Search PubMed⌕ Search

Biomedical subjects

Dai D Nghiem

Publications and source records attributed to Dai D Nghiem.

10 recordsLinked to original sources
PubMed2006

Superiority of pediatric en bloc renal allografts over living donor kidneys: a long-term functional study.

BACKGROUND: Growing waiting list for kidney transplantation in the United States makes it imperative to expand donor pool to use of pediatric kidneys. Because en bloc pediatric kidneys double nephron numbers, it would be interesting to learn how they fare compared to living donor kidneys long term. METHODS: Retrospective chart review was performed on all 72 pediatric en bloc and 75 live adult donor kidney recipients transplanted between January 1990 and December 2001. Long term graft function was assessed with glomerular filtration rate (GFR) using the abbreviated modification of diet in renal disease (MDRD) formula. RESULTS: Pediatric donor was 16.9 +/- 11.2 months old and weighed 10.7 +/- 3.8 kg. Nine en bloc kidneys thrombosed at a mean of 4.2 days posttransplantation. Proteinuria was detected later posttransplantation in en bloc group (45.6 +/- 33.6 months vs. 23.4 +/- 16.3 months, P = 0.002). Pediatric en bloc recipients had significantly higher GFR up to 8 years posttransplantation. One-year graft survival was significantly better in live donor group (93.3% vs. 81.9%, P = 0.041) but five-year graft survival rates were similar (86.7% vs. 76.3%, P = 0.125). One-year and five-year patient survival rates were similar between en bloc and live donor groups (97.3% vs. 98.6%, P = 0.585 and 94.6% vs. 93.0%, P = 0.688, respectively). CONCLUSION: Early postoperative graft thrombosis remain a challenge with pediatric en bloc renal transplants, but once the allografts survive early postoperative course, they provide better long-term function than living donor kidney transplants. In order to alleviate burden on waiting list, pediatric en bloc kidneys should be transplanted more often when available.

Adult↗
PubMed2006

Simultaneous double adult kidney transplantation using single arterial and venous anastomoses.

INTRODUCTION: To provide optimal nephron mass, two adult kidneys can be transplanted into a single recipient. TECHNICAL CONSIDERATIONS: All techniques described to date have been based on the sequential transplantation of each transplant in a separate iliac fossa. We report on an operative technique allowing the simultaneous transplantation of both kidneys into the same iliac fossa, with simultaneous revascularization through a single arterial and single venous anastomosis in 12 patients. CONCLUSIONS: This technique reduces the surgical dissection, anesthesia exposure, and risk to elderly recipients and can be added to the armamentarium of the transplant surgeon.

Adult↗
PubMed2005

Intraperitoneal catheter drainage of lymphocele: an outpatient procedure.

Laparoscopic marsupialization of lymphocele carries 13% recurrence rate, 6% injury to other organs, 12% omentoplasty, 6% open conversion and 1.8 average hospital days. A novel, simplified technique of intraperitoneal catheter drainage of lymphocele is described. Under ultrasound guidance and using the Seldinger technique, a 13F Hickman catheter was introduced into the lymphocele and connected subcutaneously to a small peritoneal window performed 5 cm apart. During the last 8 years the procedure was performed under local anesthesia in 14 patients on an outpatient basis with success (e.g. resolution of both hydronephrosis and lymphocele). One wound infection required removal of the catheter without recurrence. In another patient laparoscopy showed retraction of the catheter under the peritoneum as cause for lymphocele recurrence. In all cases absence of injury to the GU tract was confirmed by absence of extravasation of indigo carmine given intravenously. Intraperitoneal catheter drainage of post-transplant lymphocele is an effective outpatient procedure. It avoids the drawbacks of general anesthesia required by open and laparoscopic marsupialization procedures and deserves to be evaluated in a multicenter study.

Ambulatory Surgical Procedures↗
PubMed2003

Transplantation.

Explore the source record for details and available documents.

Child↗
PubMed2002

Assessment of quality of life after simultaneous pancreas-kidney transplantation.

It is unclear if simultaneous pancreas-kidney (SPK) transplantation adds to the general quality of life (QOL) achieved with kidney transplantation alone (KTA). This case-controlled study matched 27 successful SPK transplant recipients with 27 successful KTA recipients. Cases were matched for gender, age (+/- 7 years), and year of transplant (+/- 2 years). Both groups had type 1 diabetes and end-stage renal disease. Diabetes-related QOL was assessed using the Diabetes Quality of Life (DQOL) questionnaire. General QOL was assessed using Medical Outcome Health Survey Short Form-36 (SF-36) and Quality of Well Being (QWB) questionnaires. Morbidity data were obtained through chart review. There was a trend for a lower prevalence of coronary artery disease (5 of 27 versus 13 of 27) and peripheral vascular disease (5 of 27 versus 9 of 27) in SPK recipients (P = not significant). Satisfaction with diabetes-related QOL was significantly better in SPK recipients (1.8 +/- 0.5 versus 2.3 +/- 0.5; P < 0.05). SPK and KTA recipients' SF-36 physical (66 +/- 21 and 64 +/- 19) and mental (76 +/- 17 and 71 +/- 22) composite scores were similar. QWB scores also were similar for SPK (0.67 +/- 0.12) and KTA (0.63 +/- 0.10) recipients. In the first 3 months after transplantation, SPK recipients had a significantly higher number of hospital admissions per patient (1.9 +/- 0.9 versus 1.4 +/- 0.6; P < 0.05), more hospital days per patient (25.1 +/- 13.8 days versus 10.1 +/- 4.4 days; P < 0.005), and more intensive care unit days per patient (7.9 +/- 7.1 days versus 0.8 +/- 1.5 days; P < 0.005). Although SPK transplantation enhanced diabetes-related QOL, there was no improvement in overall QOL.

Adult↗
PubMedDate not supplied

Quality of life after organ transplantation in type 1 diabetics with end-stage renal disease.

UNLABELLED: Quality of life (QOL) should be an important consideration while choosing therapeutic options for patients with type 1 diabetes mellitus (DM) and end-stage renal disease (ESRD) including dialysis, cadaver (CKT) or living kidney transplant (LKT) or simultaneous pancreas-kidney (SPK) transplant. METHODS: QOL was assessed in four groups of patients with history of type 1 DM and ESRD: recipients of SPK (n = 43), CKT (n = 43), LKT (n = 11) and wait listed (WL) patients (n = 23). Diabetes Quality of Life (DQOL), Short Form-36 (SF-36) and Quality of Well-Being (QWB) questionnaires were utilized. A subset of SPK (n = 19) and CKT (n = 12) recipients underwent longitudinal QOL evaluation. RESULTS: On DQOL questionnaire, SPK group had better satisfaction subscore compared with CKT (1.8 +/- 0.5 vs. 2.2 +/- 0.6, p < 0.01) LKT (1.8 +/- 0.5 vs. 2.4 +/- 0.7, p < 0.05) and WL (1.8 +/- 0.5 vs. 2.6 +/- 0.6, p < 0.001) groups and better impact subscore compared with CKT (1.7 +/- 0.6 vs. 2.1 +/- 0.6, p < 0.05) and WL (1.7 +/- 0.6 vs. 2.3 +/- 0.6, p < 0.01) groups. There were no significant differences on physical/mental composite scores of SF-36. QWB score was better in SPK group vs. WL group (0.62 +/- 0.11 vs. 0.55 +/- 0.04, p < 0.05). Longitudinal decline in satisfaction (2.3 +/- 0.5 vs. 2.6 +/- 0.9, p = 0.058) and impact (2.0 +/- 0.5 vs. 2.2 +/- 0.5, p = 0.019) subscores of DQOL were noted in CKT group. There were no significant changes in the composite scores of SF-36 in both groups. QWB scores declined in the CKT group (0.67 +/- 0.10 vs. 0.61 +/- 0.05, p = 0.01). CONCLUSION: QOL was better in type 1 diabetics with ESRD following transplantation when compared with remaining on WL. SPK transplantation had significant positive effect on diabetes-related QOL which was sustained longitudinally but it was difficult to show an overall improvement in general QOL.

Adult↗