Quick Guide to Kidney Transplantation

Concise, easy to read, and designed for quick reference, Quick Guide to Kidney Transplantation is a compact resource for general nephrologists, residents, fellows, nurse practitioners, and others involved in the care of post-transplant patients. Focusing on must-know clinical information needed to provide optimal patient care, this expertly written guide helps you gain the knowledge and expertise you need in this complex area. Offers high-yield, easy-to-reference information on areas of kidney transplantation relevant to the general nephrologist, including the management of immunosuppressive therapy, acute and long-term complications, transplant medications, drug interactions, selection and evaluation of potential living donors, and more. Features concise text presented in bullet-point format and highlighted by full-color illustrations. Shares the knowledge and expertise of Drs. Phuong-Thu Pham and Phuong-Chi Pham of the David Geffen School of Medicine at UCLA. Presents just the right amount of information needed to provide the best possible patient care and improve graft survival as well as patient survival.

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1. Transplant Immunobiology

·  ABO BLOOD GROUP ANTIGENS

·  MAJOR HISTOCOMPATIBILITY COMPLEX, HUMAN LEUKOCYTE ANTIGEN MOLECULES

·  HUMAN LEUKOCYTE ANTIGEN–TYPING TECHNIQUES

·  Serotyping

·  DNA typing

·  Human leukocyte antigen nomenclature

·  MINOR HISTOCOMPATIBILITY ANTIGEN

·  NON–HUMAN LEUKOCYTE ANTIGENS

·  ALLORECOGNITION PATHWAYS: DIRECT, INDIRECT, AND SEMIDIRECT ALLORECOGNITION

·  HUMAN LEUKOCYTE ANTIGEN ALLOSENSITIZATION

·  TECHNIQUES FOR DETECTION OF ANTI–HUMAN LEUKOCYTE ANTIGEN ANTIBODIES: GENERAL CONCEPTS

·  CELL-BASED CYTOTOXICITY PANEL REACTIVE ANTIBODY ASSAY

·  SOLID-PHASE ASSAYS USING LUMINEX TECHNOLOGY

·  PRETRANSPLANTATION CROSSMATCH

·  VIRTUAL CROSSMATCH

·  IMMUNOLOGIC EVALUATION OF THE TRANSPLANT CANDIDATES

·  REFERENCES

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2. Immunosuppression

·  THE THREE-SIGNAL MODEL OF ALLOIMMUNE RESPONSES

·  TARGETS OF VARIOUS IMMUNOSUPPRESSIVE AGENTS

·  BASIC PRINCIPLES OF AN IMMUNOSUPPRESSIVE PROTOCOL

·  SIDE EFFECT PROFILES, DRUG-DRUG INTERACTIONS, NURSING AND DIETARY CONSIDERATIONS

·  OTHER IMMUNOSUPPRESSIVE AGENTS (ALSO SUMMARIZED IN CHAPTER 3)

·  REFERENCES

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3. Allograft Rejection: Types and Treatment Strategies

·  ALLOGRAFT REJECTION: HYPERACUTE, ACUTE, AND CHRONIC

·  Hyperacute rejection

·  Acute rejection

·  Chronic rejection

·  TREATMENT OF ACUTE REJECTION

·  Overview

·  Treatment of acute T cell–mediated rejection based on Banff classification

·  Treatment of chronic active T cell–mediated rejection

·  Treatment of acute antibody-mediated rejection

·  Donor-specific antibody testing after plasmapheresis or plasma exchange to assess treatment response

·  IVIG and rituximab recycling process

·  Treatment of chronic active antibody-mediated rejection

·  Manipulation of maintenance immunosuppression following treatment of acute T cell–mediated rejection or acute antibody-mediated rejection

·  Suggested prophylactic antibiotics and antiviral therapy following treatment of acute rejection episodes (practice may vary among transplant centers)

·  POSTTRANSPLANT IMMUNE MONITORING/SURVEILLANCE

·  REFERENCES

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4. Evaluation of the Potential Kidney Transplant Candidates

·  KIDNEY TRANSPLANTATION VERSUS DIALYSIS

·  KIDNEY TRANSPLANT EVALUATION PROCESS AND GENERAL ASSESSMENT

·  EVALUATION BY ORGAN SYSTEM

·  PATIENTS WITH SPECIFIC CONDITIONS

·  SPECIFIC KIDNEY DISEASE

·  END-STAGE KIDNEY DISEASE ASSOCIATED WITH HEMATOLOGIC MALIGNANCY

·  HIGHLY SENSITIZED CANDIDATES

·  EVALUATION OF PATIENTS FOR A REPEAT TRANSPLANT

·  REFERENCES

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5. Living Donor Evaluation

·  GENERAL EVALUATION

·  EVALUATION FOR SPECIFIC CONDITIONS

·  HEREDITARY RENAL DISEASE

·  INFECTIOUS DISEASE SCREENING

·  CANCER SCREENING

·  PREGNANCY

·  MEDICAL CLEARANCE FOR DONOR NEPHRECTOMY

·  SURGICAL EVALUATION

·  DONOR SAFETY AND LONG-TERM RENAL FUNCTION

·  REFERENCES

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6. Deceased Donor Kidney Allocation, Strategies to Expand the Living Donor Pool, and Waitlist Management

·  UNITED NETWORK FOR ORGAN SHARING LISTING CRITERIA

·  DECEASED DONOR KIDNEY ALLOCATION SYSTEM IN THE UNITED STATES

·  STRATEGIES TO EXPAND THE LIVING DONOR POOL

·  Laws, ethics, and financial aspects of living kidney donation

·  Patient education

·  Living donor options

·  Kidney paired donation registries and organ import/export exchange coordination of care

·  WAITLIST MANAGEMENT

·  Factors affecting waiting time

·  Kidney donor options to reduce waiting time

·  Waitlist management dynamics

·  United Network for Organ Sharing listing status

·  ONGOING HEALTH MAINTENANCE AND SCREENING

·  Cancer screening

·  Acquired cystic kidney disease and renal cell carcinoma screening

·  Cardiovascular screening

·  Infectious disease screening

·  REFERENCES

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7. Early and Late Posttransplant Graft Dysfunction

·  GENERAL ASSESSMENT

·  GRAFT DYSFUNCTION IN THE PERIOPERATIVE PERIOD (FIRST POSTOPERATIVE WEEK)

·  GRAFT DYSFUNCTION IN THE EARLY POSTTRANSPLANT PERIOD (1 WEEK TO 3 MONTHS POSTTRANSPLANT)

·  GRAFT DYSFUNCTION IN THE LATE POSTTRANSPLANT PERIOD (>3 MONTHS)

·  REFERENCES

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8. Glomerular Disease Recurrence After Transplantation

·  BACKGROUND

·  IMMUNOGLOBULIN A NEPHROPATHY

·  Pathophysiology of immunoglobulin A nephropathy in native kidneys

·  Recurrence of Immunoglobulin A nephropathy

·  Treatment

·  FOCAL SEGMENTAL GLOMERULOSCLEROSIS

·  Pathophysiology of focal segmental glomerulosclerosis in native kidneys

·  Recurrence of focal segmental glomerulosclerosis

·  Clinical presentation

·  Treatment

·  MEMBRANOUS NEPHROPATHY

·  Pathophysiology of membranous nephropathy in native kidneys

·  Recurrence of membranous nephropathy

·  Clinical manifestations

·  Treatment

·  MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS

·  Pathogenesis of membranoproliferative glomerulonephritis in native kidneys

·  Recurrence of membranoproliferative glomerulonephritis

·  Treatment

·  ATYPICAL HEMOLYTIC UREMIC SYNDROME

·  Recurrence of atypical hemolytic uremic syndrome

·  Clinical presentation

·  Treatment

·  LUPUS NEPHRITIS

·  Pathophysiology of lupus nephritis in native kidneys

·  Recurrence of lupus nephritis

·  Treatment

·  ANTI–GLOMERULAR BASEMENT MEMBRANE DISEASE

·  Pathophysiology of anti–glomerular basement membrane disease in native kidneys

·  Recurrence of anti–glomerular basement membrane disease

·  Treatment

·  ANTINEUTROPHIL CYTOPLASMIC AUTOANTIBODY–ASSOCIATED VASCULITIS

·  Pathophysiology of antineutrophil cytoplasmic autoantibody–associated vasculitis

·  Recurrence of antineutrophil cytoplasmic autoantibody–associated vasculitis

·  Clinical presentation

·  Treatment

·  REFERENCES

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9. Kidney Allograft Biopsy: Banff Classification and Other Transplant Histopathology

·  GENERAL OVERVIEW

·  BANFF CLASSIFICATION CATEGORIES

·  OTHERS (NOT CLASSIFIED UNDER BANFF CATEGORIES)

·  REFERENCES

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10. Common Posttransplant Abnormal Laboratory Findings

·  POSTTRANSPLANT ANEMIA

·  LEUKOPENIA AND THROMBOCYTOPENIA

·  POSTTRANSPLANT ERYTHROCYTOSIS

·  COMMON ELECTROLYTE, ACID-BASE, AND CALCIUM AND PHOSPHOROUS ABNORMALITIES

·  Hyponatremia

·  Hyperkalemia

·  Hypokalemia

·  Hypocalcemia

·  Hypercalcemia

·  Hypomagnesemia

·  Hypophosphatemia

·  Acid-base disorders

·  ABNORMAL LIVER FUNCTION TESTS

·  REFERENCES

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11. Mineral and Bone Disorders After Kidney Transplantation

·  CALCIUM

·  PHOSPHORUS

·  PARATHYROID HORMONE

·  VITAMIN D

·  BONE DISEASE

·  Spectrum of bone disease

·  REFERENCES

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12. Urologic Considerations in the Kidney Transplant Patient

·  PRETRANSPLANT UROLOGIC CONSIDERATIONS

·  THE IMMEDIATE POSTTRANSPLANT PERIOD

·  LONG-TERM UROLOGIC CONCERNS

·  OTHER UROLOGIC CONSIDERATIONS

·  REFERENCES

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13. Posttransplantation Infectious Complications and Vaccinations

·  VACCINATIONS

·  INTERNATIONAL TRAVEL VACCINATION RECOMMENDATIONS/WEBSITE

·  RISK FACTORS FOR POSTTRANSPLANTATION INFECTIOUS COMPLICATIONS

·  TIMETABLE OF POSTTRANSPLANTATION INFECTIOUS COMPLICATIONS

·  RECURRENT URINARY TRACT INFECTION WORKUP AND MANAGEMENT

·  SCREENING AND MANAGEMENT OF COMMON POSTTRANSPLANTATION VIRAL INFECTIONS

·  Cytomegalovirus

·  BK polyomavirus

·  Commonly encountered viral infections

·  Posttransplantation diarrhea and common gastrointestinal infections

·  POTENTIAL EXPOSURE TO INFECTIOUS AGENTS: WHAT TO DO

·  REFERENCES

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14. Posttransplantation Cardiovascular Disease

·  POSTTRANSPLANTATION HYPERTENSION

·  POSTTRANSPLANTATION DYSLIPIDEMIA

·  POSTTRANSPLANTATION DIABETES MELLITUS

·  General overview

·  Screening and management of posttransplantation diabetes mellitus

·  POSTTRANSPLANTATION OBESITY

·  CIGARETTE SMOKING

·  POSTTRANSPLANTATION PROTEINURIA

·  REFERENCES

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15. Posttransplantation Malignancies

·  GENERAL OVERVIEW

·  SKIN CANCERS

·  POSTTRANSPLANT LYMPHOPROLIFERATIVE DISORDER (PTLD)

·  KAPOSI SARCOMA

·  RENAL CELL CARCINOMA

·  COLORECTAL CANCER

·  GENERAL MANAGEMENT OF IMMUNOSUPPRESSION

·  REFERENCES

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16. Kidney Transplantation in Dual Organ Transplantation

·  KIDNEY ALLOCATION IN DUAL ORGAN TRANSPLANTATION

·  SIMULTANEOUS LIVER-KIDNEY TRANSPLANTATION

·  TRANSPLANT OPTIONS FOR TYPE I DIABETICS WITH DIABETIC END-STAGE KIDNEY DISEASE

·  SIMULTANEOUS HEART-KIDNEY TRANSPLANTATION

·  REFERENCES

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17. Nutrition Care for Adult Kidney Transplant Candidates and Recipients

·  NUTRITION: GENERAL OVERVIEW

·  PRETRANSPLANT

·  Nutrition assessment pretransplant

·  Nutrition-related evaluation/waitlist concerns

·  Malnutrition

·  Metabolic Bone Disease

·  Adherence

·  POSTTRANSPLANT

·  Early concerns (first 6-8 weeks posttransplant period)

·  Nutrient needs

·  Postoperative feeding

·  Nutrient-drug interactions/side effects

·  Food safety

·  Long-term concerns

·  Cardiovascular disease (CVD) and hypertension

·  Weight management

·  Osteoporosis/posttransplant bone disease

·  Herbal supplements

·  Prebiotics/probiotics

·  Alcohol

·  Special considerations

·  Bariatric Surgery

·  REFERENCES

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18. Management of Patients with a Failed Transplant

·  TIMING OF DIALYSIS REINITIATION

·  IMMUNOSUPPRESSION MANAGEMENT

·  GRAFT INTOLERANCE SYNDROME

·  INDICATIONS FOR ALLOGRAFT NEPHRECTOMY

·  THE IMPACT OF GRAFT NEPHRECTOMY ON A REPEAT TRANSPLANT

·  ALLOGRAFT NEPHRECTOMY IN PATIENTS WITH GRAFT LOSS DUE TO BK NEPHROPATHY

·  REFERENCES

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19. Modern Age Transplantation Issues

·  ORGAN TRAFFICKING AND TRANSPLANT TOURISM

·  MARIJUANA IN TRANSPLANTATION

·  Overview

·  Marijuana policy

·  “Medical marijuana”

·  Cannabis use disorder

·  Marijuana harms

·  REFERENCES

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20. Frequently Asked Questions

·  REFERENCES