A Kwiatkowski's research while affiliated with University of Warsaw and other places
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Publications (147)
Background
The aim of the study was to perform an in-depth exploratory analysis of the experience and image of one’s body among living kidney donors.
Method
The research was carried out using mixed methodology. The study on experiencing one’s own body was carried out using the sociological methodology of the grounded theory (qualitative research)....
The 3 leading causes of death in patients after solid organ transplantation (SOT) include cardiovascular diseases, malignancies, and infections. According to our current understanding, the latter play the key role in the pathogenesis of atherosclerosis. Similarly, infections (mainly viral) are implicated in the pathogenesis of at least 20% of known...
Introduction:
Most life-threatening diabetes-related complications involve the kidneys, eyes, cardiovascular system, and autonomic nervous system. Clinical islet transplantation (CITx) may be a therapeutic option for some patients. In this study, we analyzed the progression of diabetic complications after CITx and in patients waiting for islet tra...
Introduction:
Painful chronic pancreatitis (CP) is the main indication for analgesic pancreatectomy with simultaneous islet autotransplantation to prevent postoperative diabetes mellitus (DM). However, advanced CP may lead to insulin secretion disorders and DM. There are doubts as to whether islet autotransplantation in such cases is an appropriat...
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...
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...
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...
Introduction:
Estimation of kidney function is crucial in appropriate and safe
qualification living kidney donors. Glomerular filtration rate (GFR) measurement
with exogenous substances is an invasive and expensive procedure. Alternatively,
kidney function can also be assessed by GFR estimation
formulas, which base on serum creatinine and other no...
Introduction: One of the major points of living kidney donor qualification is
renal function examination. According to KDIGO, GFR should be estimated
using CKD-EPI creatinine-cystatin C formula (CKD-EPIcrea/cys). It is supposed
that novel markers such as BTP and uromodulin may be useful in estimating
renal function.
Aim: The aim of the study was to...
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:
Staphylococcus aureus infection, and health care-associated-methicillin resistant S aureus (HA-MRSA) in particular, is a serious risk for patients treated with organ transplantation. The frequent combined resistance of these bacteria to macrolides, lincosamides, and streptogramin-B (MLS-B) limits the use of these drugs in therapy.
A...
Introduction:
Because nearly 30,000 people worldwide become living kidney donors each year, donor safety is of the utmost importance. Recent studies have shown that living kidney donation is associated with an increased relative risk for end-stage renal disease (ESRD). It is essential to determine which donors will be more likely to develop ESRD....
Background:
Total pancreatectomy and autologous transplantation of pancreatic islets is a treatment option for patients with severe pain due to chronic pancreatitis. In the standard procedure, pancreatic islets are isolated and subsequently administered into the portal vein. In the case of patients with a history of thrombosis or at risk of thromb...
Background:
Multiple renal artery kidneys still represent a special challenge for surgeons, during both nephrectomy for organ donation and transplantation. Recognition of anatomical conditions with advanced imaging methods is one of the most important elements of the preoperative evaluation process.
Aim:
The purpose of the current study was to a...
Background:
It has been determined that there are about 25% patients with renal allograft failure on the waiting lists.
Methods:
We analyzed 406 patients who received a kidney graft from 2013 to 2015 in a single center. The analysis resulted in 33 pairs of patients: for one recipient in the pair it was the first transplantation and for the other...
Introduction
Possibility of an increased risk of end-stage renal disease is a major concern related with living kidney donation Therefore, the monitoring of the residual kidney function becomes the most important purpose of the follow-up system.
Material
Data analysis of 156 living kidney donors (LKDs) was conducted. The efficacy of the long-term...
Background:
Islets transplantation is an established treatment method for patients suffering from brittle diabetes with hypoglycemia unawareness. The standard implantation technique is through the portal vein into the liver. In case of liver diseases or portal hypertension, finding an extra-hepatic site is recommended. There have been attempts to...
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...
Background:
Cardiovascular (CV) complications are the major cause of death in kidney transplant (KT) patients.
Methods:
During a 3-year follow-up, 112 KT recipients, from living (LD KTRs; n = 54), and deceased (DD KTRs; n = 58) donors, were assessed for 10-year risk of fatal CV events with the use of the Heartscore tool (www.heartscore.org). In...
Background:
We report 2 cases of polyomavirus-associated nephropathy (PyVAN) emerging within the initial 8 posttransplant weeks. These cases were characterized by intraepithelial BK virus replication without typical nuclear inclusions in epithelial cells.
Methods and results:
A 70-year-old male recipient of a cadaveric kidney transplant had expe...
Introduction:
Health benefits of a living-donor kidney transplantation are numerous and well known. There is, however, a dearth of knowledge on postoperative quality of life among the living-donor (LD) compared to deceased-donor (DD) transplant recipients.
Materials and methods:
The study involved 89 patients after renal transplantation: 48 from...
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:
The aim of this study was to investigate risk factors for urinary tract infections (UTI), the causative organisms of UTI and also their management and treatment. In addition, we evaluated the effects of UTI on renal graft function.
Methods:
This analysis included 107 kidney transplant recipients (64% women) with a diagnosis of UTIs...
Allelic variants of the MYH9 gene, encoding myosin nonmuscle heavy chain type IIA, have been shown to correlate with diminished glomerular filtration rates and end-stage kidney disease in individuals of Caucasian ancestry. Myosin nonmuscle heavy chain type IIA is expressed during development as well as in injured vessels and kidney structures. We h...
Background:
Chronic kidney disease is one of the medical conditions that affect hemostasis. Patients undergoing hemodialysis present both hemorrhagic and prothrombotic tendencies. Platelet adhesion to the artificial surface of the dialyzer's membrane, blood vessel endothelial wall disruption, and quantitative and qualitative changes in clothing fa...
Background:
Blood infections with multidrug-resistant Gram-negative carbapenem-resistant bacilli are particularly dangerous and challenging to treat in organ transplant recipients. Resistance to carbapenems may be acquired, for example, in Enterobacteriaceae, Pseudomonas, or Acinetobacter spp. or innate, for example, in Stenotrophomonas maltophili...
Background:
Infections remain serious complications in solid-organ transplant recipients, despite professional medical care, the introduction of new immunosuppressive drugs, and treatment that decreases the risk of infections.
Methods:
The study covered 295 adult patients undergoing kidney transplantation (KTx) between September 2001 and Decembe...
Background:
NT-proBNP is a natriuretic neurohormone released mainly from ventricular cardiomyocytes in conditions of volumetric or pressure overload; it is suitable for use as a marker of left ventricular hypertrophy (LVH), a common disorder in renal transplant recipients. The study objective here was to assess NT-proBNP levels in the 1st year aft...
Objective:
This study aims to evaluate the frequency of microbial isolates and their susceptibility profiles cultured from clinical samples obtained from 26 simultaneous pancreas-kidney transplant (SPK) recipients suspected of infections during the early post-transplantation period.
Patients and methods:
Data on microbiologic culture of 26 adult...
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...
Reduced physical activity and high calories up-take along with carbohydrates based diet are considered to be a leading cause of diabetes mellitus rise in western countries. Together with rise in DM morbidity, increase of complicated diabetes is also observed. Pancreas transplantation occurred to be a milestone in diabetic patient management. Guine...
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...
Background:
Uridine diphosphate glucuronosyltransferase (UGT2B7) is responsible for conversion of mycophenolic acid to mycophenolic acyl-glucuronide (acylMPAG). Conflicting data exist regarding the role of UGT2B7 p.His268Tyr (802C>T, rs7439366) variant in the clinical course following organ transplantation.
Study aim:
The aim of this study was t...
Kidney transplantation (KTx) is a widely accepted method of renal function replacement therapy. Surgical site infections (SSIs), along with urinary tract infections, are among the most common infective complications after KTx. The purpose of this study was to assess the incidence of SSI in patients after KTx, identify risk factors for SSI, and clas...
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 epidemiological studies indicate that the problem of obesity and associated metabolic syndrome affects the steadily increasing population. The obesity also applies to the patients with the end-stage renal failure requiring renal replacement therapy. Morbid obesity is a contraindication to renal transplantation procedure. A significant excess we...
Urinary tract infection (UTI) is among the most common infections in solid organ transplantation, especially in kidney transplantation.
This study included 295 adult patients undergoing KTx between September 2001 and December 2007. All patients were followed prospectively for UTI during the first 4 weeks after surgery. Samples of urine were investi...
INTRODUCTION AND AIMS: Hematopoietic cell transplantation (HCT) is an increasingly common treatment for many malignancies. Each type of HCT carries
its own risks and complications. The most common chronic complications are calcinurine inhibitors (CsA) toxicities, development
of chronic graft versus host disease (GVHD). Occurrence of chronic renal d...
Actinomyces is endogenic infection with rare abdominal manifestations. Diagnosis is very difficult and not always taken into account in differential diagnosis. Disease is recurrent and treatment is mostly pharmacologic and takes a long time. The aim of the paper was to present a case of patient operated on acute cholecystitis with intraabdominal ac...
Bleeding due to fibrinolysis is a serious intraoperative complication during orthotopic liver transplantation (OLT). For a number of years aprotinin was used to minimize risk of this complication. This drug was however banned in 2007 and substituted with other antifibrinolytics. The aim of the study was to assess the potential of intraoperative thr...
Improvements in operating techniques, methods of anaesthesia and postoperative care in liver transplantation (LT) contribute to better outcomes. In order to restrict postoperative mechanical ventilation, a thoracic epidural analgesia (TEA) has been performed in our centre since 2000. In this report we present our 10-year experience of using TEA as...
Vancomycin-resistant enterococci (VRE) require epidemiological monitoring especially in transplantation wards. The aim of our work was to perform a molecular analysis of vancomycin-resistant Enterococcus faecalis (VREfl) strains among solid organ recipients during various years.
Strains were examined for the presence of different genes determining...
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...
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...
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...
The aim of the investigations was to compare the vancomycin-resistant Enterococcus faecium (VREfm) strains obtained from our patients.
Strains were compared using restriction fragment length polymorphism-pulsed field gel electrophoresis (RFLP-PFGE) of bacterial DNA.
VREfm infected 26 liver recipients, 22 kidney recipients, and 9 other surgery or ne...
The aim of the study was to describe a diagnostic protocol to lower the risk of a mycotic invasive infection among allotransplant recipients and to suggest the use of preoperative prophylaxis and/or empiric therapy. We chose a group of 268 allograft recipients with transient or constant yeast colonization or confirmed yeast infection. Among 7744 cl...
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...
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...
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...
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...