Piotr Domagala

Medical University of Warsaw · Department of General and Transplantation Surgery

Purpose An increasing number of patients treated with peritoneal dialysis eventually undergo kidney transplantation. Owing to opposing reports, we aimed to find evidence about the best time for peritoneal dialysis catheter removal in transplant patients. Methods We conducted a systematic review and random effects meta-analysis of non-randomized st...

Background Tuberous sclerosis complex (TSC) is a rare autosomal dominant genetic disease caused by mutations of either of 2 genes, TSC1 and TSC2. Renal manifestations include angiomyolipomas (AMLs), multiple cysts, and renal cell carcinoma. AMLs increase bleeding tendency and the risk of renal insufficiency which end-stage develops in 1% of affecte...

Background Infections in kidney transplant recipients are particularly challenging owing to the immunosuppressive treatment, usually long history of chronic illness, comorbidities and prior exposures to antibiotics. Among the most common complications early after surgery are surgical site infections. The aim of this study was to identify risk facto...

Introduction: An ongoing debate concerns the need for routine placement of prophylactic intra-abdominal drains following kidney transplantation. Aim: We conducted a systematic review and meta-analysis to determine whether such an approach brings any advantages in the prevention of perirenal transplant fluid collection, surgical site infection, l...

Background Infections in kidney transplant recipients are particularly challenging owing to the immunosuppressive treatment, usually long history of chronic illness, comorbidities and prior exposures to antibiotics. Among the most common complications early after surgery are surgical site infections. The aim of this study was to identify risk facto...

Background: Infections in kidney transplant recipients are particularly challenging owing to the immunosuppressive treatment, usually long history of chronic illness, comorbidities and prior exposures to antibiotics. Among the most common complications early after surgery are surgical site infections. The aim of this study was to identify risk fact...

Background Many patients with hepatic tumors cannot benefit from resection owing to the difficult anatomic sites of their lesions. Some of these patients might be eligible for ex vivo liver resection and autotransplantation. This procedure consists of complete hepatectomy, extracorporeal liver resection, and autotransplantation of the remnant liver...

Background: The clinical value of the controlling nutritional status (CONUT) score in hepatocellular carcinoma (HCC) has increased. The aim of this meta-analysis was to systematically review the association between the CONUT score and outcomes in patients undergoing hepatectomy for HCC. Methods: Embase, Medline Ovid, Web of Science, Cochrane CEN...

Background: Liver retransplantation (re-LT) accounts for up to 22% after primary liver transplantation (LT), and using donor livers for retransplantation can only be justified by successful outcome. Methods: A total of 2387 adult recipients with 2778 LT, between 1979 and 2017, were analyzed to determine risk factors and outcome of re-LT in the N...

Aim: Evidence of nutritional therapies in pancreatoduodenectomy (PD) has been shown. However, few studies focus on the association between different nutritional therapies and outcomes. The aim of this review was to summarize the current evidence of nutritional therapies such as enteral nutrition (EN), immunonutrition, and synbiotics on postoperati...

Background: In recent years, the clinical evidence of the controlling nutritional status (CONUT) score has increased in patients with gastrointestinal cancers. The purpose of this systematic review and meta-analysis was to investigate the association between the preoperative CONUT score and outcomes in patients undergoing gastrectomy for gastric c...

Background: Hypothermic machine perfusion (HMP) has become a standard method of preservation for kidneys procured from expanded-criteria donors and donors after cardiac death. There are different systems and approaches to the HMP preservation period, with cold storage prior to HMP sometimes taking several hours. This study evaluated whether the ti...

Background: Donors with acute kidney injury (AKI) are generally accepted as a valuable source of kidneys for transplant. The aim of this study was to assess the risk of developing AKI based on deceased kidney donor parameters. Materials and methods: The data of 162 kidneys procured from deceased donors after brain death were collected. These inc...

The clinical significance of the right posterior segment (RPS) graft in living donor liver transplantation (LDLT) is unknown because of its limited use and technical concerns. This study aimed to review published studies investigating outcomes of RPS grafts. The systematic literature search was conducted to retrieve data from Embase, Medline Ovid,...

Background: The hypothermic machine perfusion reduces delayed graft function after kidney transplant and allows, to some extent, predicting early graft function. However, it is difficult to identify exact perfusion criteria with which to exclude kidneys from transplant or modify post-transplant care. The aim of this study was to analyze whether re...

Background: One of the most common infective complications after kidney transplant (KTx) is surgical site infection (SSI). Providing indications of improvement of perioperative antibiotic prophylaxis (PAP) and allowing the characterization of risk factors are critical to reduce SSI. The purpose of this study was to evaluate the SSI risk factors an...

Aim: The aim of this systematic review and meta-analysis was to present the outcome of deceased adult liver transplantation from octogenarian (≥80 years old) donors compared to younger grafts. Methods: A systematic search was performed on six databases to identify all available original papers that report the outcome of adult recipients who unde...

The controlling nutritional status (CONUT) score is associated with prognosis in gastrointestinal (GI) cancer patients, but the clinical significance of the CONUT score for postoperative short-term outcome remains controversial. The aim of this study was to investigate the impact of the CONUT score on postoperative outcomes in patients with GI and...

Background: The ideal order for liver graft revascularization during liver transplantation remains unknown. The majority of liver transplant centers prefer portal venous reperfusion followed by arterial reperfusion to shorten the warm ischemia time. The aim of this study was to review the different revascularization techniques used in clinical liv...

Background: There are many doubts with regards to accepting deceased kidneys with acute kidney injury (AKI) for transplantation. Purpose: The aim of this study was to present the 5-years outcome of kidney transplantation cases where deceased donors developed AKI before organ procurement. Methods: Two hundred twenty-six deceased renal transplants we...

Background Kidney re-transplantation is a relevant option for patients who are returning to dialysis after graft failure. However, evidence is lacking to what extend a third kidney transplantation in the ipsilateral iliac fossa is safe and effective. The aim of this study was to investigate the outcomes of third kidney transplantations in the ipsil...

Background: Despite universal prophylaxis, late cytomegalovirus (CMV) infection occurs in a high proportion of kidney transplant recipients. We evaluated whether a specific viral T-cell response allows for the better identification of recipients who are at high risk of CMV infection after prophylaxis withdrawal. Methods: We conducted a prospecti...

Introduction The approach towards transplanting kidneys from ECDs in Poland is largely site-dependant. The KDRI allows for obtaining a more precise characteristic of ECDs and further stratification into “better” and “worse” quality grafts. Methods Comparison of the incidence of DGF and BPAR, median of hospitalisation time and median of eGFR at 1 y...

One of the most important problems in transplantation medicine is the ischemia/reperfusion injury of the organs to be transplanted. The aim of the present study was to assess the effect of tumor necrosis factor-alpha (TNF-alpha) inhibitor etanercept on the machine perfusion hypothermia of renal allograft kidney function and organ perfusion. No stat...

Background: Malignancies will be a leading cause of mortality in renal transplant recipients in the next 20 years. Renal cell cancer (RCC) is the most common urologic cancer in kidney transplant recipients. The risk of RCC development in kidney transplant recipients is 15-100 times higher than in the general population. The purpose of the current...

Kidney donation should not lead to deterioration of the donor's health condition, both during the perisurgical period and in the long term. Safety of a living kidney donor becomes a prerequisite for his/her qualification. Detailed diagnostic procedures are performed to exclude any abnormalities of his/her health condition. Additionally, a long-term...

Aim: A major problem for the transplant society is a shortage of organs for transplantation compared with the number of patients on the waiting list. This study aimed to assess the results of the transplantation of kidneys procured from older donors. Patients and methods: A total of 27 kidneys procured from donors age 70 years or older were tran...

Introduction: Kidney transplantation prolongs life expectancy in end-stage renal disease patients at a lesser cost than dialysis. Estimation of kidney function is crucial in the evaluation of prospective living kidney donors. Although unsurpassed in their precision methods of glomerular filtration rate (GFR) measurement with exogenous substances a...

Background: An increase in the number of obese patients on transplantation waiting lists can be observed. There are conflicting results regarding the influence of body mass index (BMI) on graft function. Methods: We performed a single-center, retrospective study of 859 adult patients who received a renal graft from deceased donors. BMI (kg/m(2))...

Background: Lynch syndrome (HNPCC, hereditary non-polyposis colorectal cancer) is a syndrome of predisposition to cancer inherited in an autosomal dominant fashion. A person with Lynch syndrome has a considerably increased risk of colorectal cancer in comparison with the general population. Case report: We present a case of a 24-year-old man wit...

Context: Machine perfusion improves graft survival. Histopathologic analysis reveals a lower incidence of chronic rejection and interstitial fibrosis in kidneys preserved with machine perfusion. Ischemic/reperfusion injury may help to explain these findings. Objective: To assess the activation of genes correlated with ischemic/reperfusion injury...

Studies have shown beneficial effects of machine perfusion (MP) on early kidney function and long-term graft survival. The aim of this study was to investigate whether the type of perfusion device could affect outcome of transplantation of deceased donor kidneys. A total of 50 kidneys retrieved from 25 donors were randomized to machine perfusion us...

Introduction. Kidney transplantation is efficacious as a renal replacement, particularly pre-emptive living donation. In Poland, the rate of transplantation of living donor kidneys is only 3%. The aim of the study was to identify the most common reasons to disqualify a potential living kidney donor. Methods. We evaluated 124 kidney donor candidates...

Few reports describing the use of organs donated by transplant recipients have been published. In this case report, kidneys procured from a brain-dead liver recipient were transplanted successfully. A 21-year-old man was referred for liver transplant after an overdose of acetaminophen. The patient's kidney function was initially normal, with proper...

The determination of kidney function plays a pivotal role in living donors renal assessment because of the long-term hazards of life with one kidney. Guidelines recommend estimation of glomerular filtration rate (GFR) by the Modification of Renal Disease (MDRD) or Cockroft-Gault equations for people with normal or near-normal renal function. Cystat...

Introduction. Kidney transplantation is efficacious as a renal replacement, particularly pre-emptive living donation. In Poland, the rate of transplantation of living donor kidneys is only 3%. The aim of the study was to identify the most common reasons to disqualify a potential living kidney donor. Methods. We evaluated 124 kidney donor candidates...

The incidence of incisional hernia following abdominal surgery varies between 2 and 13%, the rate of incisional hernia after renal transplantation varies between 1.1 and 3.8%. There are no evidence based guidelines regarding the treatment of incisional hernias in renal transplant recipients. The aim of this study was to compare results of surgical...

Using expanded criteria donor (ECD) organs is 1 strategy to make more organs available for transplant. To reduce the number of posttransplant complications and failures, there is a need to create a comprehensive system of evaluation before transplantation, especially for kidneys harvested from ECD. The aim of this study was to assess the results of...

Organ shortage is the primary barrier to kidney transplantation. To maximize organ use, organs from expanded-criteria donors (ECDs) have been used increasingly. Expanded-criteria donors are defined as individuals older than 60 years or older than 50 years with at least 2 of the following risk factors: hypertension, stroke as the cause of death, or...

Metabolic consequences resulting from loss of renal mass in living kidney donors remain uncertain. There is recent focus on the changes in the active form of vitamin D because it is an agent for cancer regulation. The objective of the study was to measure serum concentrations of 1,25-dihydroxycholecalciferol, parathyroid hormone and insulin-like gr...

This study evaluated the frequency of microbial isolates and their susceptibility profiles among cultures from the "surgical site" of 26 simultaneous pancreas-kidney (SPKT) recipients in the early posttransplant period. Data on microbiologic cultures of 26 adult patients undergoing SPKT were collected prospectively from 2001 to the end of 2006. The...

Urinary tract infection (UTI) is among the common infection in simultaneous pancreas-kidney transplantation (SPKT). The study included 26 adult patients undergoing SPKT between September 2001 and December 2006. All the patients were followed prospectively for UTI during the first 4 weeks after surgery. Urine samples were investigated for bacteriolo...

Bacteremia is among the known complications in simultaneous pancreas-kidney transplantation (SPKT). This study evaluated the frequency of microbial isolates and their susceptibility profiles among cultures of clinical samples obtained from blood and from the tips of blood vessel catheters of 26 SPKT recipients suspected of bacteremia in the early p...

Thromboelastometry is a diagnostic method presenting in graphs and numbers the dynamics of hemostasis and physical properties of the clot forming. Thromboelastometry allows quick and complete assessment of clotting and fibrinolysis mechanism respecting share of coagulation and fibrinolytic factors and also platelets. Interpretation is based on comp...

Despite documented positive effect of MachinePerfusion (MP) on long-term kidneys-graft function its wide use is restricted due to higher costs. The aim of this study was to analyze the difference in costs of kidney transplantation in patients who received organ stored in ColdStorage (CS) vs those who received kidneys stored with MP. Analysis was d...

Islets and pancreas transplantation have become standard treatments of patients with diabetic complications. However pancreas transplantation is associated with high incidence of complications and the long-term results of islet transplantation are still unsatisfactory. Loss of pancreatic islets grafts is caused not only by immunological reactions b...

Cold storage (CS) of cadaveric kidneys procured from hemodynamically stable donors for less than 24 hours is a safe procedure. Some papers indicate that continuous pulsatile machine perfusion (MP) allows for extension of preservation times, permits a wider use of kidneys damaged by preagonal ischemia, results in superior immediate function rate as...

The first kidney transplantation was performed in Poland in 1966. Since that time approximately 11,000 patients have undergone the procedure, but most of them have received the kidney from deceased donors; only 342 procedures utilized living donors (LD; 2.7%). The aim of this study was to review the results of a LD follow-up in Poland. A questionna...

The number of patients on the waiting list for kidney transplantation is increasing as a result of the cadaveric donor shortage. One way to expand the pool is living donor transplantation. However, only 2% of kidney transplants in Poland come from living-related donors. We sought to assess residual renal function, incidence of hypertension, and pro...

A prospective evaluation of the influence of methods of kidney storage prior to transplantation on long-term graft function has not been shown so far. A retrospective study undertaken in 415 patients in our department showed the benefit of machine perfusion (MP) on long-term results. The aim of the present study was to assess prospectively the long...

S11 coagulase-negative staphylococcus, 1 (0.9%) Proteus mirabilis, 1 (0.9%) Pseudomonas aeruginosa, 1 (0.9%) Salmonella spp, 1 (0.9%) Enterobacter aerogenes. The resistance rates of E. coli strains are given in the table. Among the E. coli strains isolated transplant recipients, ciprofloxacin resistance rates were 37.5% (3/8) in the first month aft...

Due to the shortage of organs for transplantation, procurement of kidneys from marginal donors is inevitable. Not infrequently, these donors are infected with hepatitis C virus (HCV). We sought to determine the effect of transplanting kidneys from anti-HCV-positive donors to anti-HCV-positive recipients. Among 765 procedures between 1994 and 2006,...

Machine perfusion (MP) has been used as the kidney preservation method in our center for over 10 years. The first, small (n = 74) prospective, single-blinded randomized study comparing MP and Cold Storage (CS) showed that the incidence of delayed graft function was higher after CS. There have been no reports in the literature on the effect of stora...

The aim of our study was to identify risk factors for early restenosis after carotid endarterectomy (CEA). Prospective follow-up of 497 primary CEAs was performed at 3, 6, 12 and 24 months by clinical assessment and duplex ultrasound to identify > or = 50% restenosis. Early restenosis occurred in 71 (14.3%) patients. By univariate analysis high car...