Results of renal transplantation using kidneys harvested from living donors at the University of Heidelberg
Bibliographic record
Abstract
BACKGROUND: Although a majority of patients undergoing renal transplantation currently receive a cadaver kidney, living donors continue to be an important source of transplanted kidneys. Recipients of living donor kidneys demonstrate improved graft survival. To expand the pool of suitable organ donors an organ procurement programme of living donors has been developed over the past 35 years. We have reviewed our living donor nephrectomy experience over this period to analyse the donor and recipient peri- and postoperative morbidity and mortality rate. METHODS: We reviewed the operative complications and the long-term outcome of 219 living donated kidney transplantations before and after introduction of cyclosporine A. Donor and graft complications as well as recipient complications and survival rate were investigated. Additionally, the findings of 16 laparoscopically operated living donors were compared to a group of 20 patients who underwent a conventional surgery. RESULTS: The overall recipient 3 and 5 year survival rates in the cyclosporine A era were 95 and 94%, respectively. Prior to the introduction of cyclosporine A, the overall recipient survival rates at 3 and 5 years were 84 and 84%, respectively. The overall graft survival rates were 92 and 85% for the cyclosporine A era compared to 68 and 60% before introduction of cyclosporine A, at 3 and 5 years, respectively. The patient and graft survival rate in the cyclosporine group were significantly higher than in the pre-cyclosporine group (log-rank: P = 0.0107 and P = 0.0003, respectively). Donor complications included pain at the incision site (35%), mild hypertension (27%), proteinuria (19%), urinary tract infections (11%), pneumothorax (5%), blood transfusion (3.5%) and wound infection (3%), with no mortalities. Our results showed a longer duration of operation, and longer warm ischaemia and cold ischaemia times in laparoscopically operated living donors than those that were seen in the conventional approach. There was no statistically significant difference in complications between both techniques. However, the hospitalization days and usage of analgesic medication in laparoscopy donors were lower than in the conventional approach. CONCLUSIONS: Similar to previous studies the results of the present analysis confirm an increase in patient and graft survival rates in the cyclosporine era compared to before its usage. Living donor nephrectomy, done through a conventional or laparoscopic approach, remains a valuable source of kidneys for transplantation with low complication rates.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".