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Salamanca-Bustos JJ, Gomez-Gomez E, Campos-Hernández JP, Carrasco-Valiente J, Ruiz-García J, Márquez-López FJ, Zurera-Tendero L, Requena-Tapia MJ. Initial Experience in the Use of Novel Auto-expandable Metal Ureteral Stent in the Treatment of Ureter Stenosis in Kidney Transplanted Patients. Transplant Proc 2018; 50:587-590. [PMID: 29579860 DOI: 10.1016/j.transproceed.2017.09.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 09/22/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Ureter stenosis in renal transplantation patients is a relatively frequent complication that negatively conditions graft evolution. The use of ureteral stents is a valid treatment alternative to the use of double-J catheters in patients for whom surgery is not contemplated or after surgical recurrence. We present our initial experience with five patients treated using this technique. MATERIALS AND METHODS We describe a total of five patients with ureteral stenosis after renal transplantation who were treated using ureteral stent model UVENTA (Taewoong Medical, Seoul, Korea) in our center. The median follow-up was 18 months (range, 4 to 38 months). We describe the clinical history of patients and previous treatments on ureteral stenosis. The technical procedure of placement is described. The clinical course is analyzed by measurement of renal function and imaging tests, as well as post-stent complications. Survival of the renal graft is evaluated. RESULTS The procedure could be completed in all patients without complications. The technique was effective in all patients, with correction of creatinine value and hydronephrosis during the renal ultrasound test. One patient suffered a urinary tract infection episode associated with the use of the ureteral stent. One patient suffered the loss of the renal graft secondary to the development of cryoglobulins. One hundred percent of the ureteral stents are functioning as of the writing of this article. CONCLUSIONS In renal transplantation patients with ureter stenosis, metallic stents are a useful technique with low morbidity and associated complications.
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Affiliation(s)
| | - E Gomez-Gomez
- Department of Urology, University Hospital Reina Sofia, Córdoba, Spain
| | | | | | - J Ruiz-García
- Department of Urology, University Hospital Reina Sofia, Córdoba, Spain
| | - F J Márquez-López
- Department of Urology, University Hospital Reina Sofia, Córdoba, Spain
| | - L Zurera-Tendero
- Department of Vascular Radiology, University Hospital Reina Sofia, Córdoba, Spain
| | - M J Requena-Tapia
- Department of Urology, University Hospital Reina Sofia, Córdoba, Spain
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2
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Sánchez-Hidalgo JM, Salamanca-Bustos JJ, Arjona-Sánchez Á, Campos-Hernández JP, Ruiz Rabelo J, Rodríguez-Benot A, Requena-Tapia MJ, Briceño-Delgado J. What Is the Influence of Both Risk Donor and Risk Receiver on Simultaneous Pancreas-Kidney Transplantation? Transplant Proc 2018; 50:664-668. [PMID: 29579883 DOI: 10.1016/j.transproceed.2017.09.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 09/21/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Some factors affect the pancreas of a marginal donor, and although their influence on graft survival has been determined, there is an increasing consensus to accept marginal organs in a controlled manner to increase the pool of organs. Certain factors related to the recipient have also been proposed as having negative influence on graft prognosis. The objective of this study was to analyze the influence of these factors on the results of our simultaneous pancreas-kidney (SPK) transplantation series. MATERIALS AND METHODS Retrospective analysis of 126 SPK transplants. Donors and recipients were stratified in an optimal group (<2 expanded donor criteria) and a risk group (≥2 criteria). A pancreatic graft survival analysis was performed using a Kaplan-Meier test and log-rank test. Prognostic variables on graft survival were studied by Cox regression. Postoperative complications (graded by Clavien classification) were compared by χ2 test or Fisher test. RESULTS Median survival of pancreas was 66 months, with no significant difference between groups (P > .05). Multivariate analysis showed risk factors to be donor age, cold ischemia time, donor body mass index, receipt body mass index, and receipt panel-reactive antibody. CONCLUSIONS In our series, the use of pancreatic grafts from donors with expanded criteria is safe and has increased the pool of grafts. Different variables, both donor and recipient, influence the survival of the pancreatic graft and should be taken into account in organ distribution systems.
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Affiliation(s)
| | | | - Á Arjona-Sánchez
- Department of Surgery, University Hospital Reina Sofia, Córdoba, Spain
| | | | - J Ruiz Rabelo
- Department of Surgery, University Hospital Reina Sofia, Córdoba, Spain
| | - A Rodríguez-Benot
- Department of Nephrology, University Hospital Reina Sofia, Córdoba, Spain
| | - M J Requena-Tapia
- Department of Urology, University Hospital Reina Sofia, Córdoba, Spain
| | - J Briceño-Delgado
- Department of Surgery, University Hospital Reina Sofia, Córdoba, Spain
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3
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Salamanca-Bustos JJ, Campos-Hernandez JP, Sánchez-Hidalgo JM, Arjona-Sánchez A, Sánchez-González A, Arenas-Bonilla AJ, Ruiz-Rabelo J, Carrasco-Valiente J, Ruiz-García J, Regueiro-López JC, Briceño-Delgado J, Requena-Tapia MJ. Validation of the Pancreatic Donor Risk Index in Simultaneous Pancreas-Kidney Transplantation Performed in Córdoba Hospital From 2000 to 2015. Transplant Proc 2017; 48:3037-3039. [PMID: 27932141 DOI: 10.1016/j.transproceed.2016.07.049] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 07/27/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND The Pancreatic Donor Risk Index (PDRI) was developed in 2010 in the United States to predict graft survival after pancreas transplantation, based on donor characteristics and logistical and technical conditions. The aim of the study was to validate the utility of PDRI as a pancreas allograft survival predictor in simultaneous pancreas-kidney transplantation (SPK) transplants performed in our hospital between 2000 and 2015. METHODS This retrospective analysis of 126 SPK transplants was performed by the same surgical team from the years 2000 to 2015. Donor variables that are integrated in the PDRI were calculated (age, sex, race, creatinine serum levels, body mass index, height, cold ischemia time, cause of death, type of pancreas transplant). Pancreatic graft survival at 1 and 5 years was calculated by use of the Kaplan-Meier test. Comparison of survival curves between PDRI risk quartiles was calculated by use of the log-rank test. Association between graft survival and variables integrating the PDRI was calculated by use of univariate Cox regression analysis. RESULTS Log-rank analysis found no statistically significant association between global graft survival and PDRI quartiles. Univariate Cox regression analysis showed a statistically significant association between graft survival and cold ischemia time (P < .05). CONCLUSIONS PDRI was not a useful tool to predict pancreatic graft outcomes in a Spanish reference population.
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Affiliation(s)
| | | | | | - A Arjona-Sánchez
- Department of Surgery, University Hospital Reina Sofía, Córdoba, Spain
| | | | | | - J Ruiz-Rabelo
- Department of Surgery, University Hospital Reina Sofía, Córdoba, Spain
| | | | - J Ruiz-García
- Department of Urology, University Hospital Reina Sofía, Córdoba, Spain
| | | | - J Briceño-Delgado
- Department of Surgery, University Hospital Reina Sofía, Córdoba, Spain
| | - M J Requena-Tapia
- Department of Urology, University Hospital Reina Sofía, Córdoba, Spain
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4
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Valero-Rosa J, Campos-Hernández JP, Carrasco-Valiente J, Gómez-Gómez E, Márquez-López FJ, Ruiz-García J, García-Rubio JH, Requena-Tapia MJ, Prieto-Castro R. Prognostic value of penile colour doppler ultrasonography for recovering erectile function after radical prostatectomy. Actas Urol Esp 2016; 40:507-12. [PMID: 27207597 DOI: 10.1016/j.acuro.2016.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 04/11/2016] [Accepted: 04/12/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To analyse the predictive utility of penile colour Doppler ultrasonography after the injection of vasoactive agents for recovering erectile function after radical prostatectomy. MATERIAL AND METHODS A retrospective study was conducted on patients with erectile dysfunction after radical prostatectomy who were treated with intracavernous injections of prostaglandins E1 between January 1, 2006 and December 31, 2012. The study included patients with no history of erectile dysfunction prior to the surgery and who did not respond to medical treatment. Colour Doppler was performed on all patients after the intracavernous injection. A peak systolic velocity ≥30cm/sec and an end diastolic velocity ≤5cm/sec were considered normal haemodynamic values. We assessed the result of the treatment during the follow-up using the International Index of Erectile Function-5. RESULTS We included 197 patients. The mean age was 60.8 (±6.3). The pathological diagnosis for all patients was adenocarcinoma, 74.1% of which were confined to the organ (T1-T2/Nx-N0). Treatment with injections after the surgery was started after a mean duration of 6.8 months (+3.5). The Doppler ultrasonography results were normal for 53 patients (26.9%). During the follow-up, 113 patients (57.4%) maintained functional erections; 55 of these patients (28%) did not require injections. Normal Doppler ultrasonography results were associated with a favourable response to treatment (p<.01). CONCLUSIONS The prostaglandin E1 test will help provide a diagnosis in erectile dysfunction for patients who have undergone prostatectomies. The test helps provide information on the vascular condition of the penis and useful prognostic information for the follow-up of these patients.
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Affiliation(s)
- J Valero-Rosa
- Departamento de Urología, Hospital Universitario Reina Sofía, Córdoba, España.
| | | | - J Carrasco-Valiente
- Departamento de Urología, Hospital Universitario Reina Sofía, Córdoba, España
| | - E Gómez-Gómez
- Departamento de Urología, Hospital Universitario Reina Sofía, Córdoba, España
| | - F J Márquez-López
- Departamento de Urología, Hospital Universitario Reina Sofía, Córdoba, España
| | - J Ruiz-García
- Departamento de Urología, Hospital Universitario Reina Sofía, Córdoba, España
| | - J H García-Rubio
- Departamento de Urología, Hospital Universitario Reina Sofía, Córdoba, España
| | - M J Requena-Tapia
- Departamento de Urología, Hospital Universitario Reina Sofía, Córdoba, España
| | - R Prieto-Castro
- Departamento de Urología, Hospital Universitario Reina Sofía, Córdoba, España
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Miñana B, Cózar JM, Palou J, Unda Urzaiz M, Medina-Lopez RA, Subirá Ríos J, de la Rosa-Kehrmann F, Chantada-Abal V, Lozano F, Ribal MJ, Rodríguez Fernández E, Castiñeiras Fernández J, Concepción Masip T, Requena-Tapia MJ, Moreno-Sierra J, Hevia M, Gómez Rodríguez A, Martínez-Ballesteros C, Ramos M, Amón Sesmero JH, Pizá Reus P, Bohorquez Barrientos A, Rioja Sanz C, Gomez-Pascual JA, Hidalgo Zabala E, Parra Escobar JL, Serrano O. Bladder cancer in Spain 2011: population based study. J Urol 2013; 191:323-8. [PMID: 23994371 DOI: 10.1016/j.juro.2013.08.049] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE We estimate the annual incidence of bladder cancer in Spain and describe the clinical profile of patients with bladder cancer enrolled in a population based study. MATERIALS AND METHODS Using the structure of the Spanish National Health System as a basis, in 2011 the AEU (Spanish Association of Urology) conducted this study with a representative sample from 26 public hospitals and a reference population of 10,146,534 inhabitants, comprising 21.5% of the Spanish population. RESULTS A total of 4,285 episodes of bladder cancer were diagnosed, of which 2,476 (57.8%) were new cases and 1,809 (42.2%) were cases of recurrence, representing an estimated 11,539 new diagnoses annually in Spain. The incidence of bladder cancer in Spain, age adjusted to the standard European population, was 20.08 cases per 100,000 inhabitants (95% CI 13.9, 26.3). Of patients diagnosed with a first episode of bladder cancer 84.3% were male, generally older than 59 years (81.7%) with a mean ± SD age of 70.5 ± 11.4 years. Of these patients 87.5% presented with some type of clinical symptom, with macroscopic hematuria (90.8%) being the most commonly detected. The majority of primary tumors were nonmuscle invasive (76.7%) but included a high proportion of high grade tumors (43.7%). According to the ISUP (International Society of Urologic Pathology)/WHO (2004) classification 51.1% was papillary high grade carcinoma. Carcinoma in situ was found in 2.2% of primary and 5.8% of recurrent cases. CONCLUSIONS The incidence of bladder cancer in Spain, age adjusted to the standard European population, confirms that Spain has one of the highest incidences in Europe. Most primary nonmuscle invasive bladder cancer corresponded to high risk patients but with a low detected incidence of carcinoma in situ.
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Carrasco-Valiente J, Anglada-Curado FJ, Aguilar-Melero P, González-Ojeda R, Muntané-Relat J, Padillo-Ruiz FJ, Requena-Tapia MJ. [State of acute phase markers and oxidative stress in patients with kidney stones in the urinary tract]. Actas Urol Esp 2012; 36:296-301. [PMID: 22301017 DOI: 10.1016/j.acuro.2011.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Accepted: 08/21/2011] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This present study has aimed to assess the state of acute phase markers and oxidative stress in patients with kidney stones. MATERIAL AND METHODS A prospective study was carried out on 100 patients with kidney stones and 25 healthy controls. Albumin, ß2 microglobulin, Gamma-glutamyl transpepsidase, Lactate dehydrogenase, Tumor necrosis factor alpha, Interleukin 1 and Interleukin-6 were evaluated as acute phase markers and lipid peroxidation products, Superoxide dismutase and Glutathione peroxidase levels acted as oxidative stress markers. RESULTS An increase in renal cell damage markers as expressed by the ß2 microglobulin (p=0.04), albumin (p=0.004), Lactate dehydrogenase (p=0.001) and Gamma glutamyl transpepsidasa (p=0.01) was observed in the patient group. There was a direct correlation between levels of ß2 microglobulin and stone size (r=0.3, p=0.03). The association between stone size and cytokine activation was observed to be stronger in patients with staghorn calculi. In these patients, Tumor necrosis factor alpha (p=0.011), Interleukin 1 (p=0.004) and Interleukin 6 (p=0.004) were significantly higher. Patients with stones in the urinary tract showed data of significantly higher oxidative stress, expressed as an increase in levels of lipid peroxidation products (p=0.03) and a decrease in the antioxidant activity of Superoxide dismutase (p=0.03) and Glutathione peroxidase (p=0.002). CONCLUSIONS Patients undergoing urolithiasis showed an elevation of acute phase markers, associated with oxidative stress as expressed by an increase in lipid peroxidation products and a decrease in the antioxidant enzyme activity.
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Affiliation(s)
- J Carrasco-Valiente
- Unidad de Gestión Clínica de Urología, Hospital Universitario Reina Sofía, Córdoba, España.
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