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Kodama H, Hatakeyama S, Hamaya T, Murakami R, Murasawa H, Yamamoto H, Yoneyama T, Ohyama C. Kidney Transplantation in a Patient With Noonan Syndrome: A Case Report. Transplant Proc 2022; 54:1601-1603. [PMID: 35810017 DOI: 10.1016/j.transproceed.2022.03.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/07/2022] [Indexed: 11/15/2022]
Abstract
Noonan syndrome (NS) is a congenital genetic abnormality characterized by short stature, delayed onset of puberty, cardiac malformations, and characteristic external malformations. Congenital chromosomal or genetic abnormalities are sometimes associated with carcinomas. Furthermore, they are difficult to manage perioperatively because of multiple complications and mental retardation. The safety of kidney transplantation for patients with NS has not been established. We are reporting the case of a 31-year-old man with NS who received a kidney transplantation after a donor's brain death. He received kidney transplantation safely and was discharged without issues. Kidney transplantation for patients with congenital chromosomal or genetic abnormalities is feasible without serious complications, with a regular follow-up, and psychological support from patients and families.
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Affiliation(s)
- Hirotake Kodama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
| | - Tomoko Hamaya
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Reiichi Murakami
- Department of Cardiology and Nephrology, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hiromi Murasawa
- Department of Urology, Oyokyo Kidney Research Institute, Hirosaki, Japan
| | - Hayato Yamamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Takahiro Yoneyama
- Department of Advanced Transplant and Regenerative Medicine, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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Henriksen KJ, Chang A, Bayliss GP. Kidney Transplant Outcomes in 2 Adults With Down Syndrome. Kidney Int Rep 2018; 3:979-984. [PMID: 29988986 PMCID: PMC6035128 DOI: 10.1016/j.ekir.2018.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Kammi J. Henriksen
- Department of Pathology, The University of Chicago, Chicago, Illinois, USA
| | - Anthony Chang
- Department of Pathology, The University of Chicago, Chicago, Illinois, USA
| | - George P. Bayliss
- Department of Medicine, Division of Kidney Disease and Hypertension, Brown University, Providence, Rhode Island, USA
- Correspondence: George Bayliss, Department of Medicine, Division of Kidney Disease and Hypertension, Alpert Medical School, Brown University, Transplant Clinic, APC 9, Rhode Island Hospital, 593 Eddy Street, Providence, Rhode Island 02903, USA.
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Kitamura A, Kondoh T, Noguchi M, Hatada T, Tohbu S, Mori KI, Matsuo M, Kunitsugu I, Kanetake H, Moriuchi H. Assessment of lower urinary tract function in children with Down syndrome. Pediatr Int 2014; 56:902-908. [PMID: 24758352 PMCID: PMC4311436 DOI: 10.1111/ped.12367] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 01/23/2014] [Accepted: 04/17/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Despite the fact that functional lower urinary tract symptoms are common among people with Down syndrome (DS), their voiding function has not been studied precisely. Our goal was to assess the lower urinary tract functions in DS. METHODS Fifty-five DS children aged 5-15 years old and 35 age-matched control children were evaluated by ultrasonography and uroflowmetry. RESULTS Eleven (20%) DS children had no uresiesthesia, 21 (38%) were urinated under guidance, nine (16%) urinated fewer than three times a day, two (4%) urinated more than 10 times a day, three (5%) used diapers, and 26 (47%) had urinary incontinence. Seven (13%), 15 (27%), and 10 (18%) DS children had weak, prolonged and intermittent urination, respectively, and seven (13%) had urination with straining. In contrast, none of the control subjects had urinary problems. In the uroflowmetrical analysis, 10 (18%), 20 (37%), 11 (20%) and five (9%) DS children showed "bell-shaped," "plateau," "staccato" and "interrupted" patterns, respectively; the remaining nine (16%) could not be analyzed. In contrast, 21 (60%), one (3%), four (11%), three (9%) and two (6%) control subjects showed bell-shaped, tower-shaped, plateau, staccato and interrupted patterns, respectively; the remaining four (11%) could not be analyzed. Residual urine was demonstrated in four (7%) DS children and one (3%) control child. CONCLUSIONS Lower urinary tract symptoms and abnormal uroflowmetry findings, which can lead to further progressive renal and urinary disorders, are common in DS children. Therefore, lower urinary tract functions should be assessed at the life-long regular medical check-ups for subjects with DS.
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Affiliation(s)
- Atsuko Kitamura
- Department of Pediatrics, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.,Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Tatsuro Kondoh
- Department of Pediatrics, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.,Misakaenosono Mutsumi Institute for Persons with Severe Intellectual/Motor Disabilities, Isahaya, Japan
| | - Mitsuru Noguchi
- Department of Urology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Teppei Hatada
- Department of Urology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Shohei Tohbu
- Department of Urology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Ken-Ichi Mori
- Department of Urology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Manabu Matsuo
- Department of Urology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Ichiro Kunitsugu
- Department of Public Health, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Hiroshi Kanetake
- Department of Urology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Hiroyuki Moriuchi
- Department of Pediatrics, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.,Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
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Kute VB, Vanikar AV, Shah PR, Gumber MR, Patel HV, Engineer DP, Thakkar UG, Trivedi HL. Down syndrome with end-stage renal disease. Indian J Clin Biochem 2014; 28:429-32. [PMID: 24426250 DOI: 10.1007/s12291-013-0308-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 01/31/2013] [Indexed: 11/29/2022]
Abstract
Down syndrome is one of the most common genetic causes of learning disabilities in children. Although the incidence of renal and urological involvement in Down syndrome is not very common, monitoring of patients with Down syndrome for renal diseases should be done regularly as patient's age into the second and third decades. With increased survival, it appears that a growing number of these patients present with chronic renal failure. Down syndrome patients are apparently not suited for peritoneal dialysis because of lacking cooperation. This procedure can be prone to failure, mainly because of an increased risk of peritonitis. Handling such patients especially those on peritoneal dialysis is challenging. Here we report a case of Down syndrome with end-stage renal disease treated with hemodialysis for 6 months. To the best of our knowledge and current literature review this is the first case report of a patient with Down syndrome undergoing hemodialysis.
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Affiliation(s)
- Vivek B Kute
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Centre, Dr H L Trivedi Institute Of Transplantation Sciences (IKDRC-ITS), Civil Hospital Campus, Ahmedabad, 380016 Gujarat India
| | - Aruna V Vanikar
- Laboratory Medicine, Department of Pathology, Transfusion Services and Immunohematology, Institute of Kidney Diseases and Research Centre, Dr H L Trivedi Institute Of Transplantation Sciences, Ahmedabad, India
| | - Pankaj R Shah
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Centre, Dr H L Trivedi Institute Of Transplantation Sciences (IKDRC-ITS), Civil Hospital Campus, Ahmedabad, 380016 Gujarat India
| | - Manoj R Gumber
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Centre, Dr H L Trivedi Institute Of Transplantation Sciences (IKDRC-ITS), Civil Hospital Campus, Ahmedabad, 380016 Gujarat India
| | - Himanshu V Patel
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Centre, Dr H L Trivedi Institute Of Transplantation Sciences (IKDRC-ITS), Civil Hospital Campus, Ahmedabad, 380016 Gujarat India
| | - Divyesh P Engineer
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Centre, Dr H L Trivedi Institute Of Transplantation Sciences (IKDRC-ITS), Civil Hospital Campus, Ahmedabad, 380016 Gujarat India
| | - Umang G Thakkar
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Centre, Dr H L Trivedi Institute Of Transplantation Sciences (IKDRC-ITS), Civil Hospital Campus, Ahmedabad, 380016 Gujarat India
| | - Hargovind L Trivedi
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Centre, Dr H L Trivedi Institute Of Transplantation Sciences (IKDRC-ITS), Civil Hospital Campus, Ahmedabad, 380016 Gujarat India
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Kupferman JC, Druschel CM, Kupchik GS. Increased prevalence of renal and urinary tract anomalies in children with Down syndrome. Pediatrics 2009; 124:e615-21. [PMID: 19752083 DOI: 10.1542/peds.2009-0181] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The goal was to investigate the prevalence of renal and urinary tract anomalies (RUTAs) in a Down syndrome (DS) population. METHODS Data were obtained from the New York State Congenital Malformation Registry (NYS-CMR) in this retrospective cohort study. The occurrence of RUTAs was assessed for children with and without DS who were born in NYS between 1992 and 2004. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for each malformation. RESULTS Between 1992 and 2004, 3832 children with DS and 3 411 833 without DS were born in NYS. The prevalence of RUTAs in the DS population was 3.2%, compared with 0.7% in the NYS population (OR: 4.5 [95% CI: 3.8 -5.4]). Children with DS had significantly increased risks of anterior urethral obstruction (OR: 29.7 [95% CI: 4.0 -217.7]), cystic dysplastic kidney (OR: 4.5 [95% CI: 1.5-14.1]), hydronephrosis (OR: 8.7 [95% CI: 6.8 -11.0]), hydroureter (OR: 8.5 [95% CI: 3.5-20.4]), hypospadias (OR: 2.0 [95% CI: 1.4 -2.9]), posterior urethral valves (OR: 7.1 [95% CI: 1.8 -28.8]), prune belly syndrome (OR: 11.9 [95% CI: 1.6 - 85.4]), and renal agenesis (OR: 5.4 [95% CI: 2.8 -10.4]). There was no significantly increased risk of ectopic kidney (OR: 1.6 [95% CI: 0.2-11.2]) or ureteropelvic junction obstruction (OR: 1.4 [95% CI: 0.2-9.9]) in the DS population. CONCLUSION Children with DS have significantly increased risks of RUTAs.
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Affiliation(s)
- Juan C Kupferman
- Divisions of Pediatric Nephrology and Hypertension, Maimonides Infants and Children's Hospital, Brooklyn, New York 11219, USA.
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Canter CE, Shaddy RE, Bernstein D, Hsu DT, Chrisant MRK, Kirklin JK, Kanter KR, Higgins RSD, Blume ED, Rosenthal DN, Boucek MM, Uzark KC, Friedman AH, Friedman AH, Young JK. Indications for Heart Transplantation in Pediatric Heart Disease. Circulation 2007; 115:658-76. [PMID: 17261651 DOI: 10.1161/circulationaha.106.180449] [Citation(s) in RCA: 175] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Since the initial utilization of heart transplantation as therapy for end-stage pediatric heart disease, improvements have occurred in outcomes with heart transplantation and surgical therapies for congenital heart disease along with the application of medical therapies to pediatric heart failure that have improved outcomes in adults. These events justify a reevaluation of the indications for heart transplantation in congenital heart disease and other causes of pediatric heart failure.
Methods and Results—
A working group was commissioned to review accumulated experience with pediatric heart transplantation and its use in patients with unrepaired and/or previously repaired or palliated congenital heart disease (children and adults), in patients with pediatric cardiomyopathies, and in pediatric patients with prior heart transplantation. Evidence-based guidelines for the indications for heart transplantation or retransplantation for these conditions were developed.
Conclusions—
This evaluation has led to the development and refinement of indications for heart transplantation for patients with congenital heart disease and pediatric cardiomyopathies in addition to indications for pediatric heart retransplantation.
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Abstract
We reviewed the literature on accessibility and outcomes of organ transplantation in individuals with mental retardation (MR) and on the prevalence of organ donation in this population. Six centers have published outcome data on renal transplantation in 34 individuals with MR. The one- and three-yr patient survival rates were 100% and 90%, respectively. The studies reported good compliance with post-transplant medications due to consistent support from family members or caregivers. The outcome studies for liver and heart transplantation among these individuals are limited. The literature on organ donation in individuals with MR is mostly concerned with legal issues. The courts generally permit organ donations when such is in the best interests of the donor.
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Affiliation(s)
- Marilee A Martens
- Nisonger Center, The Ohio State University, Columbus, OH 43210-1296, USA.
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Ohta T, Motoyama O, Takahashi K, Hattori M, Shishido S, Wada N, Gotoh Y, Yanagihara T, Hasegawa A, Sakano T. Kidney Transplantation in Pediatric Recipients With Mental Retardation: Clinical Results of a Multicenter Experience in Japan. Am J Kidney Dis 2006; 47:518-27. [PMID: 16490632 DOI: 10.1053/j.ajkd.2005.11.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2005] [Accepted: 11/07/2005] [Indexed: 11/11/2022]
Abstract
BACKGROUND There are few published reports on kidney transplantation (KT) in physically handicapped patients with mental retardation. The aim of this study is to clearly identify the outcome of KT in these patients and clarify whether handicapped patients can be candidates for KT. METHODS Our study identified 25 multiply handicapped transplant recipients from 8 institutions. Causes of mental retardation were chromosomal abnormality in 5 patients, genetic syndrome in 10 patients, developmental brain anomaly in 2 patients, and other or unknown causes in 8 patients. Primary diseases leading to end-stage renal disease were congenital urinary tract anomaly in 12 patients, focal segmental glomerulosclerosis in 3 patients, cystic kidney disease in 3 patients, and other in 7 patients. RESULTS Twenty-three patients received living-related transplants from a parent and 2 patients received cadaver transplants. Twenty-two patients were on peritoneal dialysis therapy, 2 patients were on hemodialysis therapy at the time of KT, and 1 patient underwent preemptive KT. Eleven acute rejection episodes occurred in 8 patients. All episodes were completely reversed with treatments that included mainly methylprednisolone pulse therapy. Posttransplantation lymphoproliferative disorder occurred in 2 patients. Follow-up data showed that all grafts were functioning during a mean observation period of 41.1 months (range, 4 to 187 months). All persons providing primary support for patients were satisfied with the KT and believed that quality of life was improved in both transplant recipients and themselves. CONCLUSION Results indicate that KT is not contraindicated in handicapped patients, but cannot determine which patients are unsuitable to undergo KT.
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Affiliation(s)
- Toshiyuki Ohta
- Department of Pediatrics, Hiroshima Prefectural Hospital, Hiroshima, Japan.
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Leonard H, Eastham K, Dark J. Heart and heart-lung transplantation in Down's syndrome. The lack of supportive evidence means each case must be carefully assessed. BMJ (CLINICAL RESEARCH ED.) 2000; 320:816-7. [PMID: 10731153 PMCID: PMC1127180 DOI: 10.1136/bmj.320.7238.816] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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