Effective treatment of prenatal testing: A Synthesis of Findings from 20 Studies

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Original Abstract of the Article

Main Research Findings

Kidney transplantation is associated with lower mortality and improved quality of life compared to chronic dialysis treatment. 4 The benefits of transplantation seem to increase over time. 4 Kidney transplantation is the optimal treatment strategy for end-stage renal disease. 10 However, antibody-mediated rejection can be a challenge in transplantation. 10 Therapeutic plasma exchange is effective in reducing autoantibodies. 10 Early diagnosis and precise treatment are crucial in reducing morbidity, mortality, and economic costs. 10 Machine perfusion preservation is a new method for kidney preservation. 12 It has the potential to improve graft function after transplantation compared to traditional static cold storage. 12

Treatment Summary

Cyclosporine has improved early graft survival but long-term use is associated with impaired renal function and increased cardiovascular risk factors. 1 Converting to azathioprine or mycophenolate mofetil after one year can help to avoid these adverse effects. 1 Mycophenolic acid is believed to be more potent than azathioprine and has largely replaced it as the first-line agent in primary immunosuppression. 7 However, mycophenolic acid is more expensive. 7 Tacrolimus and cyclosporine, both calcineurin inhibitors, are used for immunosuppression after kidney transplantation. 3 These agents block the pathway of T cell activation and proliferation. 3

Benefits and Risks

Benefit Summary

Kidney transplantation has several benefits compared to chronic dialysis, including lower mortality, improved quality of life, and reduced risk of cardiovascular events. 4 The benefits of transplantation seem to increase over time. 4

Risk Summary

Kidney transplantation has risks such as rejection, infection, and drug side effects. 10 Immunosuppressive medications are needed to prevent rejection, which can increase the risk of infection. 10 Early diagnosis and precise treatment of rejection are important to minimize morbidity, mortality, and economic costs. 10 Preventing ischemia-reperfusion injury is also crucial during the transplant process. 12

Comparison Between Studies

Commonalities

Multiple studies have shown that kidney transplantation is superior to chronic dialysis. 4 The benefits include lower mortality, improved quality of life, and reduced risk of cardiovascular events. 4 Rejection is a major concern in transplantation. 10 Therapeutic plasma exchange is used to treat rejection. 10

Differences

Each study used different treatments and evaluation methods. 1 For example, some studies investigated converting from cyclosporine to azathioprine or mycophenolate mofetil. 1 The success rates of transplantation and the incidence of rejection varied between studies. 10 Therapeutic plasma exchange is particularly effective in treating antibody-mediated rejection. 10 Machine perfusion preservation is a new method for kidney preservation and may improve graft function after transplantation compared to traditional static cold storage. 12

Consistency and Contradictions

Several studies consistently indicate that kidney transplantation is a superior option to chronic dialysis. 4 However, it is challenging to directly compare the results due to varying treatments and evaluation methods used. 1 The success rates of transplantation and the incidence of rejection varied between studies. 10 Therefore, a comprehensive interpretation of these findings is necessary. 10 Therapeutic plasma exchange is particularly effective in treating antibody-mediated rejection. 10 Machine perfusion preservation is a new method for kidney preservation and may improve graft function after transplantation compared to traditional static cold storage. 12

Practical Applications and Considerations

Kidney transplantation is an effective treatment for end-stage renal disease, but it carries risks such as rejection and infection. 10 Understanding these risks and consulting with a physician is essential when considering transplantation. 10 Therapeutic plasma exchange is particularly effective in treating antibody-mediated rejection. 10 Machine perfusion preservation is a new method for kidney preservation and may improve graft function after transplantation compared to traditional static cold storage. 12

Limitations of Current Research

Many studies rely on observational research, which is susceptible to selection bias and confounding factors. 4 Therefore, careful interpretation of these results is necessary. 4 Therapeutic plasma exchange is particularly effective in treating antibody-mediated rejection. 10 Machine perfusion preservation is a new method for kidney preservation and may improve graft function after transplantation compared to traditional static cold storage. 12

Future Research Directions

Further research is needed to evaluate the long-term effectiveness and safety of kidney transplantation. 4 Development of new treatments to prevent rejection and novel preservation methods to prevent ischemia-reperfusion injury are also crucial areas for future research. 10 Therapeutic plasma exchange is particularly effective in treating antibody-mediated rejection. 10 Machine perfusion preservation is a new method for kidney preservation and may improve graft function after transplantation compared to traditional static cold storage. 12

Conclusion

Kidney transplantation provides several benefits over chronic dialysis, including lower mortality and improved quality of life. 4 However, risks such as rejection and infection are also present. 10 It is crucial to understand these risks and consult with a physician before considering transplantation. 10 Therapeutic plasma exchange is particularly effective in treating antibody-mediated rejection. 10 Machine perfusion preservation is a new method for kidney preservation and may improve graft function after transplantation compared to traditional static cold storage. 12

Treatment List

Cyclosporine, azathioprine, mycophenolate mofetil, tacrolimus, calcineurin inhibitors, therapeutic plasma exchange, machine perfusion preservation

Literature analysis of 20 papers
Positive Content
20
Neutral Content
0
Negative Content
0
Article Type
3
5
12
6
20
1.

Randomized study on the conversion of treatment with cyclosporine to azathioprine or mycophenolate mofetil followed by dose reduction.

Author: Smak GregoorP J, van GelderT, van BesouwN M, van der MastB J, IJzermansJ N, WeimarW

Improved graft survival
Reduced CsA-related adverse effects

This study examined the long-term use of cyclosporine (CsA) in kidney transplantation and the benefits of switching patients to azathioprine (AZA) or mycophenolate mofetil (MMF) after one year to avoid CsA-related adverse effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

Spectrum of surgical complications after simultaneous pancreas-kidney transplantation in a prospectively randomized study of two immunosuppressive protocols.

Author: SteurerWolfgang, MalaiseJacques, MarkWalter, KoenigsrainerAlfred, MargreiterRaimund,

SPK transplantation
Surgical complications

This report analyzes the surgical complications experienced by patients receiving tacrolimus and cyclosporin microemulsion (ME)-based therapy for simultaneous pancreas-kidney transplantation (SPK).

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Tacrolimus versus cyclosporin as primary immunosuppression for kidney transplant recipients.

Author: WebsterA, WoodroffeR C, TaylorR S, ChapmanJ R, CraigJ C

Improved kidney transplant treatment
Reduced rejection
End-stage renal disease

Kidney transplantation is the best treatment for most people with end-stage kidney disease. Standard treatment involves a combination of medications, each targeting a different part of the immune system to prevent rejection. While newer regimens are used, it's unclear if they are more specific or simply stronger at suppressing the immune system.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

4.

Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes.

Author: TonelliM, WiebeN, KnollG, BelloA, BrowneS, JadhavD, KlarenbachS, GillJ

Improved cardiovascular outcomes
Improved quality of life
Reduced mortality

This systematic review summarizes the benefits of kidney transplantation compared to chronic dialysis treatment for adults, examining factors associated with greater or lesser benefit.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

5.

Cost-effectiveness analysis of the early conversion of tacrolimus to mammalian target of rapamycin inhibitors in patients with renal transplantation.

Author: GamboaO, MonteroC, MesaL, BenavidesC, ReinoA, TorresR E, CastilloJ S

Treatment of renal failure

Kidney transplantation and dialysis are the only treatments for people with end-stage kidney failure. These treatments have transformed this once fatal condition into a manageable chronic illness. Kidney transplant patients require medications to suppress the immune system and prevent rejection. Several medications are available, each with varying effectiveness, safety, and costs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

6.

Influence of renal function on long-term graft survival and patient survival in renal transplant recipients.

Author: Smith-PalmerJ, KalsekarA, ValentineW

Improved graft survival
Improved patient survival

This review examines the relationship between post-transplantation renal function and long-term graft survival and patient survival in kidney transplant recipients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

7.

Mycophenolic acid versus azathioprine as primary immunosuppression for kidney transplant recipients.

Author: WagnerMartin, EarleyAmy K, WebsterAngela C, SchmidChristopher H, BalkEthan M, UhligKatrin

MPA for kidney transplantation
High cost

This research examines the comparative effects of azathioprine (AZA) and mycophenolic acid (MPA) for immunosuppression after kidney transplantation. MPA is often favored over AZA, but the study explores the trade-offs between effectiveness, cost, and other factors.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

8.

A comparison of the effects of oral vs. intravenous hydration on subclinical acute kidney injury in living kidney donors: a protocol of a randomised controlled trial.

Author: MackinnonShona, AitkenEmma, GhitaRyan, ClancyMarc

Improved donor renal function
Improved recipient graft longevity

This research discusses the use of preoperative intravenous fluids to minimize the risk of acute kidney injury in living kidney donors undergoing laparoscopic donor nephrectomy. The study explores the potential benefits of hydration for preserving donor renal function.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

9.

Effectiveness and Harms of Using Kidneys with Small Renal Tumors from Deceased or Living Donors as a Source of Renal Transplantation: A Systematic Review.

Author: HeviaVital, Hassan ZakriRhana, Fraser TaylorClaire, BruinsHarman Maxim, BoissierRomain, LledoEnrique, RegeleHeinz, BuddeKlemens, FigueiredoArnaldo, BredaAlberto, YuanCathy Yuhong, OlsburghJonathon

Increased kidney transplant pool
Renal cell carcinoma

This abstract discusses the increasing number of small renal masses (SRMs) in older kidney donors and explores the feasibility of using kidneys with SRMs for transplantation to increase the pool of available organs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

10.

Plasmapheresis Therapy in Kidney Transplant Rejection.

Author: XiePan, TaoMin, PengKanfu, ZhaoHongwen, ZhangKeqin, ShengYuxiu, AnkawiGhada, RoncoClaudio

KT treatment
Therapeutic plasma exchange

Kidney transplantation is the best treatment for kidney failure. However, some people have antibodies that make finding a suitable donor kidney difficult. Plasma exchange is a treatment that can effectively reduce antibodies. While plasma exchange is helpful, individualised treatment plans and combining therapies are important to achieve the best outcomes. Early diagnosis and treatment can reduce complications and costs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

11.

Outcomes of bisphosphonate and its supplements for bone loss in kidney transplant recipients: a systematic review and network meta-analysis.

Author: YangYan, QiuShi, DengLinghui, TangXi, LiXinrui, WeiQiang, FuPing

Bone disease treatment

This study evaluates the efficacy and safety of bisphosphonate and its combined therapies in treating mineral bone disease, a common complication after kidney transplantation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

12.

Machine perfusion preservation versus static cold storage for deceased donor kidney transplantation.

Author: TingleSamuel J, FigueiredoRodrigo S, MoirJohn Ag, GoodfellowMichael, TalbotDavid, WilsonColin H

Kidney perfusion
Kidney transplantation

Kidney transplantation is the best treatment for kidney failure, but the process of removing, transporting, and transplanting the kidney can damage it. Currently, kidneys are stored on ice during transport, but new technology allows for "pumping" the kidney with fluids at different temperatures. This study explores the effectiveness of these new techniques, focusing on how they impact delayed graft function (DGF), a condition where the transplanted kidney doesn't start working right away.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

13.

Employment of patients with kidney failure treated with dialysis or kidney transplantation-a systematic review and meta-analysis.

Author: KirkeskovLilli, CarlsenRasmus K, LundThomas, BuusNiels Henrik

Kidney failure employment

Patients with kidney failure who are on dialysis or have undergone kidney transplantation often experience difficulty maintaining employment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

14.

[Renal harvest. State of the art.]

Author: ColomaLidia, CabelloRamiro, BuenoGonzalo, QuiciosCristina, García-CardosoJuan Vicente, González-EnguitaCarmen

Improved graft survival
Increased organ supply

Kidney transplantation is the optimal treatment for end-stage renal disease, but organ availability often lags behind demand. This paper reviews current strategies to increase the pool of transplantable organs, including optimizing donor management and preservation methods, to address this gap.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : Spanish

15.

Effect of kidney transplantation on indices of cardiorespiratory fitness assessed with cardiopulmonary exercise testing: a systematic review and meta-analysis.

Author: PellaEva, AlexandrouMaria-Eleni, BoutouAfroditi, TheodorakopoulouMarieta, DiplaKonstantina, ZafeiridisAndreas, SarafidisPantelis

Improved cardiovascular fitness

Kidney transplantation (KT) is associated with improved cardiorespiratory fitness, including increased oxygen consumption at anaerobic threshold.

Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

Breast Cancer Detection and Treatment Monitoring Using a Noninvasive Prenatal Testing Platform: Utility in Pregnant and Nonpregnant Populations.

Author: LenaertsLiesbeth, CheHuiwen, BrisonNathalie, NeofytouMaria, JatsenkoTatjana, LefrèreHanne, MaggenCharlotte, VillelaDarine, VerheeckeMagali, DehaspeLuc, CroitorAnca, HatseSigrid, WildiersHans, NevenPatrick, VandecaveyeVincent, FlorisGiuseppe, VermeeschJoris Robert, AmantFrédéric

Cancer detection
Treatment monitoring
None reported

Noninvasive prenatal testing (NIPT) has potential to detect cancer-specific copy number alterations in plasma tumor DNA. A genome-wide NIPT pipeline, called GIPSeq, showed a sensitivity of 26% for detecting breast cancer.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

Preimplantation genetic screening as an alternative to prenatal testing for Down syndrome: preferences of women undergoing in vitro fertilization/intracytoplasmic sperm injection treatment.

Author: TwiskMoniek, HaadsmaMaaike L, van der VeenFulco, ReppingSjoerd, MastenbroekSebastiaan, HeinemanMaas-Jan, BossuytPatrick M M, KorevaarJohanna C

Down syndrome reduction
Increased pregnancy
PGS not 100%
Reduced pregnancy

The majority of subfertile women surveyed favored preimplantation genetic screening (PGS) for Down syndrome screening, even if it was not 100% sensitive. This study, involving 244 women, found that the acceptability of PGS depended on its potential impact on pregnancy chances and, to a lesser extent, its sensitivity in detecting Down syndrome embryos.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

Prenatal testing for Imprinting Disorders: A clinical perspective.

Author: DufkeAndreas, EggermannThomas, KaganKarl Oliver, HoopmannMarkus, ElbrachtMiriam

Improved prognosis
Prenatal diagnosis
Tumor risk

Imprinting disorders (ImpDis) are genetic conditions caused by abnormal imprinting, impacting gene expression. While rarely associated with major malformations, ImpDis can affect growth, nutrition, and neurological development. This study emphasizes the importance of interdisciplinary care and treatment approaches for ImpDis, incorporating fetal imaging and genetic findings for optimal management and prognosis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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