1.Synchronous nephrectomy with unilateral dual kidney transplantation: feasibility in patients with adult polycystic kidney disease.
Fiona WU ; Zhaolong DENG ; David CONSIGLIERE ; Ho Yee TIONG
Singapore medical journal 2012;53(8):e163-5
Adult polycystic kidney disease (APKD) accounts for 2% of end-stage renal disease in Singapore and is a major indication for kidney transplantation. We report synchronous nephrectomy with unilateral cadaveric dual kidney transplantation (DKT) in a patient with APKD. Simple nephrectomy of the right native 27-cm polycystic kidney was performed to provide adequate space for unilateral DKT. Right donor kidney transplantation was performed at the site of native nephrectomy. End-to-side anastomosis of the right donor renal vein to the distal inferior vena cava and the right donor artery to the common iliac artery were performed. Left donor kidney was transplanted below the right kidney, with its vessels anastomosed to the right external iliac vessels. Ureter anastomosis was performed after perfusion of both kidneys. Lich-Gregoir anastomosis of the left donor ureter to the bladder and direct right donor ureter to native ureter anastomosis was established. This case illustrates that synchronous nephrectomy with DKT is feasible to facilitate implantation on the same side.
Adult
;
Anastomosis, Surgical
;
Humans
;
Kidney
;
surgery
;
Kidney Failure, Chronic
;
surgery
;
Kidney Transplantation
;
methods
;
Male
;
Middle Aged
;
Nephrectomy
;
methods
;
Polycystic Kidney, Autosomal Dominant
;
surgery
;
Tomography, X-Ray Computed
;
Ureter
;
surgery
2.Flattening the biological age curve by improving metabolic health: to taurine or not to taurine, that' s the question.
Kwok M HO ; Anna LEE ; William WU ; Matthew T V CHAN ; Lowell LING ; Jeffrey LIPMAN ; Jason ROBERTS ; Edward LITTON ; Gavin M JOYNT ; Martin WONG
Journal of Geriatric Cardiology 2023;20(11):813-823
The aging population is an important issue around the world especially in developed countries. Although medical advances have substantially extended life span, the same cannot be said for the duration of health span. We are seeing increasing numbers of elderly people who are frail and/or have multiple chronic conditions; all of these can affect the quality of life of the elderly population as well as increase the burden on the healthcare system. Aging is mechanistically related to common medical conditions such as diabetes mellitus, ischemic heart disease, cognitive decline, and frailty. A recently accepted concept termed 'Accelerated Biological Aging' can be diagnosed when a person's biological age-as measured by biomarkers of DNA methylation-is older than their corresponding chronological age. Taurine, a conditionally essential amino acid, has received much attention in the past few years. A substantial number of animal studies have provided a strong scientific foundation suggesting that this amino acid can improve cellular and metabolic health, including blood glucose control, so much that it has been labelled one of the 'longevity amino acids'. In this review article, we propose the rationale that an adequately powered randomized-controlled-trial (RCT) is needed to confirm whether taurine can meaningfully improve metabolic and microbiome health, and biological age. This trial should incorporate certain elements in order to provide the much-needed evidence to guide doctors, and also the community at large, to determine whether this promising and inexpensive amino acid is useful in improving human metabolic health.