Renal & Vascular Diseases

Comparison of symptom management strategies for pain, erectile dysfunction, and depression in patients receiving chronic hemodialysis: A cluster randomized effectiveness trial - Abstract

BACKGROUND AND OBJECTIVES: Pain, erectile dysfunction (ED), and depression are common yet frequently untreated in chronic hemodialysis patients.

Contrast-enhanced ultrasound assessment of complex cystic lesions in renal transplant recipients with acquired cystic kidney disease: Preliminary experience - Abstract

We prospectively studied the potential value of contrast-enhanced ultrasound (CEUS) to characterize complex acquired cystic kidney disease (ACKD) or suspected solid renal masses, avoiding the risk of inducing acute kidney injury in 138 renal transplant recipients by contrast-enhanced computed tomography (CT).

Conversion from calcineurin inhibitors to everolimus with low-dose cyclosporine in renal transplant recipients with squamous cell carcinoma of the skin - Abstract

Squamous cell carcinoma of the skin (SCC) is the most frequent cancer in renal transplant recipients.

Chronic kidney disease in patients with ileal conduit urinary diversion - Abstract

While renal dysfunction is often observed in patients following urinary diversion due to bladder cancer, there have been few studies on this subject.

Debilitating lower urinary tract symptoms in the post-renal transplant population can be predicted pretransplantation - Abstract

BACKGROUND: Overactive bladder and benign prostatic hyperplasia commonly cause lower urinary tract symptoms (LUTS) in the renal transplant (RTx) population.

Congenital seminal vesicle cyst associated with ipsilateral renal agenesis and cryptorchidism causing bladder outlet obstruction: A case report and review of the literature - Abstract

Seminal vesicle cysts combined with ipsilateral renal agenesis are a rare urological anomaly. We present a 24-year-old single man who suffered from difficulty urinating and irritative voiding symptoms for 4 years. The symptoms worsened in the last 6 months. A physical examination revealed right cryptorchidism with a pelvic mass. Digital rectal examination revealed a palpable large soft mass behind the prostate.

Minimal fat renal angiomyolipoma: The initial study with contrast-enhanced ultrasonography - Abstract

We visualized minimal fat renal angiomyolipomas (AMLs) by contrast-enhanced ultrasonography (CEUS).

Risk of de novo cancers after transplantation: Results from a cohort of 7217 kidney transplant recipients, Italy 1997-2009 - Abstract

To assess incidence and risk factors for de novo cancers (DNCs) after kidney transplant (KT), we carried out a cohort investigation in 15 Italian KT centres.

Common and uncommon bilateral adult renal masses - Abstract

Masses can involve the kidney unilaterally or bilaterally.

Immediate renal transplantation after radical prostatectomy for low-risk prostate cancer - Abstract

INTRODUCTION: For most cancers, a two- to five-yr period with no evidence of disease must be demonstrated before organ transplantation.

Primary hyperoxaluria Type 1, a too often missed diagnosis and potentially treatable cause of end-stage renal disease in adults: Results of the Dutch cohort - Abstract

Background: Primary hyperoxaluria Type 1, an inherited disorder with increased endogenous oxalate production, leads to the development of urolithiasis, nephrocalcinosis and end-stage renal disease (ESRD).

Inflammatory pseudotumor of the kidney mimicking malignancy on 18F-FDG PET/CT in a patient with diabetes and hepatocellular carcinoma - Abstract

Inflammatory pseudotumor (IPT) is a pseudoneoplastic lesion that most commonly involves lung.

Isolated renal hydatid cyst: A rare occurrence - Abstract

A 20-year-old female presented with upper abdominal pain. The renal function tests and liver function tests were within normal range.

Urologic de novo malignancies after kidney transplantation: A single center experience - Abstract

INTRODUCTION:Urologic cancers are the second or third most common malignancies in renal transplant (RT) recipients.

Fever of unknown origin (FUO) and a renal mass: Renal cell carcinoma, renal tuberculosis, renal malakoplakia, or xanthogranulomatous pyelonephritis? - Abstract

Often patients with fevers of unknown origin (FUOs) present with loss of appetite, weight loss, and night sweats, without localizing signs.

Malignancies after kidney transplantation: Hong Kong renal registry - Abstract

Manystudies have shown that kidney transplant recipients have a higher incidence of cancers when compared with general population.

Single-port kidney removal through the belly button boosts living-donor satisfaction

BALTIMORE, MD USA (Press Release) - September 12, 2012 -

University of Maryland study findings advance navel nephrectomy as standard of care

In the largest study of its kind, living donors who had a kidney removed through a single port in the navel report higher satisfaction in several key categories, compared to donors who underwent traditional multiple-port laparoscopic removal.

The new technique has been described as virtually scarless, because nearly the entire incision, once healed, is hidden within the belly button. Researchers at the University of Maryland School of Medicine in Baltimore found the belly button group had significantly improved satisfaction with the cosmetic outcome and the overall donation process. Additionally, the new technique was associated with fewer limitations in bending, kneeling or stooping following surgery, and slightly less pain after surgery, compared to the multi-port approach. At the same time, the study found the two procedures equally safe. The results are published online today in the Annals of Surgery.

“Everything we do in organ transplantation is based on the generosity of organ donors,” says lead author Rolf Barth, M.D., associate professor of surgery at the University of Maryland School of Medicine and transplant surgeon at University of Maryland Medical Center. “If we as surgeons can safely improve the donation process for our living donors by perfecting less-invasive surgical options, we should embrace these new approaches.”

Single-port donor nephrectomy (kidney removal), also known as laparoendoscopic single-site (LESS) surgery, has been the standard of care for living kidney donors at the University of Maryland Medical Center (UMMC) for the past three years; however, no objective data previously existed to compare the single-port with the multiple-port laparoscopic techniques. UMMC is only the third hospital in the country to consistently use this surgical approach on living donors and, to date, has employed the single-port technique in 215 donors.

“Once this surgical procedure came to our attention, we wasted no time in adopting this as our standard technique in 2009,” says senior author Benjamin Philosophe, M.D., Ph.D., associate professor of surgery at the University of Maryland School of Medicine and Head, Section of Liver Transplantation and Hepatobiliary Surgery at the University of Maryland Medical Center. “It seemed like the logical next step in the surgical evolution of living donation.”

The researchers took a two-pronged approach. They analyzed the surgical results of 135 single-port and 100 multi-port donors from the UMMC patient database and measured transplant outcomes. They also sent two questionnaires to 100 single-port patients and a group of 100 multi-port donors – all of whom had their procedures performed by the same surgeons with similar laparoscopic equipment at the University of Maryland Medical Center.

The analysis determined that LESS surgery is a safe option for kidney donation without increasing risks or complications to the donor. Single-port nephrectomy leaves only one small scar in the center of the navel, which typically fades over time. The multi-port approach leaves several scars. Beyond the cosmetic benefit, the data suggested single-port donors were more satisfied with their donation decision. “For a living kidney donor who leaves the operating room with no health benefit from the surgical procedure and only a small band-aid over the umbilicus, LESS may be more,” says Barth.

“The single-port donor nephrectomy operation is more technically challenging than the standard multiple-port donation technique used nearly everywhere else in the U.S.” says Stephen T. Bartlett, M.D., the Peter Angelos Distinguished Professor; chair, Department of Surgery at the University of Maryland School of Medicine; and surgeon-in-chief at the University of Maryland Medical System. “Our Division of Transplantation has a long-standing reputation for leading the way in transplant innovation, and our surgeons are handpicked for their ability to master complex surgical techniques and consistently try to make the patient’s experience as safe and effective as possible.”

“Our transplant surgeons work tirelessly to assess and improve every angle of the transplant process,” says E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs, University of Maryland; the John Z. and Akiko K. Bowers Distinguished Professor; and dean, University of Maryland School of Medicine. “The standard of care elsewhere is not good enough for our patients, and this team of surgeons continues to impress me with their commitment to the advancement of medicine through surgical excellence.”

The UMMC transplant team is conducting workshops to train other transplant surgeons in the LESS technique, and has been selected to author a chapter on this technique in the surgical textbook Kidney Transplantation.

This study on single-port donor nephrectomy is a natural milestone in the surgical advancement of living kidney donation. In 2003, UMMC urologist Michael W. Phelan, M.D., a co-author of this Annals of Surgery paper, published a study on the advances in laparoscopic nephrectomy, which accurately predicted the increased use and standardization of laparoscopic techniques for kidney donation.

According to the Organ Procurement and Transplantation Network (OPTN), as of June 1, 2012, more than 92,000 people are on the kidney transplant waiting list in the U.S. Living donation can help many patients receive a transplant sooner and avoid dialysis or deteriorating health that often occurs while waiting for a transplant from a deceased donor.

The University of Maryland Division of Transplantation, which focuses on kidney, pancreas and liver transplantation, is one of the nation’s largest transplant programs, set to exceed 400 transplants in 2012. The Division offers living donation as an option for liver and kidney patients to decrease patient wait times and improve patient outcomes.

About the University of Maryland School of Medicine, University of Maryland Medical Center

Founded in 1807, the University of Maryland School of Medicine in Baltimore is the oldest public medical school in the United States, and the first to institute a residency training program. The School of Medicine was the founding school of the University of Maryland and today is an integral part of the 11-campus University System of Maryland. The partnership between the University of Maryland Medical Center (UMMC) and the University of Maryland School of Medicine allows cutting edge medical research and discovery to rapidly innovate and improve patient care and prepare the next generation of health care professionals through excellent training and education. The University of Maryland Medical Center (UMMC) is a 779-bed teaching hospital in Baltimore and the flagship institution of the 11-hospital University of Maryland Medical System. Patients are referred nationally and regionally for advanced medical, surgical and critical care. All physicians on staff at the Medical Center are faculty physicians of the University of Maryland School of Medicine.

View Video: Kidney Donation Surgery Through One Port in Belly Button Preferred By Living Donors

Barth RN, Phelan MW, Goldschen L, Munivenkatappa RB, Jacobs SC, Bartlett ST, Philosophe B. “Single-port donor nephrectomy provides improved patient satisfaction and equivalent outcomes.” Annals of Surgery. DATE NEEDED DOI: 10.1097/SLA.0b013e318262ddd6

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University of Maryland School of Medicine
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A comparative study of 3-week and 6-week duration of double-J stent placement in renal transplant recipients - Abstract

Purpose:To compare the efficiency and safety of 3-week and 6-week duration of double-J stent placement in patients who received a kidney transplant.

Renal pedicle vessel control during transperitoneal laparoscopic nephrectomy using Hem-o-lok clips with and without LigaSure sealing - Abstract

INTRODUCTION: The technique used to control and divide the renal vessels during laparoscopic nephrectomy is critical to successful surgical outcomes.

Electrocardiographic changes in patients undergoing hemodialysis - Abstract

INTRODUCTION: Patients with end-stage renal disease who are on long-term dialysis support have a very high mortality. Nearly half of deaths on dialysis are secondary to myocardial infarction, cardiac arrest, malignant arrhythmias, and other cardiac causes. The purpose of the present study was to compare electrocardiogram (ECG) disturbances before and after hemodialysis.