Description
Elsevier Kidney Transplantation by Stuart J. Knechtle, Lorna P. Marson
Instructions for Online Access
Title of Book
Cover image
Title page
Table of Contents
Any screen, Any time, Anywhere
Copyright
Preface
Video Contents
Chapter 2
Chapter 5
Chapter 6
Chapter 8
Chapter 17
Chapter 36
Chapter 43
Contributors
1. Kidney Transplantation: A History
Abstract
Chapter Outline
Early Experiments
Human Kidney Transplants
The Middle Years
Post–World War II
Immunosuppression and the Modern Era
Chemical Immunosuppression
A Time of Optimism
Tissue Typing
The 1970s Plateau
Waiting for the Xenografts
Conclusion
References
2. The Immunology of Transplantation
Abstract
Chapter Outline
Introduction
Activation of the Immune System Peri-Transplant
Stimulation of Adaptive Alloimmunity
T Cell–Mediated Rejection
B-Cell Activation and Antibody-Mediated Rejection
Transplant Tolerance
Conclusion
References
3. Chronic Kidney Failure: Renal Replacement Therapy
Abstract
Chapter Outline
Introduction
Definition and Referral Timing
Prevalence and Incidence
Etiology
Treatment of CKD5
Choice and Planning for the Individual Patient
Dialysis Posttransplant
Return to Dialysis after Transplant Failure
Renal Replacement Therapy Modality and Survival
Quality of Life
References
4. The Recipient of a Renal Transplant
Abstract
Chapter Outline
The Patient With Chronic Kidney Disease
General Concepts
Counseling
Specific Medical Considerations
Preparation for Transplantation
References
5. Access for Renal Replacement Therapy
Abstract
Chapter Outline
Introduction
Fistulas and Synthetic Grafts
Peritoneal Dialysis
Conclusion
References
6. Brain Death and Cardiac Death: Donor Criteria and Care of Deceased Donor
Abstract
Chapter Outline
Introduction
Death by Neurologic Criteria (Brain Death)
Death by Cardiopulmonary Criteria (Circulatory Death)
Donor Management
Other Topics in Donor Management
Conclusion
References
7. Medical Evaluation of the Living Donor
Abstract
Chapter Outline
History of Living Donation and Donor-related Ethics
The Rationale for Living Donation
Medical Evaluation
Surgical Evaluation
Long-Term Outcomes After Living Donation
Financial Considerations
Living-Donor Quality Initiatives
References
8. Donor Nephrectomy
Abstract
CHAPTER OUTLINE
Deceased Donor Nephrectomy
Donation After Brain Death
Donation After Cardiac Death
Normothermic Regional Perfusion
Living Donor Nephrectomy
Anesthetic Management
Open Donor Nephrectomy
Laparoscopic Donor Nephrectomy
Right Donor Nephrectomy
Single-Port Donor Nephrectomy
Robotic Donor Nephrectomy
Complications
Summary
Acknowledgment
References
9. Kidney Preservation
Abstract
Chapter Outline
Introduction
Organ Damage After Death
Cold Storage
Hypothermic Machine Perfusion
Normothermic machine perfusion
Normothermic regional perfusion
Conclusion
References
10. Histocompatability in Kidney Transplantation
Abstract
Chapter Outline
Historical Background
The Human Leukocyte Antigen System
Human Leukocyte Antigen Matching
Human Leukocyte Antigen–Specific Allosensitization
Donor Crossmatching
Immunologic Risk Stratification
Non–Human Leukocyte Antigen Antibodies
Strategies for Transplanting Sensitized and Highly Sensitized Patients
Posttransplant Monitoring
Concluding Remarks
References
11. Surgical Techniques of Kidney Transplantation
Abstract
CHAPTER OUTLINE
Preparation of Recipient
Preparation of the Kidney
Site
Incision
Preparation of Operative Bed
Revascularization
Reconstruction of the Urinary Tract
Closure
Pediatric Recipient
Pediatric Donor
Double Kidney Transplant
Transplant Nephrectomy
Laparoscopic and Robotic Transplant
References
12. Urological Complications After Kidney Transplant and Transplantation Into an Abnormal Bladder
Abstract
CHAPTER OUTLINE
Select Urological Complications After Kidney Transplant
Transplantation and the Abnormal Bladder
Assessment of Lower Urinary Tract Function and Pretransplant Workup
Special Pretransplant Issues
Posttransplant Issues
Results of Renal Transplantation Into Reconstructed and Abnormal Bladders
Special Considerations for the Transplant Surgeon
Conclusion
References
13. Perioperative Care of Patients Undergoing Kidney Transplantation
Abstract
CHAPTER OUTLINE
Comorbidities in End-Stage Renal Disease
Preoperative Considerations
Intraoperative Considerations
Postoperative Care
Anesthesia for Patients After Kidney Transplantation
Kidney-Pancreas Transplantation
References
14. Early Course of the Patient With a Kidney Transplant
NON-PRINT ITEMAbstract
CHAPTER OUTLINE
Overview
Surgical Complications
Rejection During the Early Postoperative Period
Medical Complications
Summary
References
15. Azathioprine and Mycophenolates
Abstract
CHAPTER OUTLINE
Introduction
History
Mechanism of Action
Clinical Pharmacology and Blood Monitoring
Clinical Toxicities of Mycophenolates
Combination Therapy Utilizing MMF or Azathioprine in Kidney Transplantation
Use of Mycophenolates to Minimize or Avoid Other Immunosuppressants
Therapeutic Drug Monitoring
Acknowledgment
References
16. Steroids
Abstract
CHAPTER OUTLINE
Introduction
Mechanism of Action
Steroid Resistance
Dosage
Treatment of Acute Rejection
Side Effects
Steroid Withdrawal and Avoidance
Conclusions
References
17. Calcineurin Inhibitors
Abstract
CHAPTER OUTLINE
Introduction
Cyclosporine
Tacrolimus
Mechanism of Action
Pharmacokinetic Properties
Pharmacogenetics
Absorption and Distribution
Metabolism and Elimination
Special Patient Populations
Clinical Studies in Kidney Transplantation
Clinical Studies in Kidney-Pancreas Transplantation
Side Effects and Tolerability of Calcineurin Inhibitors
Conclusions
References
18. mTOR Inhibitors: Sirolimus and Everolimus
Abstract
CHAPTER OUTLINE
Discovery
Mechanism of Action
Pharmacokinetics
Therapeutic Blood Monitoring
Pharmacogenetics
Drug Interactions
Use of mTOR Inhibitors
mTOR Inhibitors and Malignancy
Safety and Side Effects of mTOR Inhibitors
Summary and Conclusions
References
19. Antilymphocyte Globulin, Monoclonal Antibodies, and Fusion Proteins
Abstract
CHAPTER OUTLINE
Introduction
Historical Perspective
Antibody Structure and Function
Fusion Protein Structure and Function
General Clinical Considerations for the Use of Antibody and Fusion Protein Preparations
Polyclonal Antibody Preparations
Specific Clinical Applications of Polyclonal Antibody Preparations
Monoclonal Antibody and Fusion Protein Preparations
Monoclonal Antibodies and Fusion Proteins in Clinical Transplantation Practice
Monoclonal Antibodies and Fusion Proteins in Clinical Transplantation Investigation
Conclusions
References
20. Other Forms of Immunosuppression
Abstract
CHAPTER OUTLINE
Small Molecules
Total Lymphoid Irradiation
Photopheresis
Splenectomy
Plasmapheresis
References
21. Approaches to the Induction of Tolerance
Abstract
CHAPTER OUTLINE
Introduction
Understanding the Immunologic Mechanisms Behind Tolerance Induction
Strategies With the Potential to Induce Immunologic Tolerance to an Allograft
Leukocyte Depletion at the Time of Transplantation
Cell Therapy
The Future of Tolerance in Kidney Transplantation
References
22. Transplantation in the Sensitized Recipient and Across ABO Blood Groups
CHAPTER OUTLINE
What Is Sensitization and How Is It Measured?
Clinical Approaches to Sensitized Patients
Rejection and Immunologic Risk
Mechanistic View of Antibody Production and Injury
ABO-Incompatible Transplantation
Conclusion
References
23. Paired Exchange Programs for Living Donors
Abstract
CHAPTER OUTLINE
Introduction
Matching Process
Match-Rank Selection and Exhaustive Search
Integer Programming
Additional Matching Challenges
Expanding the Donor-Recipient Pool
Nondirected and Bridge Donors
Inclusion of Compatible Pairs and Deceased Donors
Advanced Donations and International Exchange Programs
Additional Logistical, Legal, and Ethical Considerations
References
24. Kidney Allocation
Abstract
CHAPTER OUTLINE
Introduction
Histocompatibility
Donor Kidney Longevity and Risk Indices
Recipient Factors
Fast Track or Rescue Allocation
Multiorgan Offering
Other Considerations
Local Versus Regional/National/International Allocation
Development of Kidney Allocation Schemes
Monitoring of Offering Schemes
References
25. Pathology of Kidney Transplantation
Abstract
CHAPTER OUTLINE
Abbreviations [selected]
Kidney Allograft Biopsy
Donor Kidney Biopsy
Hyperacute Rejection
Acute Kidney Allograft Rejection
Late Graft Diseases
Protocol Biopsies
Acute Tubular Necrosis
Calcineurin Inhibitor Nephrotoxicity
Target of Rapamycin Inhibitor Toxicity
Drug-Induced Acute Tubulointerstitial Nephritis
Infections
Major Kidney Vascular Disease
De Novo Glomerular Disease
Recurrent Kidney Disease
Posttransplant Malignancy and Posttransplant Lymphoproliferative Disease/Lymphoid Proliferations and Lymphomas Associated With Immune Deficiency and Dysregulation
Future Directions in Biopsy Assessment
Acknowledgments
References
26. Biomarkers for Posttransplant Allograft Monitoring
Abstract
CHAPTER OUTLINE
Introduction and General Considerations
Antigen-Specific Biomarkers
Tissue Injury Biomarkers
Inflammation Biomarkers
Net State of Immunosuppression Biomarkers
“Omics” Biomarkers
Summary and Future Direction
References
27. Chronic Allograft Failure
Abstract
CHAPTER OUTLINE
Introduction
Pathophysiology and Mechanistic Theories of Chronic Allograft Injury
Time Course of Allograft Damage
Diagnostic Considerations in Failing Kidney Allograft
Treatment of a Failing Kidney Allograft
Summary
References
28. Vascular and Lymphatic Complications After Kidney Transplantation
Abstract
CHAPTER OUTLINE
Introduction
Technical Complications and Their Prevention
HEMATOMA
Vascular Thrombosis and Thrombophilia
Torsion
Vascular Access Thrombosis
Deep Vein Thrombosis
Vascular Causes of Ureteric Complications
Mycotic Aneurysm
Biopsy-Related Vascular Complications
Transplant Renal Artery Stenosis
LYMPHOCELE
CONCLUSIONS
References
29. Cardiovascular Disease in Renal Transplantation
Abstract
CHAPTER OUTLINE
Introduction
Background: Cardiovascular Disease in Chronic Kidney Disease
Epidemiology of Posttransplant Cardiovascular Disease
Novel and Transplant-Specific Risk Factors
Specific Risk Factors and Management
Hypertension and Left Ventricular Hypertrophy
Vascular Stiffness and Calcification
Dyslipidemia
Renal Function
Smoking
Diabetes Mellitus
Obesity and the Metabolic Syndrome
Other Risk Factors and Interventions
Screening
Intervention and Secondary Prevention
Other Cardiovascular Conditions
Effect of Arteriovenous Fistula on Cardiovascular Risk
Predicting Cardiovascular Risk
Trial End Points
Conclusion
References
30. Infection in Kidney Transplant Recipients
CHAPTER OUTLINE
Overview
Risk of Infection
Timeline of Infection
Assessment of Infectious Diseases in Recipients and Potential Donors Before Transplantation
Selected Infections of Importance
Conclusions
References
31. Transplantation in a Pandemic: Lessons Learned From COVID-19
Abstract
CHAPTER OUTLINE
Introduction
COVID-19 and Impact on Organ Donation and Transplant Activity
Pandemic Outcomes for Kidney Transplant Recipients
Management of Kidney Transplant Patients During the COVID-19 Pandemic
Planning and Preparedness for Future Pandemics
References
32. Liver Disease Among Renal Transplant Recipients
Abstract
CHAPTER OUTLINE
Overview of Incidence and Clinicopathological Associations
Combined Liver and Kidney Diseases
Specific Immunosuppressive Agents in Renal Transplantation and Hepatotoxicity
Hepatitis Viruses Associated With Renal Transplantation
Nonalcoholic Fatty Liver Disease and Renal Transplant
Hepatocellular Carcinoma After Renal Transplantation
Systemic Infections Resulting in Hepatitis and Liver Disease
References
33. Neurological Complications After Kidney Transplantation
Abstract
CHAPTER OUTLINE
Neurological Complications of Chronic Kidney Disease
Neurological Complications After Kidney Transplantation
Summary
Acknowledgments
References
34. Cutaneous Disease in Kidney Transplantation Patients
Abstract
CHAPTER OUTLINE
Introduction
Cutaneous Malignancy in Renal Transplant Patients
Immunosuppressive Drug Considerations
Conclusion on Cutaneous Malignancy in OTRs
Immunosuppressive Drug Cutaneous Side Effects
Premalignant and Benign Cutaneous Tumors in Renal Transplant Patients
Infections and Inflammatory Cutaneous Findings in Organ Transplant Recipients
Common Inflammatory Disorders
Conclusion
References
35. Cancer in Kidney Failure and Kidney Transplantation
Abstract
CHAPTER OUTLINE
Cancer in People With Kidney Failure
Cancer in Kidney Transplant Recipients
Conclusions
References
36. Pancreas and Kidney Transplantation for Diabetic Nephropathy
Abstract
CHAPTER OUTLINE
History of Pancreas Transplantation
Recent Trends in Pancreas Transplantation
Indications and Patient Selection
Donor Selection and Management
Surgical Procedure
Postoperative Management of Common Complications
Surgical, Medical, and Urologic Complications
Induction and Maintenance Immunosuppression
Rejection Rates, Diagnosis, and Management
Pancreas Transplant Outcomes
Beneficial Effects of Pancreas Transplantation on Glycemic Control, Quality of Life, and Secondary Complications
Summary
References
37. Kidney Transplantation in Children
Abstract
CHAPTER OUTLINE
Introduction
Epidemiology of End-Stage Kidney Disease in Children
Access to Transplantation
Timing of Transplantation
Patient and Graft Survival
Contraindications to Transplantation
Recurrence of Original Disease
Pretransplant Evaluation
Perioperative Management of Pediatric Renal Transplant Recipients
Immunosuppressive Protocols and Drugs
Acute Rejection in Pediatric Transplantation
Long-Term Management Posttransplant
References
38. Advancing Kidney Transplantation in Low- and Middle-Income Countries: Challenges and Strategies
Abstract
CHAPTER OUTLINE
Introduction: The Role of Organ Transplantation in Low- and Middle-Income Countries
The Need for Kidney Transplantation
Minimum Requirements to Perform Transplantation
Moving Ahead: Future Perspectives and Strategies
References
39. Results of Kidney Transplantation
Abstract
CHAPTER OUTLINE
Introduction
Renal Failure Treatments—Dialysis Versus Transplantation
Kidney Donation
Factors Influencing Outcomes of Transplantation
Graft Survival
Cancer Risk
Pregnancy After Kidney Transplantation
Kidney Transplantation in Human Immunodeficiency Virus–Positive Patients
Prevalence of People Living With a Functioning Kidney Transplant
Rehospitalization
Long-Term Outcomes of Kidney Transplantation
COVID-19-Era Transplantation
Quality of Life
Conclusion
Acknowledgment
References
40. Psychosocial Aspects of Kidney Transplantation and Living Kidney Donation
Abstract
CHAPTER OUTLINE
Introduction
Pretransplant Dialysis
Kidney Transplantation
Living Kidney Donation
Conclusion
References
41. Ethical and Legal Aspects of Kidney Donation
Abstract
CHAPTER OUTLINE
Definitions
Introduction
Deceased Donor Organ Allocation
Expansion and Encouragement of Living Kidney Donation
Commercialization of Organs
Conclusion
Acknowledgments
References
42. Xenotransplantation
Abstract
CHAPTER OUTLINE
Introduction
A Brief History of Clinical Xenotransplantation
Selection of Animal Source
Immunologic Barriers to Xenotransplantation
Genetic Modification of Source Animals
Immunosuppression for Xenotransplantation
Preclinical Outcomes of Kidney Xenotransplantation
Zoonotic Infection
Ethical Issues in Xenotransplantation
Transition to Clinical Trials and Conclusions
References
43. Evidence in Transplantation
Abstract
CHAPTER OUTLINE
Introduction
Levels of Evidence
Searching the Literature
Randomized Controlled Trials
Nonrandomized and Observational Studies
Systematic Reviews
Meta-Analysis
Biomedical/Industrial Sponsorship
Conclusion
Acknowledgment
References
Index
Confidence is ClinicalKey