A5007567881- Renal Transplantation Outcomes and Treatments
- Organ Donation and Transplantation
- Organ Transplantation Techniques and Outcomes
- Neurological Complications and Syndromes
- Renal and Vascular Pathologies
- Transplantation: Methods and Outcomes
- Liver Disease and Transplantation
- Geriatric Care and Nursing Homes
- Pharmacological Effects and Toxicity Studies
- Pregnancy and Medication Impact
- Polyomavirus and related diseases
- Viral-associated cancers and disorders
- Ethics in Clinical Research
- Palliative Care and End-of-Life Issues
- Renal Diseases and Glomerulopathies
- Blood donation and transfusion practices
- Cytomegalovirus and herpesvirus research
- Organ and Tissue Transplantation Research
- Potassium and Related Disorders
- Bone and Joint Diseases
- Frailty in Older Adults
- Magnesium in Health and Disease
- Pneumocystis jirovecii pneumonia detection and treatment
- Electronic Health Records Systems
- Complement system in diseases
University Health Network
2016-2025
University of Toronto
2014-2025
Toronto General Hospital
2015-2024
Kidney Associates
2014
Delayed graft function (DGF) is commonly considered a risk factor for acute rejection, although this finding has not been uniformly observed across all studies. The link between DGF and rejection may have changed over time due to advances in immunosuppression medical management. Here we conducted cohort study of 645 patients 12 years evaluate the association biopsy-proven (BPAR) modern kidney transplant recipients. was defined as need at least one dialysis session first week after...
Outcomes of kidney transplant recipients with increased body mass index (BMI) remain controversial. We studied the relationship between BMI and clinically relevant outcomes among at a large center.We performed an observational cohort study all transplants our center from January 1, 2000 to December 31, 2010 determine if transplantation is associated adverse outcomes, including delayed graft function biopsy-proven acute rejection (BPAR). Recipient was categorized as <20, 20 24.9 (reference),...
Several studies suggest a link between post-transplant hypomagnesemia and new-onset diabetes after transplantation (NODAT), but this relationship remains controversial. We conducted retrospective cohort study of 948 nondiabetic kidney transplant recipients from January 1, 2000, to December 31, 2011, examine the association serum magnesium level NODAT. Multivariable Cox proportional hazards models were fitted evaluate risk NODAT as function baseline (at 1 month), time-varying (every 3...
Abstract Background Kidney transplantation (KT) improves clinical outcomes of patients with end stage renal disease. Little has been reported on the impact early post-operative surgical complications (SC) long-term following KT. We sought to determine vascular complications, urological site and peri-graft collections within 30 days patient survival, graft function, hospital readmissions. Methods conducted a single-centre, observational cohort study examining adult (≥ 18 years) who received...
Antibody-mediated rejection (AMR) accounts for >50% of kidney allograft loss. Donor-specific antibodies (DSA) against HLA and non-HLA antigens in the glomeruli tubulointerstitium cause AMR while inflammatory cytokines such as TNFα trigger graft injury. The mechanisms governing cell-specific injury remain unclear.Unbiased proteomic analysis laser-captured microdissected was performed on 30 for-cause biopsy specimens with early AMR, acute cellular (ACR), or tubular necrosis (ATN).A total 107...
The Kidney Transplant Program at the Toronto General Hospital uses numerous electronic health record platforms housing patient information that is often not coded in a systematic manner to facilitate quality assurance and research. To address this, comprehensive renal transplant research system was conceived by multidisciplinary healthcare team. Data analysis from presented programmatic retreats, scientific meetings, peer-reviewed manuscripts contributes improvement knowledge kidney transplantation.
We examined if African or Asian ethnicity was associated with lower access to kidney transplantation (KT) in a Canadian setting.Patients referred for KT the Toronto General Hospital from January 1, 2003, December 31, 2012, who completed social work assessment, were included (n = 1769). The association between and time referral completion of evaluation receipt using Cox proportional hazards models.About 54% sample white, 13% African, 11% East Asian, South Asian; 7% had "other" 121) ethnic...
Living kidney donor evaluation commonly includes nuclear renography to assess split function and computed tomography (CT) scan evaluate anatomy. To streamline workup minimize exposure radioisotopes, we sought the feasibility of using proportional volume from CT volumetry in lieu renography. We examined correlation between techniques assessed their ability predict residual postoperative following live nephrectomy. In a cohort 224 donors, compared derived by with found only modest (left R(2)...
CMV-D+/R- serostatus is the only well-established risk factor for late-onset cytomegalovirus (CMV) infection/disease (i.e., incident CMV after cessation of prophylactic antiviral therapy). This study aimed to explore other potential factors in kidney transplant recipients.We conducted a retrospective cohort 641 recipients Toronto, Canada, from January 1, 2003, December 31, 2010. The cumulative incidence was assessed using Kaplan-Meier product-limit method. Potential were examined Cox...
Despite comprehensive multidisciplinary candidacy assessments to determine appropriateness for solid organ transplantation, limitations persist in identifying candidates at risk of adverse outcomes. Frailty measures may help inform evaluation. Our main objective was create a transplant frailty index (FI), using the cumulative deficits model, from data routinely collected during assessments. Secondary objectives included creating social vulnerability (SVI) assessment and evaluating...
Early hospital readmissions (EHRs) after kidney transplantation range in incidence from 18%-47% and are important substantial healthcare quality indicators. EHR can adversely impact clinical outcomes such as graft function patient mortality well costs. EHRs have been extensively studied American systems, but these associations not explored within a Canadian setting. Due to significant differences the delivery of outcomes, results studies cannot be readily applicable populations. A better...
Intraoperative hypotension is associated with acute kidney injury after surgery. However, the definition (duration and magnitude) of during transplantation (KT) surgery on early graft function remains unclear.
The association of hyperuricemia with kidney allograft outcomes remains controversial. We studied this problem in 1170 transplants from January 2000 to December 2010. primary endpoint was total graft failure (i.e. loss or death). Conventional, time-dependent and marginal structural Cox proportional hazards models were fitted, the latter accounting for function as a time-varying confounder affected by prior uric acid levels. Uric level associated an increased risk time-fixed (HR 1.02 [95% CI:...
In Brief Background Kidney transplant recipients (KTR) may be at increased risk for Clostridium difficile infections (CDI) but factors and outcomes in this population have not been well studied. Methods An observational cohort study was conducted to determine the incidence, factors, of CDI KTR. A total 1816 KTR transplanted between 2000 2013 Toronto General Hospital were included. Sixty-eight patients developed CDI. Controls selected a 4:1 ratio using risk-set sampling, explored conditional...
Context: Valganciclovir is used not only for cytomegalovirus prophylaxis after kidney transplantation but can also induce leukopenia, thereby making patients more susceptible to other infections. The epidemiology of leukopenia in on valganciclovir remains poorly understood. Objective: To determine the incidence and risk factors receiving transplantation. Methods: In this single-center, retrospective, cohort study, we included recipients transplanted from January 1, 2003, December 31, 2010,...
Posttransplant lymphoproliferative disorder (PTLD) is a severe complication after kidney transplantation. This study examined the incidence, risk factors, clinical management, and outcomes of PTLD in cohort transplant recipients.This single-center included 1642 patients transplanted from January 1, 2000, to December 31, 2012, with follow-up until 2013. The incidence factors for were using Cox proportional hazards model. A model was also used assess association graft outcomes.Sixteen...
Kidney transplant recipients are at risk for complications resulting in early hospital readmission. This study sought to determine the incidences, factors, causes, and financial costs of readmissions.This single-centre cohort included 1461 kidney from 1 Jul 2004 31 Dec 2012, with least 1-year follow-up. Early readmission was defined as hospitalization within 30 or 90-days postdischarge admission. Associations between various parameters posttransplant were determined using multivariable Cox...
A history of mental health (MH) disorders or nonadherence (NA) may be barriers to completing the work-up (WU) and/or undergoing kidney transplantation (KT) but this has not been well documented. In work, we analyzed relationship between a MH NA and likelihood WU KT.Patients referred for KT Toronto General Hospital from January 1, 2003, December 31, 2012, who completed social work assessment, were included (n = 1769). The association time referral completion examined using Cox proportional...
Cross-sectional studies of patients dependent on dialysis show that they have a high need for help with routine daily activities. In many cases, individuals who undergo kidney transplantation previously been treated significant period time, thus the characteristics may be similar. The purpose this study was to estimate rate functional disability in cross-sectional population older functioning transplant.Kidney transplant patients, aged 65 years or more, were approached participate. Patients...