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  1. Article ; Online: Transplant Outcomes After Exposure of Deceased Kidney Donors to Contrast Medium.

    Chotkan, Kinita A / Hilbrands, Luuk B / Putter, Hein / Konjin, Cynthia / Schaefer, Brigitte / Beenen, Ludo F M / Pol, Robert A / Braat, Andries E

    Transplantation

    2023  Volume 108, Issue 1, Page(s) 252–260

    Abstract: Background: The administration of contrast medium is associated with acute kidney injury; however, the effect of exposure of a deceased organ donor to contrast medium on kidney transplant outcomes has been poorly studied.: Methods: A retrospective ... ...

    Abstract Background: The administration of contrast medium is associated with acute kidney injury; however, the effect of exposure of a deceased organ donor to contrast medium on kidney transplant outcomes has been poorly studied.
    Methods: A retrospective analysis of all deceased kidney donors between 2011 and 2021 and their corresponding recipients in the Netherlands was conducted. Multivariable analyses were performed to assess the associations between contrast medium exposure and delayed graft function (DGF)/graft survival. Linear mixed models were used to assess the differences in mean estimated glomerular filtration rate values in recipients 1 to 6 y after transplantation.
    Results: In total, 2177 donors and 3638 corresponding kidney graft recipients were included. Twenty-four percent of the donors (n = 520) were exposed to contrast medium, corresponding to 23% of recipients (n = 832). DGF was observed in 36% (n = 1321) and primary nonfunction in 3% (n = 122) of recipients. DGF rates for donation after brain death (DBD) and donation after circulatory death (DCD) donors showed no significant effect of contrast medium exposure ( P  = 0.15 and P  = 0.60 for DBD and DCD donors, respectively). In multivariable analyses, contrast medium administration was not significantly associated with a higher DGF risk (odds ratio 1.06; 95% confidence interval, 0.86-1.36; P  = 0.63) nor was a significant predictor for death-censored graft failure (hazard ratio 1.01; 95% confidence interval, 0.77-1.33; P  = 0.93). Linear mixed models showed no difference in mean estimated glomerular filtration rate values in recipients 1 to 6 y posttransplantation ( P  = 0.78).
    Conclusions: This study indicates that contrast medium administration in DBD and DCD donors has no negative effect on early and long-term kidney graft function.
    MeSH term(s) Humans ; Kidney Transplantation/adverse effects ; Tissue and Organ Procurement ; Retrospective Studies ; Graft Survival ; Tissue Donors ; Brain Death ; Delayed Graft Function/etiology
    Language English
    Publishing date 2023-09-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 208424-7
    ISSN 1534-6080 ; 0041-1337
    ISSN (online) 1534-6080
    ISSN 0041-1337
    DOI 10.1097/TP.0000000000004745
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Decision-Making And Selection Bias in Four Observational Studies on Duchenne and Becker Muscular Dystrophy.

    Naarding, Karin J / Doorenweerd, Nathalie / Koeks, Zaïda / Hendriksen, Ruben G F / Chotkan, Kinita A / Krom, Yvonne D / de Groot, Imelda J M / Straathof, Chiara S / Niks, Erik H / Kan, Hermien E

    Journal of neuromuscular diseases

    2020  Volume 7, Issue 4, Page(s) 433–442

    Abstract: Background: Natural history data are essential for trial design in Duchenne (DMD) and Becker muscular dystrophy (BMD), but recruitment for observational studies can be challenging.: Objective: We reviewed reasons why patients or caregivers declined ... ...

    Abstract Background: Natural history data are essential for trial design in Duchenne (DMD) and Becker muscular dystrophy (BMD), but recruitment for observational studies can be challenging.
    Objective: We reviewed reasons why patients or caregivers declined participation, and compared characteristics of participants and non-participants to assess possible selection bias in four observational studies, three on DMD and one on BMD.
    Methods: Three pediatric DMD studies focused on cross-sectional cognitive function and brain MRI (DMDbrain, n = 35 and DMDperfusion, n = 12), and on longitudinal upper extremity function and muscle MRI (DMDarm, n = 22). One adult BMD study assessed longitudinal functioning (n = 36). Considerations for non-participation were retrospectively reviewed from screening logs. Age, travel-time, DMD gene mutations and age at loss of ambulation (DMDarm and BMD study only), of participants and non-participants were derived from the Dutch Dystrophinopathy Database and compared using nonparametric tests (p < 0.05).
    Results: The perceived burden of the protocol (38.2%), use of MRI (30.4%), and travel-time to the study site (19.1%) were the most frequently reported considerations for non-participation. Only few patients reported lack of personal gain (0.0- 5.9%). Overall, participating patients were representative for the studied sub-populations, except for a younger age of DMDarm study participants and a complete lack of participants with a mutation beyond exon 63.
    Conclusion: Optimizing patient involvement in protocol design, improving MRI experiences, and integrating research into clinics are important factors to decrease burden and facilitate participation. Nationwide registries are essential to compare participants and non-participants and ensure representative observational research. Specific effort is needed to include patients with distal mutations in cognitive studies.
    MeSH term(s) Adolescent ; Adult ; Child ; Cross-Sectional Studies ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Muscular Dystrophy, Duchenne/diagnosis ; Muscular Dystrophy, Duchenne/diagnostic imaging ; Observational Studies as Topic/statistics & numerical data ; Patient Participation/statistics & numerical data ; Patient Selection ; Refusal to Participate/statistics & numerical data ; Retrospective Studies ; Selection Bias ; Young Adult
    Language English
    Publishing date 2020-08-21
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2214-3602
    ISSN (online) 2214-3602
    DOI 10.3233/JND-200541
    Database MEDical Literature Analysis and Retrieval System OnLINE

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