Metabolic risk after living kidney donation: an analysis of the Swiss Organ Living-Donor Health Registry.

Background: Due to persistent organ shortage, the selection criteria for living kidney donors have broadened to include elderly donors and those with co-morbidities. As little is known about metabolic health after living kidney donation, this prospective, multicentre cohort study explored metabolic changes among living kidney donors, with a particular focus on weight trajectories.

Methods: We analysed metabolic and cardiovascular parameters before and after living kidney donation in 466 consecutive living kidney donors recorded in the Swiss Organ Living-Donor Health Registry between January 2018 and August 2022.

Impact of Repeated Non-Fatal Infections on Quality of Life and Graft Function in ABO-Incompatible Kidney Transplants.

Background: Kidney transplantation (KT) is the preferred treatment for kidney failure, with living donor KT (LDKT) offering better outcomes and improved quality of life (QOL) than deceased donor KT. ABO incompatibility (ABOi) once restricted LDKT, but desensitization protocols now enable ABOi LDKT, expanding the donor pool with favorable outcomes. However, added risks of ABOi remain debated.

Why Living Kidney Donors Are Declined: A Swiss Single Center Observation Over 15 Years.

Introduction: Living kidney donation plays a crucial role in addressing organ shortage. Careful and holistic donor assessment is required to minimize donor risks. While acceptance patterns are well documented, donor candidates beyond the threshold remain largely unexamined.

[Eye Spy: What Red Eyes Could Reveal About Your Kidneys].

TINU syndrome (Tubulointerstitial Nephritis and Uveitis) is a rare autoimmune disorder that causes inflammation in the kidneys and eyes. It manifests as uveitis and impaired kidney function. Diagnosis is based on symptom correlation and kidney biopsy.

Reintegration Into the Workforce After Kidney Transplantation Based on Urbanization Status in Switzerland.

Introduction: Most of Switzerland's population and employment opportunities are concentrated in urban areas. Although kidney transplantation (KT) is the preferred therapy for eligible candidates, individuals in rural areas face challenges accessing specialized medical services due to longer travel distances. Limited understanding exists regarding patients' perspectives on returning to work after KT and whether this correlates with their urbanization status, potentially influencing outcomes.

[French translation and adaptation of the KDIGO nomenclature for kidney function and disease].

A harmonized medical nomenclature that is accessible to the lay people is crucial to raising awareness of insidious health problems such as chronic kidney disease and facilitating communication between healthcare professionals. This article presents the proposals of a French-speaking working group for the translation and adaptation into French of the nomenclature for renal function and disease that resulted from a KDIGO consensus conference published in English in 2020. In particular, the working group recommends abandoning terms that used to correspond in French to “chronic renal failure”, “acute renal failure”, “end-stage renal failure”, “uremia”, “cadaveric donor” and “microalbuminuria”, in favor of French equivalents of “chronic renal disease”, “acute kidney injury”, “renal failure”, “uremic syndrome”, “deceased donor” and “albuminuria”.

Desensitization With Imlifidase for HLA-Incompatible Deceased Donor Kidney Transplantation: A Delphi International Expert Consensus.

Highly sensitized (HS) patients in need of kidney transplantation (KTx) typically spend a longer time waiting for compatible kidneys, are unlikely to receive an organ offer, and are at increased risk of antibody-mediated rejection (AMR). Desensitization using imlifidase, which is more rapid and removes total body immunoglobulin G (IgG) to a greater extent than other methods, enables transplantation to occur between HLA-incompatible (HLAi) donor-recipient pairs and allows patients to have greater access to KTx. However, when the project was launched there was limited data and clinical experience with desensitization in general and with imlifidase specifically.

Assessment of access and outcomes of kidney transplantation through the reforms of the Swiss organ allocation system.

Introduction: The Swiss allocation system for kidney transplantation has evolved over time to balance medical urgency, immunological compatibility, and waiting time. Since the introduction of the transplantation law in 2007, which imposed organ allocation on a national level, the algorithm has been optimized. Initially based on waiting time, HLA compatibility, and crossmatch performed by cell complement-dependent cytotoxicity techniques, the system moved in 2012 to a score including HLA compatibility, waiting time, anti-HLA antibodies detected by the Luminex technology, and a virtual crossmatch.

EXAM: Ex-vivo allograft monitoring dashboard for the analysis of hypothermic machine perfusion data in deceased-donor kidney transplantation.

Deceased-donor kidney allografts are exposed to ischemic injury during ex vivo transport due to the lack of blood oxygen supply. Hypothermic machine perfusion (HMP) effectively reduces the risk of delayed graft function in kidney transplant recipients compared to standard cold storage. However, no free software implementation is available to analyze HMP data for state-of-the-art visualization and quality control.

Early Complications in Kidney Donors and Course of Health-related Quality of Life 12 mo After Donation: An Analysis of the Swiss Organ Living-Donor Health Registry.

Background: Since 1998, the Swiss Organ Living-Donor Health Registry (SOL-DHR) has recorded peri- and postoperative complications of living kidney (LK) donors, as reported by all Swiss transplant centers and has collected follow-up data prospectively.

Methods: We analyzed the early complications of 2379 consecutive individuals who donated a kidney between January 1998 and June 2022 and assessed their health-related quality of life (HRQoL) 1 y after donation.

Results: In total, 447 early complications in 404/2379 LK donors (17.

Pre-transplant donor specific antibodies in ABO incompatible kidney transplantation - data from the Swiss transplant cohort study.

Background: Living donor (LD) kidney transplantation in the setting of ABO blood group incompatibility (ABOi) has been previously reported to be associated with increased risk for antibody-mediated rejection (ABMR). It is however unclear if the presence of pre-transplant donor specific antibodies (DSA) works as an additive risk factor in the setting of ABOi and if DSA positive ABOi transplants have a significantly worse long-term outcome as compared with ABO compatible (ABOc) DSA positive transplants.

Methods: We investigated the effect of pre-transplant DSA in the ABOi and ABOc setting on the risk of antibody-mediated rejection (ABMR) and graft loss in a cohort of 952 LD kidney transplants.

Immunogenicity of High-Dose Versus MF59-Adjuvanted Versus Standard Influenza Vaccine in Solid Organ Transplant Recipients: The Swiss/Spanish Trial in Solid Organ Transplantation on Prevention of Influenza (STOP-FLU Trial).

Background: The immunogenicity of the standard influenza vaccine is reduced in solid-organ transplant (SOT) recipients, so new vaccination strategies are needed in this population.

Methods: Adult SOT recipients from 9 transplant clinics in Switzerland and Spain were enrolled if they were >3 months after transplantation. Patients were randomized (1:1:1) to a MF59-adjuvanted or a high-dose vaccine (intervention), or a standard vaccine (control), with stratification by organ and time from transplant.

Magnetic blood purification-based soluble fms-like tyrosine kinase-1 removal in comparison with dextran sulfate apheresis and therapeutic plasma exchange.

Background: Preeclampsia remains one of the most serious complications of pregnancy. Effective therapies are yet to be developed. Recent research has identified an imbalance of angiogenic and antiangiogenic factors as a root cause of preeclampsia.

Clinical prediction model for prognosis in kidney transplant recipients (KIDMO): study protocol.

Background: Many potential prognostic factors for predicting kidney transplantation outcomes have been identified. However, in Switzerland, no widely accepted prognostic model or risk score for transplantation outcomes is being routinely used in clinical practice yet. We aim to develop three prediction models for the prognosis of graft survival, quality of life, and graft function following transplantation in Switzerland.

Donation type and the effect of pre-transplant donor specific antibodies - Data from the Swiss Transplant Cohort Study.

Introduction: The type of donation may affect how susceptible a donor kidney is to injury from pre-existing alloimmunity. Many centers are, therefore, reluctant to perform donor specific antibody (DSA) positive transplantations in the setting of donation after circulatory death (DCD). There are, however, no large studies comparing the impact of pre-transplant DSA stratified on donation type in a cohort with a complete virtual cross-match and long-term follow-up of transplant outcome.

The impact of pre-transplant donor specific antibodies on the outcome of kidney transplantation - Data from the Swiss transplant cohort study.

Background: Pre-transplant donor specific antibodies (DSA), directed at non-self human leukocyte antigen (HLA) protein variants present in the donor organ, have been associated with worse outcomes in kidney transplantation. The impact of the mean fluorescence intensity (MFI) and the target HLA antigen of the detected DSA has, however, not been conclusively studied in a large cohort with a complete virtual cross-match (vXM).

Methods: We investigated the effect of pre-transplant DSA on the risk of antibody-mediated rejection (ABMR), graft loss, and the rate of eGFR decline in 411 DSA positive transplants and 1804 DSA negative controls.

[Nomenclature for kidney function and kidney diseases - Improving assessment and prognosis through precision and comprehensibility].

Kidney disease represents an increasing global health problem. Its mitigation requires effective communication between all stakeholders involved in assessment, diagnosis and therapy and individuals affected by kidney disease. However, as of today the nomenclature for kidney function and kidney disease is far from uniform.

A National Survey Comparing Patients' and Transplant Professionals' Research Priorities in the Swiss Transplant Cohort Study.

We aimed to identify, assess, compare and map research priorities of patients and professionals in the Swiss Transplant Cohort Study. The project followed 3 steps. 1) Focus group interviews identified patients' ( = 22) research priorities.

Infection Risk in the First Year After ABO-incompatible Kidney Transplantation: A Nationwide Prospective Cohort Study.

Background: ABO-incompatible (ABOi) kidney transplantation (KT) expands the kidney donor pool and may help to overcome organ shortage. Nonetheless, concerns about infectious complications associated with ABOi-KT have been raised.

Methods: In a nationwide cohort (Swiss Transplant Cohort Study), we compared the risk for infectious complications among ABOi and ABO-compatible (ABOc) renal transplant recipients.

Age at Time of Kidney Transplantation as a Predictor for Mortality, Graft Loss and Self-Rated Health Status: Results From the Swiss Transplant Cohort Study.

The effect of age on health outcomes in kidney transplantation remains inconclusive. This study aimed to analyze the relationship between age at time of kidney transplantation with mortality, graft loss and self-rated health status in adult kidney transplant recipients. This study used data from the Swiss Transplant Cohort Study and included prospective data of kidney transplant recipients between 2008 and 2017.

Relevance of deceased donor proteinuria for kidney transplantation: A comprehensive national cohort study.

Purpose: Proteinuria is frequent in patients with nephropathies and associated with progressive kidney disease and risk for end stage kidney disease. However, the relevance of deceased donor proteinuria on transplant outcome remains uncertain. In this nationwide cohort study, we evaluated the prevalence of proteinuria in deceased donor candidates and measured the impact on outcome after kidney transplantation.

Cohort profile: The Swiss Transplant Cohort Study (STCS): A nationwide longitudinal cohort study of all solid organ recipients in Switzerland.

Purpose: The Swiss Transplant Cohort Study (STCS) is a prospective multicentre cohort study which started to actively enrol study participants in May 2008. It takes advantage of combining data from all transplant programmes in one unique system to perform comprehensive nationwide reporting and to promote translational and clinical post-transplant outcome research in the framework of Swiss transplantation medicine.

Participants: Over 5500 solid organ transplant recipients have been enrolled in all six Swiss transplant centres by end of 2019, around three-quarter of them for kidney and liver transplants.

Demographic, psychosocial and health disparities between living and deceased renal allograft recipients in Switzerland.

Background: Living donor renal transplantation is widely performed in Switzerland with a superior long-term outcome and lower waiting time compared with deceased renal transplantation. However the chances of receiving a living donor kidney transplant are not the same for all transplant candidates. The current study aimed to identify psychosocial and demographic characteristics that predict lower access to living kidney donation in Switzerland.