Kidney transplantation and donation in the transgender population: A single-institution case series.

Autor: Ramadan OI; Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA., Naji A; Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA., Levine MH; Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA., Porrett PM; Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA., Dunn TB; Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA., Nazarian SM; Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA., Weinrieb RM; Department of Psychiatry, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA., Kaminski M; Penn Transplant Institute, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA., Johnson D; Department of Pharmacy, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA., Trofe-Clark J; Department of Pharmacy, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.; Division of Nephrology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA., Lorincz IS; Division of Endocrinology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA., Blumberg EA; Division of Infectious Disease, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA., Weikert BC; Division of Infectious Disease, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA., Bleicher M; Division of Nephrology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA., Abt PL; Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Jazyk: angličtina
Zdroj: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2020 Oct; Vol. 20 (10), pp. 2899-2904. Date of Electronic Publication: 2020 May 27.
DOI: 10.1111/ajt.15963
Abstrakt: The medical needs of the transgender population are increasingly recognized within the US health care system. Hormone therapy and gender-affirming surgery present distinct anatomic, hormonal, infectious, and psychosocial issues among transgender kidney transplant donors and recipients. We present the first reported experience with kidney transplantation and donation in transgender patients. A single-center case series (January 2014-December 2018) comprising 4 transgender kidney transplant recipients and 2 transgender living donors was constructed and analyzed. Experts in transplant surgery, transplant psychiatry, transplant infectious disease, pharmacy, and endocrinology were consulted to discuss aspects of care for these patients. Four transgender patients identified as male-to-female and 2 as female-to-male. Three of 6 had gender-affirming surgeries prior to transplant surgery, 1 of whom had further procedures posttransplant. Additionally, 4 patients were on hormone therapy. All 6 had psychiatric comorbidities. The 4 grafts have done well, with an average serum creatinine of 1.45 mg/dL at 2 years (range 1.01-1.85 mg/dL). However, patients encountered various postoperative complications, 1 of which was attributable to modified anatomy. Thus, transgender kidney transplant patients can present novel challenges in regard to surgical considerations as well as pre- and posttransplant care. Dedicated expertise is needed to optimize outcomes for this population.
(© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.)
Databáze: MEDLINE
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