of RZV or placebo 1-2 months (M) apart 4-18M posttransplant. Anti-glycoprotein E (gE) antibody concentrations, gE-specific CD4 T-cell frequencies, and vaccine response rates were assessed at 1M post-dose 1, and 1M and 12M post-dose 2. Solicited and unsolicited adverse events (AEs) were recorded for 7 and 30 days after each dose, respectively. Solicited general symptoms and unsolicited AEs were also collected 7 days before first vaccination. Serious AEs (including biopsy-proven allograft rejections) and potential immune-mediated diseases (pIMDs) were recorded up to 12M post-dose 2. Results. Two hundred sixty-four participants (RZV: 132; placebo: 132) were enrolled between March 2014 and April 2017. gE-specific humoral and cell-mediated immune responses were higher in RZV than placebo recipients across postvaccination time points and persisted above prevaccination baseline 12M post-dose 2. Local AEs were reported more frequently by RZV than placebo recipients. Overall occurrences of renal function changes, rejections, unsolicited AEs, serious AEs, and pIMDs were similar between groups. Conclusions. RZV was immunogenic in chronically immunosuppressed RT recipients. Immunogenicity persisted through 12M postvaccination. No safety concerns arose. © The Author(s) 2019.
  • Helanterä, Ilkka; Ekstrand, Agneta; Lempinen, Marko (2017)
  • Helanterä, Ilkka; Ahopelto, Kaisa; Lempinen, Marko (2020)
    Munuaisensiirtoja elävältä luovuttajalta on Suomessa perinteisesti tehty vain vähän, mutta niiden määrää on viime vuosina pyritty lisäämään. Uusi kudoslaki mahdollistaa yhä useamman toimimisen elävänä luovuttajana. Munuaisluovuttajan riskit ovat vähäiset ja nykyään erittäin hyvin tunnetut.
  • Finne, Patrik; Helanterä, Ilkka; Lempinen, Marko (2019)
    Odotusajan lyheneminen vaikuttaisi suotuisasti potilaiden elämään.
  • Paajanen, Hanna; Tuomi, Tiinamaija (2019)
  • Helanterä, Ilkka; Peltonen, Reetta (2019)
  • Helanterä, Ilkka; Lempinen, Marko (2017)
  • Helanterä, Ilkka; Isoniemi, Helena; Lempinen, Marko; Nordin, Arno; Honkanen, Eero; Jalanko, Hannu; Huhti, Jutta; Tertti, Risto; Miettinen, Marja; Mäkelä, Satu (2017)
  • Hölttä, Tuula; Jalanko, Hannu (2019)
    Nefroottisen oireyhtymän (NS) taustalla on epäyhtenäinen ryhmä munuaissairauksia, joita esiintyy kaiken ikäisillä. Steroidihoitoon reagoiva nefroottinen oireyhtymä on lapsuuden yleisin munuaiskeräsen sairaus. Ennuste on hyvä. Lääkehoito tehoaa huonosti noin 20 %:lla potilaista. Heistä pienellä osalla oireyhtymän aiheuttaa geenivirhe. Geenitutkimuksia suositellaan muun muassa potilaille, joilla ensimmäinen sairausjakso on todettu alle vuoden ikäisenä. Samoin, jos sairaus ei rajoitu munuaisiin tai suunnitellaan munuaisensiirtoa.
  • Måsabacka, Marie (Helsingfors universitet, 2009)
    Chronic allograft nephropathy is still the major cause for loss of transplanted kidneys. A prominent feature is luminal narrowing of blood vessels due to proliferating and migrating smooth muscle cells (SMCs). The mechanism is much like that of atherosclerosis. We hypothesized that platelet derived growth factor (PDGF), vascular endothelial growth factor and epidermal growth factor play an important role in the process. This was based on the observation that drugs inhibiting these growth factors decreased luminal narrowing in a rat model. To test the hypothesis SMC were cultured in vitro. They were stimulated to proliferate with PDGF. After this, two growth factor inhibitors, sunitinib and erlotinib, were administered to the culture in three different doses. The results are clear: both sunitinib and erlotinib inhibit SMC proliferation in a dose dependent matter. If SMC proliferation and migration could be prevented, it could potentially result in a decrease of late allograft loss.
  • Nordin, Arno (2020)
    Vatsanalueen elinsiirrot ovat lisääntyneet, mistä kiitos kuuluu elinluovuttajia tunnistaville ja hoitaville tahoille. Tarvitaan kuitenkin edelleen aktiivisia toimia, jotta luovuttajien määrä saataisiin lisääntymään nykyisestä.