• <tr id="yyy80"></tr>
  • <sup id="yyy80"></sup>
  • <tfoot id="yyy80"><noscript id="yyy80"></noscript></tfoot>
  • 99热精品在线国产_美女午夜性视频免费_国产精品国产高清国产av_av欧美777_自拍偷自拍亚洲精品老妇_亚洲熟女精品中文字幕_www日本黄色视频网_国产精品野战在线观看 ?

    Practical recommendations for kidney transplantation in the COVID-19 pandemic

    2020-12-29 13:32:57AshrafImamKerenTzukertHadarMerhavRihamImamSamirAbuGazalaRoyAbelMichalDranitzkiElhalelAbedKhalaileh
    World Journal of Transplantation 2020年9期

    Ashraf Imam, Keren Tzukert, Hadar Merhav, Riham Imam, Samir Abu-Gazala,Roy Abel, Michal Dranitzki Elhalel, Abed Khalaileh

    Ashraf Imam, Hadar Merhav, Riham Imam, Samir Abu-Gazala, Abed Khalaileh, Transplantation Unit, Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel

    Keren Tzukert, Roy Abel, Michal Dranitzki Elhalel, Department of Nephrology, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel

    Abstract Kidney transplantation at the time of a global viral pandemic has become challenging in many aspects. Firstly, we must reassess deceased donor safety (for the recipient) especially in communities with a relatively high incidence of coronavirus disease 19 (COVID-19). With respect to elective live donors, if one decides to do them at all, similar considerations must be made that may impose undue hardship on the donor. Recipient selection is also problematic since there is clear evidence of a much higher morbidity and mortality from COVID-19 for patients older than 60 and those with comorbidities such as hypertension, diabetes, obesity and lung disease. Unfortunately, many, if not most of dialysis patients fit that mold. We may and indeed must reassess our allocation policies, but this must be done based on data rather than conjecture. Follow-up routines must be re-engineered to minimize patient travel and exposure. Reliance on technology and telemedicine is paramount. Making this technology available to patients is extremely important. Modifying or changing immunosuppression protocols is controversial and not based on clinical studies. Nevertheless, we should reassess the need for induction therapy across the board for ordinary patients and the more liberal use of mammalian target of rapamycin inhibitors in transplant patients with proven infection.

    Key Words: COVID-19; Kidney transplantation; Organ donation; Coronavirus; SARSCoV2

    INTRODUCTION

    Kidney transplantation (KT) is the treatment of choice for end-stage kidney disease[1]. The progress in immunosuppression along with the advances in surgical techniques has led to an improvement in transplantation outcomes. However, the increased risk of infection in immunocompromised patients can negatively affect the results of transplantation. The appearance of the new coronavirus disease 2019 (COVID-19), which is highly infectious and carries a high mortality risk, presents significant challenges to transplantation in general, to KT in particular and to living donor KT specifically.

    COVID-19 is caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV2)[2]. COVID-19 was confirmed following several severe cases of pneumonia in the city of Wuhan in China in December 2019[3], and shortly thereafter, this disease spread worldwide[4]affecting more than 1.5 million people with more than 110 thousand deaths[5]. In Israel, the first diagnosed case of COVID-19 was announced on February 21, 2020. Since then, more than 11000 cases have been confirmed of which 110 died[6]. As reported elsewhere, COVID-19-related mortality is far more prevalent in older patients and those with comorbidities[7].

    During the SARS epidemic in 2003 and the Middle East respiratory syndrome (MERS) in 2018, there was no increased mortality among immunocompromised patients[8,9]. Conversely, in the current COVID-19 pandemic, several reports have demonstrated the severity of this disease among immunocompromised transplanted patients[10,11].

    Under the current circumstances, there are clear obstacles and challenges that almost all transplant centers in the world encounter due to the lack of evidence-based medicine regarding kidney transplant management in this setting. In this report, we highlight our local measures and guidelines that were adopted by the KT unit at Hadassah – Hebrew University Medical Center in Jerusalem, Israel.

    DECEASED DONORS

    We expected the number of organs from deceased donors to decrease during the pandemic, as a result of the extreme load on the intensive care units causing care to be diverted from brain dead potential donors. Also, at times of societal stress, the tendency to donate organs goes down and lastly due to the social distancing there are far less road accidents and brain injuries. Surprisingly, our center was only minimally affected regarding deceased donors during this period.

    The risk of transmission of COVID-19 by a deceased donor is not yet known, but we believe that there is a possibility of viral transmission, since it was reported that there is a 15% chance of isolating the virus from blood[12]. Moreover, some pathological changes were reported in organs other than the lungs in COVID-19 patients[13].

    In order to minimize the previously mentioned potential hazards, whether they are from the donor, the recipient or the team, we adopted the recommendations of the National Transplantation Steering Committee for consideration of a potential deceased kidney donor. These criteria include: (1) The donor must have a negative nasopharyngeal swab for COVID-19; (2) The donor should have no history of traveling abroad in the last 14 days and no exposure to a proven COVID-19 patient; (3) Every potential donor with diagnosed pneumonia should test negative for COVID-19, if no test can be performed the donor is rejected; (4) A donor that was treated by a medical team that took care of proven COVID-19 patients should be rejected; and (5) In the case of a donor with cardiac death (DCD), if there is insufficient time to gather all this information, the donor should be rejected. By accumulating knowledge on COVID-19 disease, we believe the following additional factors should be considered: (1) The presence of upper respiratory symptoms or fever; (2) Lymphopenia; (3) Chest computed tomography (CT) scan with findings that can be attributed to COVID-19 infection; and (4) High suspicion of COVID-19 infection, based on epidemiologic and clinical signs, even if COVID-19 polymerase chain reaction (PCR) is negative. We also apply the same criteria for liver donors.

    The importance of performing a chest CT scan and considering lymphopenia for every potential donor stems from the report published by Guanet al[14]who demonstrated that in a large cohort of 1099 COVID-19 patients, 96% of the patients had specific abnormal findings in the lungs, and 82.1% had lymphopenia.

    Regarding the 5threcommendation of the steering committee for a DCD donor, we recommend that the technique of machine perfusion should be utilized. This can provide a relatively safe environment for the kidneys and even enhance their performance while allowing additional time for missing data to be acquired. The application of these strict criteria on potential deceased kidney donors should decrease the risk of infection for both the transplant team and future recipients.

    LIVING DONORS

    Transplantation from living donors brings additional considerations. These are elective, pre-scheduled carefully planned transplantations[15]. Thus, stringent safety criteria must be implemented in order to protect the donor, the recipient and the team.

    We believe that donors must undergo a period of 14 d isolation prior to transplantation. This may prove to be an undue and indeed unbearable burden for some donors and is to be explained at length during medical and psychosocial evaluation. Of note, PCR tests still show significant percentages of false negative results, and antibody detection assays are not yet commonly available.

    The recent outbreak resulted in the Ministry of Health and transplantation centers temporarily withholding all living-related transplantation activities. This will eventually lead to an increased number of patients on dialysis treatment, with its prognostic and financial implications.

    KIDNEY TRANSPLANT RECIPIENTS

    In Israel, there are more than 857 patients on the waiting list. All of which are treated by dialysis, nevertheless, this number does not include patients who may need preemptive kidney transplant. In 2019, a total of 411 KT were performed in Israel, 248 from living donors and 163 from deceased donors[16].

    In order to minimize the damage from the decreased number of donations, every effort should be made to stratify the patients who may be able to benefit from a kidney transplant in this pandemic era.

    In Israel, we have implemented an old for old allocation policy for many years with great success. However, in these times, when it is clear that COVID-19 infection severity and mortality increase with age and comorbidities[7,17]we may need to reconsider this policy. Our present approach is that older recipients (> 65 years) should be informed of their inherent greater risk and if they decline the offer it should be rerouted to a younger patient. Although there is presently no data to make any projection or firm recommendation, we believe that due to the pandemic a reassessment of allocation policies in order to maximize safety and reduce mortality, morbidity and graft loss may be required.

    Finally, according to the recommendations that were published on March 20, 2020 by the European Dialysis Working Group of ERA-EDTA, dialysis patients should be instructed to stay away from crowds whenever possible, to use individual means of transportation, to use protective measures in order to conserve their hygiene , and even to avoid personal contact with family members[18]. We suggest that these recommendations should be applied to kidney transplant recipients during and after hospitalization.

    POST-OPERATIVE FOLLOW-UP

    The clinical course following KT is fraught with complications in the best of cases. In order to minimize this, patients are advised to adhere to a strict follow-up routine. COVID-19 may expose these patients to added hazards when traveling and visiting medical clinics. As a result, we suggest tailoring an individual follow-up strategy that balances the risks with the needed intensity of visits for each patient. The plethora of technology devices and applications allowing effective telemedicine should be used as much as possible. However, patients who lack smart phones or computers with internet access may present a problem. In Israel this is almost universally due to religious prohibition and can be dealt with in an ad hoc manner. In places where economic considerations prevent patients from accessing technology, reach-out should be made to insurers, providers and charitable institutions to step into the gap. Telemedicine will assume an important future role in the care of these patients. Particular emphasis should be placed on strict adherence to the government's instructions regarding social isolation, hygiene habits and awareness of the signs and symptoms related to COVID-19. This means that patients arriving at clinics must have N95 masks and wear gloves. This personal protective equipment should be prescribed and delivered to transplant patients.

    IMMUNOSUPPRESSION

    Intuitively, one would tend to decrease immunosuppression in the face of a viral pandemic. We do not have any information as to whether that will benefit patients and the consequences are almost surely increased rates of rejection, increased immunosuppression, infection and graft loss. Thymoglobulin, a T cell depleting agent, is routinely used as an induction treatment. It has been linked to an increased rate of viral infections such as CMV, HSV and BK and to viral-related complicationse.g., posttransplant lymphoproliferative disorder[19]. Thus, it makes sense to speculate that it will increase the rate and the severity of COVID-19 infections. Its advantage is that it decreases the rate of rejection and allows the use of lower CNI levels. If the recipient is of higher immunological risk, the importance of thymoglobulin induction rises. Therefore, should we avoid thymoglobulin and move to non-depleting regimens,e.g., Basiliximab (CD25R antagonist) or avoid induction at all? This will increase the risk of acute rejection, and if rejection occurs this could result in a whole anti-rejection treatment protocol accumulating to a much larger dose of immunosuppression. The issue of induction therapy for all needs to be examined and perhaps there is logic in using induction for higher immunological risk recipients. Nevertheless, at this time, due to lack of evidence-based reports, we believe institutions should continue their induction practices as before.

    Corticosteroids have a major role in all anti-rejection protocols. In our institution, high dose methylprednisolone is given with induction with rapid tapering off down to 40 mg/day on day 6. Routinely, we do not use steroid-avoidance or steroid withdrawal protocols. Should one move to steroid-avoidance protocols now? No decrease in CMV infection rate was found when steroid avoidance or withdrawal protocols were compared to steroid maintenance protocols[20], and data regarding BK nephritis rates are conflicting. When investigating the previous, SARS-COVID experience, the Chinese reported advantageous outcomes when combining high dose steroids with hydroxychloroquine[21]and recently, a favorable outcome was suggested when steroids were used in the context of a cytokine storm[17,22]. However, studies in animal models indicated that long-term use of steroids facilitates viral replication[23]. According to existing (or non-existing evidence-based data), we believe that we should continue using the current steroid protocol that we practice and are familiar with, as no clear evidence proves that avoiding steroids would be of any benefit.

    Anti-metabolites, mainly mycophenolate, are used in most maintenance protocols, depleting and interfering with both B and T lymphocytes functions. MPA was shown to inhibit viral replication of 4 different coronaviruses (not including COVID-19) in cell culture[24]. Unfortunately, animal models indicated that MPA worsened disease activity in both common marmosets (significantly higher mortality)[25]and Balb/c mice[26]. MPA together with interferon-b was associated with survival in one clinical report of MER-CoV patients. However, this was significant only in univariate analysis and the greater predictor of survival was disease severity at presentation[27]. Taken together, and in agreement with our common practice during viral infections such as CMV, EBV or HSV, we tend to lower mycophenolate dose and even to hold it. In the case of the few transplant patients we treated for COVID19 infection, who presented with leukopenia, we stopped mycophenolate. We plan to re-start mycophenolate when 2 consecutive COVID 19 PCR tests are negative.

    The calcineurin inhibitors, cyclosporine and tacrolimus are the mainstay of immunosuppression regimens for solid organ transplantation, affecting T cell activation and function. Although there is no doubt regarding their efficacy, calcineurin inhibitors were linked to an increased rate of viral infections. Mammalian target of rapamycin (mTOR) inhibitors were suggested to be beneficial regarding viral infections (refs for BK, HPV viral verrucae). Should we convert the treatment protocol from CNIs to de-novo mTOR inhibitors? Should we use low dose CNI protocols together with low dose mTOR inhibitors? FK binding protein (FKBP) binds the coronavirus non-structural protein (NSP-1), thus explaining the mode of action of Tacrolimus inhibition of human coronavirus replication in cell culture[28]. However, no data are available on CNI effectiveness in inhibiting disease progression in animal models or humans.

    MTOR inhibitors were shown to inhibit MERS-CoV replicationin vitro[29]Another work based on network drug repurposing suggested Sirolimus as a potential treatment for coronavirus infection[30]. Taken together, it is still unclear if CNI should be avoided or minimized, but in low immunological risk patients, mTOR inhibitorsbased protocols along with low dose CNI are a reasonable possibility.

    In summary, choosing immunosuppressive protocols during the COVID-19 pandemic is challenging. This is true for induction and treatment for newly transplanted patients as well as for maintenance treatment and for infected transplanted patients. Literature is scarce and mostly inconclusive. One should probably use well practiced protocols, avoid over-immunosuppression as much as possible, and minimize it in stable patients. Infected patients should probably be evaluated for severity of symptoms and signs, and if mild, holding the antimetabolites is acceptable. If moderate or severe, it is possible to hold CNIs, but continue, or even increase the steroids dose.

    Contrary to the logic in decreasing immunosuppression during a pandemic, it is important to remember, that at these times ambulatory patients are more difficult to follow. Patients tend to refrain from arriving at the hospital for routine tests, even to outpatient clinics, and community clinics are overloaded. Downgrading the levels of immunosuppression will demand a very tight follow-up protocol that will enable detection of rejections at the earliest time.

    MEDICAL STAFF SAFETY

    The novel coronavirus has been threatening not only the lives of medical professionals, but also their mental health. This outbreak has caused enormous distress in many health workers who particularly deal with coronavirus patients. This is mainly explained by the various stressful situations including work overload, isolation and relentless fear of infecting patients and family and shortage of medical equipment in some cases[31,32]. In addition to this, the transplantation team is primarily exposed to distress and anxiety due to their stressful work, and this makes the pandemic even more severe. Moreover, it was reported that a number of medical health providers had committed suicide during this pandemic. These facts have caused a serious burden on health systems worldwide.

    CONCLUSION

    Measurements have been adopted by some governments including creating a telephone line for psychiatric consultations and mental health support to fight depression, suicidal attempts and other psychiatric issues.

    久久中文字幕一级| 极品人妻少妇av视频| 一级,二级,三级黄色视频| 又大又爽又粗| 免费观看a级毛片全部| 亚洲天堂av无毛| 国产精品秋霞免费鲁丝片| 精品国产一区二区久久| 七月丁香在线播放| av又黄又爽大尺度在线免费看| 女人精品久久久久毛片| 日本一区二区免费在线视频| av福利片在线| 一级毛片 在线播放| 91麻豆av在线| 欧美精品av麻豆av| 国产av国产精品国产| 一本—道久久a久久精品蜜桃钙片| 久久国产精品大桥未久av| 国产亚洲精品久久久久5区| 大话2 男鬼变身卡| 大香蕉久久成人网| a级片在线免费高清观看视频| 欧美黑人精品巨大| 在线精品无人区一区二区三| 国产成人精品在线电影| 丝袜美腿诱惑在线| 亚洲av欧美aⅴ国产| 欧美在线一区亚洲| 午夜av观看不卡| 日韩一卡2卡3卡4卡2021年| 国产精品三级大全| 久久综合国产亚洲精品| 国产免费一区二区三区四区乱码| 亚洲国产精品成人久久小说| 国产精品久久久久久精品古装| 国产成人系列免费观看| 午夜福利,免费看| 亚洲精品久久久久久婷婷小说| 最黄视频免费看| 日韩av免费高清视频| 日日夜夜操网爽| 亚洲一区中文字幕在线| 国产亚洲av高清不卡| 欧美日韩黄片免| 精品亚洲成a人片在线观看| 男人添女人高潮全过程视频| 亚洲,欧美,日韩| 男女下面插进去视频免费观看| 国产成人一区二区三区免费视频网站 | 视频区图区小说| 亚洲九九香蕉| 欧美在线黄色| 久久久精品免费免费高清| videos熟女内射| 日韩制服丝袜自拍偷拍| 国产在线一区二区三区精| 国产成人欧美| 亚洲图色成人| av在线老鸭窝| 亚洲第一av免费看| 久久国产精品男人的天堂亚洲| 久久久欧美国产精品| 90打野战视频偷拍视频| 国产福利在线免费观看视频| 国产熟女午夜一区二区三区| 亚洲国产欧美在线一区| 夫妻午夜视频| 免费观看a级毛片全部| 久久久久久久久久久久大奶| 亚洲中文av在线| 91麻豆精品激情在线观看国产 | 少妇精品久久久久久久| 在线精品无人区一区二区三| 一区二区av电影网| 国产精品熟女久久久久浪| 亚洲成人免费av在线播放| 亚洲av美国av| 免费观看av网站的网址| 男女免费视频国产| 欧美日韩综合久久久久久| 波野结衣二区三区在线| 亚洲精品美女久久久久99蜜臀 | 久久久精品国产亚洲av高清涩受| 精品久久久久久电影网| 国产男女内射视频| 中文字幕高清在线视频| 一边摸一边做爽爽视频免费| 丝袜喷水一区| 日韩欧美一区视频在线观看| 国产精品麻豆人妻色哟哟久久| 午夜视频精品福利| 麻豆乱淫一区二区| 欧美成人午夜精品| 久久久国产一区二区| 母亲3免费完整高清在线观看| 欧美日韩亚洲综合一区二区三区_| 久久精品人人爽人人爽视色| www.999成人在线观看| 国产亚洲精品久久久久5区| 成人黄色视频免费在线看| 久久久久国产一级毛片高清牌| 精品少妇久久久久久888优播| 黄色 视频免费看| 考比视频在线观看| 亚洲九九香蕉| 男女免费视频国产| 欧美日韩亚洲综合一区二区三区_| 精品久久久久久久毛片微露脸 | 久久人人爽人人片av| 啦啦啦啦在线视频资源| 在线观看一区二区三区激情| 中文字幕人妻丝袜一区二区| 男的添女的下面高潮视频| 日韩一卡2卡3卡4卡2021年| 久久久久久久久免费视频了| 久久青草综合色| 亚洲一卡2卡3卡4卡5卡精品中文| 亚洲成国产人片在线观看| 久久久精品94久久精品| 一区二区三区乱码不卡18| 蜜桃国产av成人99| 午夜福利一区二区在线看| 久久精品人人爽人人爽视色| 国产精品免费大片| 老司机靠b影院| 女性生殖器流出的白浆| 午夜久久久在线观看| 欧美成人午夜精品| 国产三级黄色录像| 国产亚洲午夜精品一区二区久久| 91字幕亚洲| 一级毛片黄色毛片免费观看视频| 成人18禁高潮啪啪吃奶动态图| 久久精品久久久久久久性| 国产精品九九99| 国产精品亚洲av一区麻豆| 亚洲欧美中文字幕日韩二区| 成年人免费黄色播放视频| 日韩一卡2卡3卡4卡2021年| 五月天丁香电影| 18禁国产床啪视频网站| 女人精品久久久久毛片| 精品国产超薄肉色丝袜足j| 看十八女毛片水多多多| 黑人猛操日本美女一级片| 丰满饥渴人妻一区二区三| 欧美激情极品国产一区二区三区| 亚洲国产中文字幕在线视频| 女人被躁到高潮嗷嗷叫费观| 精品久久久久久久毛片微露脸 | 国产精品亚洲av一区麻豆| 国产精品免费视频内射| 国产一区二区激情短视频 | 五月天丁香电影| 国产欧美日韩一区二区三 | 国产一区亚洲一区在线观看| 丝袜在线中文字幕| 男女下面插进去视频免费观看| 久久热在线av| 日本五十路高清| 欧美精品一区二区大全| 亚洲色图综合在线观看| 久久亚洲精品不卡| 精品久久久久久电影网| 国语对白做爰xxxⅹ性视频网站| 国产爽快片一区二区三区| 色视频在线一区二区三区| 亚洲成人手机| 欧美精品亚洲一区二区| 成年av动漫网址| 国产日韩欧美亚洲二区| 少妇精品久久久久久久| 亚洲,欧美精品.| 肉色欧美久久久久久久蜜桃| 汤姆久久久久久久影院中文字幕| 精品久久久久久电影网| 啦啦啦在线免费观看视频4| 亚洲五月色婷婷综合| 天天影视国产精品| 大香蕉久久网| 高清黄色对白视频在线免费看| 免费女性裸体啪啪无遮挡网站| 天堂中文最新版在线下载| 人成视频在线观看免费观看| 日韩大码丰满熟妇| 国产精品人妻久久久影院| 午夜福利视频精品| 在线亚洲精品国产二区图片欧美| 1024香蕉在线观看| 又大又爽又粗| 亚洲av电影在线观看一区二区三区| 欧美性长视频在线观看| 秋霞在线观看毛片| 丝袜在线中文字幕| 精品亚洲乱码少妇综合久久| 久久久欧美国产精品| 亚洲人成77777在线视频| 免费人妻精品一区二区三区视频| 日韩av免费高清视频| 老司机影院成人| 亚洲欧美色中文字幕在线| 肉色欧美久久久久久久蜜桃| 国产精品人妻久久久影院| 欧美人与性动交α欧美软件| 亚洲精品中文字幕在线视频| 日本五十路高清| 亚洲国产看品久久| 一区二区日韩欧美中文字幕| 久久人妻福利社区极品人妻图片 | 久久久精品国产亚洲av高清涩受| 丰满迷人的少妇在线观看| 在线观看免费高清a一片| 国产极品粉嫩免费观看在线| 亚洲av电影在线观看一区二区三区| 久久久久网色| 十八禁高潮呻吟视频| 精品少妇黑人巨大在线播放| 亚洲五月婷婷丁香| 中文字幕精品免费在线观看视频| 国产精品九九99| 亚洲欧洲日产国产| 十八禁高潮呻吟视频| 欧美日韩成人在线一区二区| 五月天丁香电影| 性高湖久久久久久久久免费观看| 欧美日韩视频高清一区二区三区二| 无遮挡黄片免费观看| 如日韩欧美国产精品一区二区三区| 免费日韩欧美在线观看| 午夜福利在线免费观看网站| 精品一区二区三区av网在线观看 | 一级片'在线观看视频| 纯流量卡能插随身wifi吗| 男女下面插进去视频免费观看| 久久国产亚洲av麻豆专区| 欧美变态另类bdsm刘玥| 欧美人与性动交α欧美精品济南到| 黄片播放在线免费| 91九色精品人成在线观看| 免费在线观看日本一区| 一区二区三区激情视频| 国产精品二区激情视频| 国产色视频综合| 精品少妇久久久久久888优播| 纯流量卡能插随身wifi吗| 久久久国产精品麻豆| 日韩一卡2卡3卡4卡2021年| 99国产精品一区二区三区| 青春草视频在线免费观看| bbb黄色大片| 一级a爱视频在线免费观看| 亚洲av国产av综合av卡| av在线播放精品| 午夜免费观看性视频| 精品久久久久久电影网| 欧美日韩亚洲高清精品| 男女国产视频网站| 波多野结衣av一区二区av| 欧美日韩视频精品一区| 亚洲三区欧美一区| 天天躁夜夜躁狠狠久久av| 男男h啪啪无遮挡| 亚洲国产精品999| 欧美日韩亚洲国产一区二区在线观看 | 91字幕亚洲| 免费看十八禁软件| 9热在线视频观看99| 国产男女超爽视频在线观看| 免费一级毛片在线播放高清视频 | 欧美97在线视频| 亚洲av成人精品一二三区| 国产精品一二三区在线看| 中文字幕人妻丝袜制服| 人妻人人澡人人爽人人| www.av在线官网国产| 欧美大码av| 美女午夜性视频免费| 黄色片一级片一级黄色片| 国产亚洲一区二区精品| 十八禁人妻一区二区| 久久精品亚洲熟妇少妇任你| 美女高潮到喷水免费观看| 搡老乐熟女国产| 精品国产一区二区三区四区第35| 99久久精品国产亚洲精品| 美女视频免费永久观看网站| 两性夫妻黄色片| 男人爽女人下面视频在线观看| 美女高潮到喷水免费观看| 精品第一国产精品| 赤兔流量卡办理| 在线av久久热| 精品人妻一区二区三区麻豆| 亚洲欧美成人综合另类久久久| 在线观看www视频免费| av网站免费在线观看视频| 亚洲欧美清纯卡通| 久久国产精品大桥未久av| 亚洲色图综合在线观看| 欧美日本中文国产一区发布| 黄色怎么调成土黄色| 热99久久久久精品小说推荐| 激情五月婷婷亚洲| 另类亚洲欧美激情| 欧美国产精品一级二级三级| 欧美亚洲日本最大视频资源| a级片在线免费高清观看视频| 中文字幕亚洲精品专区| 亚洲精品美女久久久久99蜜臀 | 午夜91福利影院| 嫩草影视91久久| 少妇裸体淫交视频免费看高清 | 97在线人人人人妻| 99香蕉大伊视频| 亚洲中文字幕日韩| 日韩一本色道免费dvd| 五月天丁香电影| 肉色欧美久久久久久久蜜桃| 欧美人与性动交α欧美软件| 51午夜福利影视在线观看| 午夜日韩欧美国产| 国产高清不卡午夜福利| 精品国产国语对白av| 亚洲av日韩精品久久久久久密 | 久久天堂一区二区三区四区| 色综合欧美亚洲国产小说| 无遮挡黄片免费观看| 99久久精品国产亚洲精品| 欧美+亚洲+日韩+国产| 亚洲色图 男人天堂 中文字幕| 亚洲熟女毛片儿| 久久精品成人免费网站| 国产精品一区二区精品视频观看| 电影成人av| 一边摸一边抽搐一进一出视频| 狠狠婷婷综合久久久久久88av| 亚洲av片天天在线观看| 最近中文字幕2019免费版| 大片免费播放器 马上看| 国产精品九九99| 免费在线观看日本一区| 国产三级黄色录像| 午夜日韩欧美国产| 久久中文字幕一级| 不卡av一区二区三区| 久久人妻福利社区极品人妻图片 | 美女主播在线视频| 妹子高潮喷水视频| 亚洲色图 男人天堂 中文字幕| 久久久精品区二区三区| 一区在线观看完整版| 免费看av在线观看网站| 别揉我奶头~嗯~啊~动态视频 | 国产精品九九99| 亚洲精品av麻豆狂野| 99国产精品免费福利视频| 欧美久久黑人一区二区| 午夜福利,免费看| 两个人看的免费小视频| 一二三四社区在线视频社区8| 50天的宝宝边吃奶边哭怎么回事| 一二三四社区在线视频社区8| 色视频在线一区二区三区| 99re6热这里在线精品视频| 国产成人av激情在线播放| 欧美人与善性xxx| 黄色a级毛片大全视频| 中文字幕人妻丝袜一区二区| 啦啦啦在线免费观看视频4| 九草在线视频观看| netflix在线观看网站| 色网站视频免费| 国产免费一区二区三区四区乱码| 肉色欧美久久久久久久蜜桃| 国产片特级美女逼逼视频| 纵有疾风起免费观看全集完整版| 狂野欧美激情性bbbbbb| 久久性视频一级片| 三上悠亚av全集在线观看| 又大又黄又爽视频免费| 97在线人人人人妻| 91麻豆av在线| 考比视频在线观看| 人人澡人人妻人| 国产欧美日韩精品亚洲av| 又粗又硬又长又爽又黄的视频| a级片在线免费高清观看视频| 超色免费av| 热re99久久国产66热| 另类亚洲欧美激情| 午夜av观看不卡| 亚洲一区中文字幕在线| av有码第一页| 国产高清国产精品国产三级| 午夜福利一区二区在线看| 精品一区在线观看国产| 人人妻人人爽人人添夜夜欢视频| av国产精品久久久久影院| www.av在线官网国产| 午夜福利视频精品| 狠狠婷婷综合久久久久久88av| 日本欧美国产在线视频| 男女边摸边吃奶| 麻豆乱淫一区二区| 午夜av观看不卡| 三上悠亚av全集在线观看| 亚洲av成人精品一二三区| 女人高潮潮喷娇喘18禁视频| 亚洲成国产人片在线观看| 欧美在线黄色| 丰满人妻熟妇乱又伦精品不卡| 亚洲精品一二三| 国产成人av激情在线播放| 啦啦啦 在线观看视频| 亚洲中文日韩欧美视频| 成年美女黄网站色视频大全免费| 曰老女人黄片| 大香蕉久久成人网| 伊人久久大香线蕉亚洲五| 两人在一起打扑克的视频| 午夜影院在线不卡| 欧美日韩亚洲国产一区二区在线观看 | 国产麻豆69| 免费在线观看影片大全网站 | 久久国产精品人妻蜜桃| 日本欧美视频一区| 国产亚洲午夜精品一区二区久久| 人妻一区二区av| 日日爽夜夜爽网站| 你懂的网址亚洲精品在线观看| 国产片特级美女逼逼视频| 中国美女看黄片| 啦啦啦啦在线视频资源| 黄色片一级片一级黄色片| 亚洲成人免费av在线播放| 日韩av免费高清视频| 免费看不卡的av| 50天的宝宝边吃奶边哭怎么回事| 亚洲av电影在线进入| 51午夜福利影视在线观看| 欧美国产精品va在线观看不卡| 美女大奶头黄色视频| 久久久久国产精品人妻一区二区| 欧美日韩视频精品一区| 国产日韩欧美亚洲二区| 国产精品三级大全| 一二三四社区在线视频社区8| 精品高清国产在线一区| 久久99一区二区三区| 一二三四在线观看免费中文在| 成人手机av| 成人国产一区最新在线观看 | 久久毛片免费看一区二区三区| 青青草视频在线视频观看| 视频区欧美日本亚洲| 2021少妇久久久久久久久久久| 久久天躁狠狠躁夜夜2o2o | 首页视频小说图片口味搜索 | 国产99久久九九免费精品| 国产一区二区激情短视频 | 国产又爽黄色视频| 久久国产精品人妻蜜桃| 午夜福利在线免费观看网站| 下体分泌物呈黄色| 欧美精品一区二区免费开放| 亚洲精品一区蜜桃| 国产亚洲午夜精品一区二区久久| 国产在线视频一区二区| 我要看黄色一级片免费的| 伊人亚洲综合成人网| 亚洲av综合色区一区| 国产麻豆69| 日韩电影二区| 亚洲欧美日韩高清在线视频 | 精品人妻熟女毛片av久久网站| 男男h啪啪无遮挡| 亚洲国产精品一区二区三区在线| 黄网站色视频无遮挡免费观看| 久久精品久久久久久噜噜老黄| 无遮挡黄片免费观看| 男女国产视频网站| 视频区欧美日本亚洲| 女性被躁到高潮视频| 嫁个100分男人电影在线观看 | 自拍欧美九色日韩亚洲蝌蚪91| 亚洲成人国产一区在线观看 | 纵有疾风起免费观看全集完整版| 国产无遮挡羞羞视频在线观看| 精品久久久久久电影网| 人妻 亚洲 视频| av在线播放精品| 国产伦人伦偷精品视频| 丰满饥渴人妻一区二区三| 极品人妻少妇av视频| 乱人伦中国视频| 免费在线观看黄色视频的| netflix在线观看网站| 午夜精品国产一区二区电影| 久久性视频一级片| 亚洲成人免费电影在线观看 | xxxhd国产人妻xxx| 高清视频免费观看一区二区| 国产人伦9x9x在线观看| 亚洲视频免费观看视频| 免费av中文字幕在线| 两个人免费观看高清视频| 2018国产大陆天天弄谢| 国产精品香港三级国产av潘金莲 | 午夜免费男女啪啪视频观看| 国产1区2区3区精品| 国产女主播在线喷水免费视频网站| 啦啦啦啦在线视频资源| 一本—道久久a久久精品蜜桃钙片| 1024香蕉在线观看| 91九色精品人成在线观看| 亚洲精品日韩在线中文字幕| 男人舔女人的私密视频| 日本猛色少妇xxxxx猛交久久| 成年人免费黄色播放视频| 欧美精品啪啪一区二区三区 | 一本色道久久久久久精品综合| 国产成人av激情在线播放| 久久女婷五月综合色啪小说| 老司机在亚洲福利影院| 99热国产这里只有精品6| 国产精品香港三级国产av潘金莲 | 久久精品国产亚洲av高清一级| 妹子高潮喷水视频| 精品久久蜜臀av无| 亚洲国产日韩一区二区| 欧美国产精品va在线观看不卡| 日本av免费视频播放| 午夜精品国产一区二区电影| 国产成人啪精品午夜网站| 五月开心婷婷网| 777久久人妻少妇嫩草av网站| 操出白浆在线播放| 欧美黑人精品巨大| 99久久综合免费| 1024视频免费在线观看| av在线app专区| 9色porny在线观看| 日本a在线网址| 悠悠久久av| 熟女少妇亚洲综合色aaa.| 欧美激情极品国产一区二区三区| 老司机在亚洲福利影院| 久久久精品国产亚洲av高清涩受| 久久天堂一区二区三区四区| 国语对白做爰xxxⅹ性视频网站| 大香蕉久久成人网| 天天影视国产精品| 亚洲,一卡二卡三卡| 美女大奶头黄色视频| www.自偷自拍.com| av天堂久久9| 免费观看人在逋| 999精品在线视频| 一级片'在线观看视频| 国产三级黄色录像| 一级黄色大片毛片| 日韩大片免费观看网站| 一二三四社区在线视频社区8| 欧美精品啪啪一区二区三区 | 午夜激情久久久久久久| 女人久久www免费人成看片| a 毛片基地| 极品人妻少妇av视频| 亚洲国产精品999| 国产精品熟女久久久久浪| 亚洲人成电影免费在线| 国产精品国产av在线观看| 精品国产国语对白av| 久久性视频一级片| 美女中出高潮动态图| 亚洲成人手机| 亚洲精品久久久久久婷婷小说| 国产无遮挡羞羞视频在线观看| 国产欧美日韩综合在线一区二区| 老司机在亚洲福利影院| 丝袜喷水一区| 久久久久久亚洲精品国产蜜桃av| 国产精品久久久av美女十八| 色综合欧美亚洲国产小说| 国产精品久久久av美女十八| 久久精品久久精品一区二区三区| 美女大奶头黄色视频| 日本五十路高清| 人人妻人人添人人爽欧美一区卜| 欧美精品一区二区大全| 精品亚洲乱码少妇综合久久| 青青草视频在线视频观看| 男女下面插进去视频免费观看| 老熟女久久久| 91老司机精品| 欧美精品人与动牲交sv欧美| av在线app专区| 免费在线观看日本一区| 一级,二级,三级黄色视频| 精品亚洲成国产av| 校园人妻丝袜中文字幕| 美女大奶头黄色视频| 国产亚洲av片在线观看秒播厂| av国产精品久久久久影院| 久久精品成人免费网站| 午夜影院在线不卡| 丝袜美足系列| 如日韩欧美国产精品一区二区三区| 午夜福利乱码中文字幕| av电影中文网址| 日韩伦理黄色片| 宅男免费午夜| 亚洲精品日本国产第一区| 亚洲国产av影院在线观看|