Kidney Transplantation 1: An Overview--Recipient Evaluation and Immunosuppression

2017 ◽  
Author(s):  
Belinda T. Lee ◽  
Anil Chandraker ◽  
Jamil Azzi ◽  
Martina M McGrath
Keyword(s):  
Kidney Transplantation ◽  
Human Leukocyte ◽  
Basic Knowledge ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Early Management ◽  
Leukocyte Antigen ◽  
Medical Evaluation ◽  
Stage Renal Disease ◽  
End Stage

Kidney transplantation remains the optimal renal replacement therapy for patients with end-stage renal disease (ESRD). A timely referral to kidney transplantation and a thorough pretransplantation evaluation ensure improvement in the morbidity and mortality of ESRD patients. Basic knowledge of immune biology and an in-depth understanding of the different induction and maintenance therapies used post kidney transplantation are imperative for optimal patient management. In this review, we discuss the multidisciplinary process of pretransplantation evaluation of kidney transplant recipients. We also discuss state-of–the-art early management post kidney transplantation with the different immunosuppressive therapies currently available. This review contains 3 figures, 11 tables, and 106 references. Key words: crossmatch, donor-specific antibody, immunosuppression, human leukocyte antigen, immunosuppression, induction, maintenance, medical evaluation, transplantation

Kidney Transplantation 1: An Overview--Recipient Evaluation and Immunosuppression

2017 ◽  
Author(s):  
Jamil Azzi ◽  
Belinda T. Lee ◽  
Anil Chandraker ◽  
Martina M McGrath
Keyword(s):  
Kidney Transplantation ◽  
Human Leukocyte ◽  
Basic Knowledge ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Early Management ◽  
Leukocyte Antigen ◽  
Medical Evaluation ◽  
Stage Renal Disease ◽  
End Stage

Kidney transplantation remains the optimal renal replacement therapy for patients with end-stage renal disease (ESRD). A timely referral to kidney transplantation and a thorough pretransplantation evaluation ensure improvement in the morbidity and mortality of ESRD patients. Basic knowledge of immune biology and an in-depth understanding of the different induction and maintenance therapies used post kidney transplantation are imperative for optimal patient management. In this review, we discuss the multidisciplinary process of pretransplantation evaluation of kidney transplant recipients. We also discuss state-of–the-art early management post kidney transplantation with the different immunosuppressive therapies currently available. This review contains 3 figures, 11 tables, and 106 references. Key words: crossmatch, donor-specific antibody, immunosuppression, human leukocyte antigen, immunosuppression, induction, maintenance, medical evaluation, transplantation

P1732RECURRENCE OF GLOMERULONEPHRITIS POST TRANSPLANT

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Umesh Lingaraj ◽  
Ricken Mehta ◽  
Shivaprasad SM ◽  
Kishan A ◽  
Leelavathi V ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Renal Disease ◽  
Kidney Transplant ◽  
End Stage Renal Disease ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplant ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims Glomerulonephritis (GN) is a major cause of end stage renal disease (ESRD)1. It represents the primary cause of end stage renal disease (ESRD) for 25% of the dialysis population1 and 45% of the transplant population. For patients with GN requiring renal replacement therapy, kidney transplantation is associated with superior outcomes compared with dialysis2. The possibility of recurrence of the original disease after transplantation was described in a seminal paper more than 40 years ago, and it is now clear that all forms of GN may recur after kidney transplantation.3 To study the recurrence of glomerulonephritis post-transplant in a tertiary care centre. Method 120 renal transplant recipients were analyzed from September 2015 to August 2019 at the Institute of Nephro-Urology, Bangalore. It was a retrospective analysis of data Results 120 adult patients underwent kidney transplantation, out of these 70 had GN as primary cause of kidney disease. 85.8% were males, 14.2 % females. 58.9 % were biopsy proven GN, remaining 41.1 % diagnosed based on history and clinical presentation. All but one patient had their first transplant. Out of these kidney transplant recipients 08 (11.4%) had recurrence of GN.  From these 4/08 was recurrent IgA N, 2/08 were PGNMID, 1/08 MGN, 1/08 aHUS. Graft loss due to recurrent GN was seen in 1/08 patients (12.5%). Conclusion Our study showed that 11.4 % of kidney transplant recipients with GN as their cause of ESRD had recurrent GN post kidney transplantation. IgAN was the most type of GN that recurred most frequently followed by PGNMID. Recurrence of GN was in par with other studies and did not affect graft survival

Plasmapheresis Therapy in Kidney Transplant Rejection

2018 ◽  
Vol 47 (1-3) ◽  
pp. 73-84 ◽  
Author(s):  
Pan Xie ◽  
Min Tao ◽  
Kanfu Peng ◽  
Hongwen Zhao ◽  
Keqin Zhang ◽  
...  
Keyword(s):  
End Stage Renal Disease ◽  
Multimodal Treatment ◽  
Transplant Rejection ◽  
Human Leukocyte ◽  
Economic Costs ◽  
Leukocyte Antigen ◽  
Antibody Mediated Rejection ◽  
Stage Renal Disease ◽  
End Stage ◽  
Optimal Treatment Strategy

Kidney transplantation (KT) is considered an optimal treatment strategy for end-stage renal disease. But human leukocyte antigen-sensitized, ABO-incompatible and antibody-mediated rejection might be the alarming hurdles in KT. Therapeutic plasma exchange is the mainstay of the antibody reduction therapy for reducing autoantibody more effectively. Even in the treatment for highly sensitized patients, it has played an indispensable role. However, clinicians should tailor therapies to individual patient’s needs and multimodal treatment will bring better outcomes. Early diagnosis and precise treatment would reduce morbidity, mortality, and economic costs.

Kidney Transplantation 1: An Overview--Recipient Evaluation and Immunosuppression

2013 ◽  
Author(s):  
Jamil Azzi ◽  
Belinda T. Lee ◽  
Anil Chandraker
Keyword(s):  
Kidney Transplantation ◽  
Primary Care Physicians ◽  
Human Leukocyte ◽  
Visual Aids ◽  
Coordinated Care ◽  
Comprehensive Overview ◽  
Successful Transplantation ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Half a century after the first successful kidney transplantation, we still stand at the crossroads of immunology and transplantation, where science meets art in the management of complex end-stage renal disease (ESRD) patients. Successful transplantation requires not only a lifetime’s commitment from patients but also a multidisciplinary approach, bringing together surgeons, transplant nephrologists, primary care physicians, scientists, and nurses to provide coordinated care. Although transplantation is the treatment of choice for the vast majority of ESRD patients, many patients remain on dialysis due to a relative imbalance between demand for and supply of suitable organs. This chapter provides a comprehensive overview of recipient evaluation and immunosuppression. Risk factors that prohibit transplantation are discussed, as are human leukocyte antigen/ABO compatibility, transplant immunobiology, induction therapy, maintenance therapy, transplantation for special populations, and future directions in the field. Tables outline Amsterdam Living Donation Forum guidelines, ABO blood group compatibilities, and pretransplant immunologic testing. Visual aids include graphs, charts, cell illustrations, and an evaluative algorithm. This chapter contains 10 figures, 3 tables, 101 references, and 5 Board-styled MCQs.

scholarly journals A path to renal transplantation in Nepal

1970 ◽  
Vol 1 (1) ◽  
pp. 52-55
Author(s):  
J Enns ◽  
G Aryal
Keyword(s):  
Renal Transplantation ◽  
Renal Replacement Therapy ◽  
Human Leukocyte Antigen ◽  
Replacement Therapy ◽  
Human Leukocyte ◽  
Cost Effective ◽  
Leukocyte Antigen ◽  
Post Transplant ◽  
Stage Renal Disease ◽  
End Stage

End Stage Renal Disease affects many people in the world. There are three methods of renal replacement therapy available to patients: Continuous ambulatory peritoneal dialysis, haemodialysis and transplantation. Transplantation is the most viable and cost effective form of renal replacement therapy that is available for these patients. There are 3 factors required to help ensure a successful renal transplantation program: A well legislated donor and recipient program, Human Leukocyte Antigen testing (pre and post transplant), as well as a post transplant follow up program. Keywords: Renal Transplant; South Asia; Nepal; Human Leukocyte Antigen DOI: 10.3126/jpn.v1i1.4453 Journal of Pathology of Nepal (2011) Vol.1, 52-55

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