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kidney transplantation from HCV-viremic donors into uninfected recipients is associated with excellent short-term outcomes. However, concerns regarding an increased risk for the development of de novo donor specific antibodies (DSA) and acute rejection have been raised in single center reports.a retrospective study of HCV-negative kidney- only transplant recipients between 2018 and 2020. Patients were grouped based on the donor HCV status into group 1; HCV-viremic donors, and group 2; HCV- negative donors. Inverse probability of treatment weighting (IPTW), with weights derived from the propensity score, were used to estimate the effect of donors' HCV-viremia on the recipients. The primary objective was to compare the one-year incidence of de novo DSA. Secondary outcomes included group comparison of the incidence of biopsy proven acute rejection (BPAR), one-year patient and allograft survival, and one-year renal allograft function.71 patients were included in the HCV NAT+ group, and 440 in the HCV- negative group. One-year incidence of de novo DSA was higher in the HCV NAT+ group in the IPTW weighted analysis (19% vs 9%, p = 0.02). In the unweighted analysis, BPAR occurred in 7% of recipients in the HCV NAT+ group, compared to 3% in the control group (P = 0.06). However, due to the low event rate in the in the IPTW weighted groups, a statistical significance test could not be performed. Average estimated GFR was higher in the HCV-viremic group at 3 months (61 vs 53 ml/min/1.73 m 2 p = 0.002), but comparable at 6 (59 vs 56 ml/min/1.73m 2, p = 0.31) and 12 months (60 vs 55 ml/min/1.73m 2, p = 0.07). Patient and allograft survival were comparable between the two groups.kidney transplant from HCV-viremic donors was associated with an increased risk for the development of post-transplant de novo DSA in the first year after transplantation, but no difference in patient and graft survival. This article is protected by copyright. All rights reserved.

kidney transplantation from Hepatitis C virus (HCV) viremic donors to uninfected recipients is associated with excellent short-term outcomes. However, HCV viremia might be associated with an increased risk for post-transplant viral complications.We designed a retrospective study of HCV-negative kidney-only transplant recipients between 2018 and 2020. Recipients were grouped into group 1; HCV-negative donors, and group 2; HCV-viremic donors. Patients were matched 1:1 using propensity score. The primary objectives were to compare the incidence of cytomegalovirus (CMV) viremia ≥ 200 ml/IU, and BK viremia ≥1000 copies/ml between the groups. Secondary outcomes included group comparison of CMV disease, BK viremia ≥10 000 copies/ml, and 1-year patient and allograft survival.The study included 634 patients in group 1, and 71 patients in group 2. Sixty-five pairs of patients were matched. Incidence of CMV viremia (33.3% vs. 40.0%, p = .4675), and BK viremia (15.9% vs. 27.7%, p = .1353) did not differ significantly between groups in the matched cohort. Incidence of CMV disease (81.0% vs. 76.9%, p = 1.000), and BK viremia ≥10 000 copies/ml (9.5% vs. 16.9%, p = .2987) were comparable between groups. There was no difference in the 1-year patient or allograft survival between groups.kidney transplant from HCV-viremic donors is not associated with increased risk for BK or CMV viremia.

There are no standardized benchmarks to measure productivity and compensation of transplant nephrologists in the United States, and consequently, criteria set for general nephrologists are often used.A web-based survey was sent to 809 nephrologists who were members of the American Society of Transplantation to gather data on measures of productivity, compensation, and job satisfaction. Factors associated with higher total compensation and job satisfaction were examined.Of 365 respondents, 260 were actively practicing in the United States and provided data on compensation. Clinical productivity was assessed variably, and although 194 (76%) had their work relative value units (wRVUs) reported to them, only 107 (44%) had an established RVU target; 234 (90%) had fixed base compensation, and 172 (66%) received a bonus on the basis of clinical workload (68%), academic productivity (31%), service (32%), and/or teaching responsibility (31%). Only 127 respondents (49%) filled out time studies, and 92 (35%) received some compensation for nonbillable transplant activity. Mean total compensation (base salary and bonus) was $274,460±$91,509. The unadjusted mean total compensation was higher with older age and was higher for men; Hispanic and White respondents; adult care transplant nephrologists; residents of the western United States; US medical school graduates; nonuniversity hospital employees; and those with an administrative title, higher academic rank, and a higher number of years in practice. Two hundred and nine respondents (80%) thought their compensation was unfair, and 180 (70%) lacked a clear understanding of how they were compensated. One hundred forty-five respondents (55%) reported being satisfied or highly satisfied with their job. Job satisfaction was greater among those with higher amounts of compensation and US medical school graduates.We report significant heterogeneity in the assessment of productivity and compensation for transplant nephrologists and the association of compensation with job satisfaction.

Acute kidney injury (AKI) is a common complication after lung transplantation (LT) and is associated with higher cost and mortality. We sought to evaluate the incidence of postoperative AKI, defined as AKI within 14 days of transplant, and identify associated perioperative factors.We conducted a single-center, retrospective review of 153 lung transplant recipients. Postoperative AKI was determined using the RIFLE (Risk, Injury, Failure, Loss, End Stage) criteria. Perioperative covariates and their association with postoperative AKI were analyzed using Cox proportional hazards. Kaplan-Meier survival curves were constructed to evaluate patient survival at 1 year and data finalization. A sub-analysis was performed evaluating factors associated with early AKI (within 48 h of transplant) and late AKI.Postoperative AKI occurred in 36.6% of patients with 51.8% of cases occurring within 48 h of LT. Recipient race, transplant type, cardiopulmonary support, and red blood cell administration were associated with postoperative AKI. Survival was significantly lower in patients with postoperative AKI following LT.Postoperative AKI within 2 weeks of lung transplant is associated with lower short- and long-term survival. Perioperative factors associated with postoperative AKI may be potential points of intervention to minimize AKI development in the future.

Remnant cholesterol (RC) is the cholesterol content of circulating triglyceride-rich lipoproteins. Studies employing a simple calculation of RC from routine lipid/lipoprotein measures have demonstrated associations between RC levels and cardiovascular disease (CVD) outcomes in both observational study, and lipid lowering clinical trial cohorts. There are no published data evaluating the potential relationship between remnant cholesterol and CVD in chronic kidney transplant recipients [KTRs], a population with excess risk for fatal and non-fatal CVD. RC was calculated, using non-fasting plasma samples, as total cholesterol - [HDL cholesterol + LDL cholesterol] in n=3002 FAVORIT trial [NCT00064753] participants at randomization (mean 37.6, standard deviation ± 21.3, range 4-230 mg/dl). During a median follow-up of 4.0-years, the cohort experienced n=419 CVD outcomes [myocardial infarction, stroke, resuscitated sudden death, CVD death, and CVD procedural events, pooled]. Multivariable logistic regression modeling revealed that each 10 mg/dl increase of RC conferred a 16.4% increase [95% CI, 3.6-30.8%] in CVD risk adjusted for age, baseline CVD, diabetes, smoking, race, sex, body-mass index, LDL, HDL, natural log triglycerides, estimated glomerular filtration rate, natural log urinary albumin/creatinine, type of kidney graft, graft vintage, and the use of calcineurin inhibitors, steroids, or lipid lowering drugs. Given the residual risk for CVD after recommended LDL levels are achieved, these data suggest that interventions [i.e., such as eicosapentaenoic acid ethyl ester, which can lower RC by ~25-30%; Atherosclerosis 2016; 253: 81-87] targeting elevated RC concentrations in KTRs, merit consideration.

BACKGROUND The utility of cardiac stress testing as a risk-stratification tool before kidney transplantation remains debatable owing to discordance with coronary angiography and outcome yields at different centers. METHODS We conducted a retrospective study of 273 diabetic kidney transplant recipients from 2006 to 2010. By protocol, all diabetic patients underwent pharmacological radionucleotide stress test or dobutamine stress echocardiography before transplant. We compared the 1-year cardiac outcomes between those with negative stress test results and those with positive stress test results. RESULTS Patients with a positive stress test result (n=67) underwent coronary angiogram, and significant coronary artery disease (≥70% coronary stenosis) was found in 35 (52.2%) patients. Of the latter, 32 (91.4%) underwent cardiac revascularization (24 underwent cardiac stenting and 8 underwent coronary artery bypass grafting). The rest (n=35) were treated medically. Within 1 year after transplant, the group with positive stress test results experienced more cardiac events (34.3% vs. 3.9%, P