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Primary Care of the Adult Kidney Transplant and Kidney-Pancreas Transplant Recipient

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Primary Care of the Solid Organ Transplant Recipient

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Abstract

Kidney transplantation is the most common type of solid organ transplant performed. The increasing number of kidney transplant recipients provides both a need and an opportunity for primary care providers to play an important role in caring for this patient population. Care of the kidney and kidney-pancreas transplant recipient requires a thorough review of the patient’s transplant history, knowledge of common transplant protocols and medications, familiarity with the adverse effects of medications, and meticulous evaluations of the patient in both routine follow-up visits as well as acute care visits. Primary care providers can partner with nephrologists to take care of a range of issues for these patients, including metabolic and cardiovascular complications. This chapter addresses important background information as well as guidance on evaluation and management of the kidney transplant recipient in the primary care setting.

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References

  1. United States Renal Data System. Chapter 5: Mortality. In: 2017 USRDS annual data report: volume 2—ESRD in the United States. Accessed online 4 Oct 2019, at https://www.usrds.org/2017/download/v2_c05_Mortality_17.pdf.

  2. Rabbat CG, Thorpe KE, Russell JD, Churchill DN. Comparison of mortality risk for dialysis patients and cadaveric first renal transplant recipients in Ontario, Canada. J Am Soc Nephrol. 2000;11:917–22.

    CAS  PubMed  Google Scholar 

  3. Wolfe RA, Ashby VB, Milford EL, Ojo AO, Ettenger RE, Agodoa LY, Held PJ, Port FK. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med. 1999;341:1725–30.

    CAS  PubMed  Google Scholar 

  4. Tonelli M, Wiebe N, Knoll G, Bello A, Browne S, Jadhav D, Klarenbach S, Gill J. Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes. Am J Transplant. 2011;11:2093–109.

    CAS  PubMed  Google Scholar 

  5. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3:1–150.

    Google Scholar 

  6. Fowler KJ. Accountability of dialysis facilities in transplant referral: CMS needs to collect national data on dialysis facility kidney transplant referrals. Clin J Am Soc Nephrol. 2018;13(2):193–4. https://doi.org/10.2215/CJN.13741217.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Murray JE. The fight for life: Harvard Medicine. Accessed online 28 Jan 2020 at: https://hms.harvard.edu/magazine/science-emotion/fight-life.

  8. United States Renal Data System. 2018 USRDS annual data report: Epidemiology of kidney disease in the United States. Bethesda: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2018. Accessed online 1 Jan 2020.

    Google Scholar 

  9. Wu C, Evans I, Joseph R, Shapiro R, Tan H, Basu A, Smetanka C, Khan A, McCauley J, Unruh M. Comorbid conditions in kidney transplantation: association with graft and patient survival. J Am Soc Nephrol. 2005;l16:3437–44.

    Google Scholar 

  10. Ramos EL, Tisher CC. Recurrent diseases in the kidney transplant. Am J Kidney Dis. 1994;24:142–54.

    CAS  PubMed  Google Scholar 

  11. Meier-Kriesche H-U, Kaplan B. Waiting time on dialysis as the strongest modifiable risk factor for renal transplant outcomes: a paired donor kidney analysis. Transplantation. 2002;74:1377–81.

    PubMed  Google Scholar 

  12. Hart A, Smith JM, Skeans MA, Gustafson SK, Wilk AR, Castro S, Robinson A, Wainright JL, Snyder JJ, Kasiske BL, Israni AK. OPTN/SRTR 2017 annual data report: kidney. Am J Transplant. 2019;19(Suppl 2):19–123. https://doi.org/10.1111/ajt.15274.

    Article  PubMed  Google Scholar 

  13. Sanfilippo FP, Vaughn WK, Peters TG, Shield CF, Adams PL, Lorber MI, Williams GM. Factors affecting the waiting time of cadaveric kidney transplant candidates in the United States. JAMA. 1992;267:247–52.

    CAS  PubMed  Google Scholar 

  14. Organ Procurement and Transplantation Network Policies. Policy 8: allocation of kidneys. Effective date: 1/9/2020. Available online at: https://optn.transplant.hrsa.gov/media/1200/optn_policies.pdf.

  15. Friedewald JJ, Samana CJ, Kasiske BL, Israni AK, Stewart D, Cherikh W, Formica RN. The kidney allocation system. Surg Clin North Am. 2013;93:1395–406.

    PubMed  Google Scholar 

  16. Stewart DE, Kucheryavaya AY, Klassen DK, Turgeon NA, Formica RN, Aeder MI. Changes in deceased donor kidney transplantation one year after KAS implementation. Am J Transplant. 2016;16:1834–47.

    CAS  PubMed  Google Scholar 

  17. Cass A, Cunningham J, Snelling P, Ayanian JZ. Late referral to a nephrologist reduces access to renal transplantation. Am J Kidney Dis. 2003;42:1043–9.

    PubMed  Google Scholar 

  18. Stewart DE, Klassen DK. Early experience with the new kidney allocation system: a perspective from UNOS. Clin J Am Soc Nephrol. 2017;12(12):2063–5. https://doi.org/10.2215/CJN.06380617.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Forsythe JLR. Deceased-donor kidney transplantation. In: Oniscu G, Forsythe J, Pomfret E, editors. Transplantation surgery: Springer Surgery Atlas Series. Berlin: Springer; 2019.

    Google Scholar 

  20. Zand MS. Immunosuppression and immune monitoring after renal transplantation. Semin Dial. 2005;18:511–9.

    PubMed  Google Scholar 

  21. Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant. 2009;9(Suppl 3):S1–155.

    Google Scholar 

  22. Cecka JM. Calculated PRA (CPRA): the new measure of sensitization for transplant candidates. Am J Transplant. 2010;10(1):26–9. https://doi.org/10.1111/j.1600-6143.2009.02927.x.

    Article  CAS  PubMed  Google Scholar 

  23. Mourad G, Garrigue V, Squifflet JP, et al. Induction versus noninduction in renal transplant recipients with tacrolimus-based immunosuppression. Transplantation. 2001;72:1050–5.

    CAS  PubMed  Google Scholar 

  24. Charpentier B, Rostaing L, Berthoux F, et al. A three-arm study comparing immediate tacrolimus therapy with antithymocyte globulin induction therapy followed by tacrolimus or cyclosporine A in adult renal transplant recipients. Transplantation. 2003;75:844–51.

    CAS  PubMed  Google Scholar 

  25. Webster AC, Ruster LP, McGee R, Matheson SL, Higgins GY, Willis NS, Chapman JR, Craig JC. Interleukin 2 receptor antagonists for kidney transplant recipients. Cochrane Database Syst Rev. 2010, 2010;(1):CD003897. https://doi.org/10.1002/14651858.CD003897.pub3.

  26. Brennan DC, Flavin K, Lowell JA, et al. A randomized, double-blinded comparison of thymoglobulin versus Atgam for induction immunosuppressive therapy in adult renal transplant recipients. Transplantation. 1999;67:1011–8.

    CAS  PubMed  Google Scholar 

  27. Ciancio G, Burke GW, Gaynor JJ, Roth D, Kupin W, Rosen A, Cordovilla T, Tueros L, Herrada E, Miller J. A randomized trial of thymoglobulin vs. alemtuzumab (with lower dose maintenance immunosuppression) vs. daclizumab in renal transplantation at 24 months of follow-up. Clin Transpl. 2008;22:200–10.

    Google Scholar 

  28. Brennan DC, Schnitzler MA. Long-term results of rabbit antithymocyte globulin and basiliximab induction. N Engl J Med. 2008;359:1736–8.

    CAS  PubMed  Google Scholar 

  29. Gonwa T, Johnson C, Ahsan N, et al. Randomized trial of tacrolimus + mycophenolate mofetil or azathioprine versus cyclosporine + mycophenolate mofetil after cadaveric kidney transplantation: results at three years. Transplantation. 2003;75:2048–53.

    CAS  PubMed  Google Scholar 

  30. Krämer BK, European Tacrolimus vs Cyclosporin Microemulsion Renal Transplantation Study Group, Montagnino G, et al. Efficacy and safety of tacrolimus compared with cyclosporin A microemulsion in renal transplantation: 2 year follow-up results. Nephrol Dial Transplant. 2005;20:968–73.

    PubMed  Google Scholar 

  31. Webster AC, Woodroffe RC, Taylor RS, Chapman JR, Craig JC. Tacrolimus versus ciclosporin as primary immunosuppression for kidney transplant recipients: meta-analysis and meta-regression of randomised trial data. BMJ. 2005;331(7520):810.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Guerra G, Ciancio G, Gaynor JJ, et al. Randomized trial of immunosuppressive regimens in renal transplantation. J Am Soc Nephrol. 2011;22:1758–68.

    CAS  PubMed  PubMed Central  Google Scholar 

  33. Vincenti F, Charpentier B, Vanrenterghem Y, et al. A phase III study of belatacept-based immunosuppression regimens versus cyclosporine in renal transplant recipients (BENEFIT study). Am J Transplant. 2010;10:535–46.

    CAS  PubMed  Google Scholar 

  34. Vincenti F, Blancho G, Durrbach A, et al. Five-year safety and efficacy of belatacept in renal transplantation. J Am Soc Nephrol. 2010;21:1587–96.

    PubMed  PubMed Central  Google Scholar 

  35. Lebranchu Y, Halimi JM, Bock A, Chapman J, Dussol B, Fritsche L, Kliem V, Oppenheimer F, Pohanka E, Salvadori M, Soergel M, Tufveson G, MOST International Study Group. Delayed graft function: risk factors, consequences and parameters affecting outcome-results from MOST, a Multinational Observational Study. Transplant Proc. 2005;37(1):345–7.

    CAS  PubMed  Google Scholar 

  36. Saidi RF, Elias N, Kawai T, Hertl M, Farrell ML, Goes N, Wong W, Hartono C, Fishman JA, Kotton CN, Tolkoff-Rubin N, Delmonico FL, Cosimi AB, Ko DS. Outcome of kidney transplantation using expanded criteria donors and donation after cardiac death kidneys: realities and costs. Am J Transplant. 2007;7(12):2769–74.

    CAS  PubMed  Google Scholar 

  37. Naesens M, Kuypers DRJ, Sarwal M. Calcineurin inhibitor nephrotoxicity. Clin J Am Soc Nephrol. 2009;4:481–508.

    CAS  PubMed  Google Scholar 

  38. Agena F, dos Santos Prado E, Souza PS, da Silva GV, FBC L, Mion D, Nahas WC, David-Neto E. Home blood pressure (BP) monitoring in kidney transplant recipients is more adequate to monitor BP than office BP. Nephrol Dial Transplant. 2011;26:3745–9.

    PubMed  Google Scholar 

  39. Tait BD, Süsal C, Gebel HM, et al. Consensus guidelines on the testing and clinical management issues associated with HLA and non-HLA antibodies in transplantation. Transplantation. 2013;95:19–47.

    CAS  PubMed  Google Scholar 

  40. Racusen LC. Protocol transplant biopsies in kidney allografts: why and when are they indicated? Clin J Am Soc Nephrol. 2006;1:144–7.

    PubMed  Google Scholar 

  41. Wilkinson A. Protocol transplant biopsies: are they really needed? Clin J Am Soc Nephrol. 2006;1:130–7.

    PubMed  Google Scholar 

  42. Henderson LK, Nankivell BJ, Chapman JR. Surveillance protocol kidney transplant biopsies: their evolving role in clinical practice. Am J Transplant. 2011;11(8):1570–5.

    CAS  PubMed  Google Scholar 

  43. Owda AK, Abdallah AH, Haleem A, Hawas FA, Mousa D, Fedail H, Al-Sulaiman MH, Al-Khader AA. De novo diabetes mellitus in kidney allografts: nodular sclerosis and diffuse glomerulosclerosis leading to graft failure. Nephrol Dial Transplant. 1999;14:2004–7.

    CAS  PubMed  Google Scholar 

  44. Ranghino A, Segoloni GP, Lasaponara F, Biancone L. Lymphatic disorders after renal transplantation: new insights for an old complication. Clin Kidney J. 2015;8:615–22.

    CAS  PubMed  PubMed Central  Google Scholar 

  45. Baliu C, Esforzado N, Campistol JM, Mascaró JM. Chronic lymphedema in renal transplant recipients under immunosuppression with sirolimus: presentation of 2 cases. JAMA Dermatol. 2014;150(9):1023–4.

    PubMed  Google Scholar 

  46. Hamouda M, Sharma A, Halawa A. Urine leak after kidney transplant: a review of the literature. Exp Clin Transplant. 2018;16:90–5.

    PubMed  Google Scholar 

  47. Bruno S. Transplant renal artery stenosis. J Am Soc Nephrol. 2004;15:134–41.

    PubMed  Google Scholar 

  48. Roufosse C, Simmonds N, Clahsen-van Groningen M, et al. A 2018 reference guide to the Banff classification of renal allograft pathology. Transplantation. 2018;102:1795–814.

    PubMed  PubMed Central  Google Scholar 

  49. Haas M, Loupy A, Lefaucheur C, et al. The Banff 2017 kidney meeting report: revised diagnostic criteria for chronic active T cell-mediated rejection, antibody-mediated rejection, and prospects for integrative endpoints for next-generation clinical trials. Am J Transplant. 2018;18:293–307.

    CAS  PubMed  PubMed Central  Google Scholar 

  50. Vineyard GC, Fadem SZ, Dmochowski J, Carpenter CB, Wilson RE. Evaluation of corticosteroid therapy for acute renal allograft rejection. Surg Gynecol Obstet. 1974;138:225–9.

    CAS  PubMed  Google Scholar 

  51. Hoitsma AJ, Reekers P, Kreeftenberg JG, van Lier HJ, Capel PJ, Koene RA. Treatment of acute rejection of cadaveric renal allografts with rabbit antithymocyte globulin. Transplantation. 1982;33:12–6.

    CAS  PubMed  Google Scholar 

  52. Webster AC, Wu S, Tallapragada K, Park MY, Chapman JR, Carr SJ. Polyclonal and monoclonal antibodies for treating acute rejection episodes in kidney transplant recipients. Cochrane Database Syst Rev. 2017;7:CD004756. https://doi.org/10.1002/14651858.CD004756.pub4.

    Article  PubMed  Google Scholar 

  53. Djamali A, Kaufman DB, Ellis TM, Zhong W, Matas A, Samaniego M. Diagnosis and management of antibody-mediated rejection: current status and novel approaches. Am J Transplant. 2014;14:255–71.

    CAS  PubMed  PubMed Central  Google Scholar 

  54. Solez K, Colvin RB, Racusen LC, et al. Banff ’05 meeting report: differential diagnosis of chronic allograft injury and elimination of chronic allograft nephropathy. Am J Transplant. 2007;7:518–26.

    CAS  PubMed  Google Scholar 

  55. Cosio FG, Gloor JM, Sethi S, Stegall MD. Transplant glomerulopathy. Am J Transplant. 2008;8:492–6.

    CAS  PubMed  Google Scholar 

  56. Solez K, Colvin RB, Racusen LC, et al. Banff 07 classification of renal allograft pathology: updates and future directions. Am J Transplant. 2008;8:753–60.

    CAS  PubMed  Google Scholar 

  57. Carpenter CB. Long-term failure of renal transplants: adding insult to injury. Kidney Int Suppl. 1995;50:S40–4.

    CAS  PubMed  Google Scholar 

  58. Butler JA, Roderick P, Mullee M, Mason JC, Peveler RC. Frequency and impact of nonadherence to immunosuppressants after renal transplantation: a systematic review. Transplantation. 2004;77:769–76.

    PubMed  Google Scholar 

  59. Ramos E, Drachenberg CB, Wali R, Hirsch HH. The decade of polyomavirus BK-associated nephropathy: state of affairs. Transplantation. 2009;87:621–30.

    PubMed  Google Scholar 

  60. Mengel M, Marwedel M, Radermacher J, Eden G, Schwarz A, Haller H, Kreipe H. Incidence of polyomavirus-nephropathy in renal allografts: influence of modern immunosuppressive drugs. Nephrol Dial Transplant. 2003;18:1190–6.

    CAS  PubMed  Google Scholar 

  61. Dadhania D, Snopkowski C, Ding R, Muthukumar T, Chang C, Aull M, Lee J, Sharma VK, Kapur S, Suthanthiran M. Epidemiology of BK virus in renal allograft recipients: independent risk factors for BK virus replication. Transplantation. 2008;86:521–8.

    PubMed  PubMed Central  Google Scholar 

  62. Drachenberg CB, Papadimitriou JC. Polyomavirus-associated nephropathy: update in diagnosis. Transpl Infect Dis. 2006;8:68–75.

    CAS  PubMed  Google Scholar 

  63. Wiseman AC. Polyomavirus nephropathy: a current perspective and clinical considerations. Am J Kidney Dis. 2009;54:131–42.

    PubMed  Google Scholar 

  64. Sharma SG, Nickeleit V, Herlitz LC, de Gonzalez AK, Stokes MB, Singh HK, Markowitz GS, D’Agati VD. BK polyoma virus nephropathy in the native kidney. Nephrol Dial Transplant. 2001;28:620–31.

    Google Scholar 

  65. Awan AA, Niu J, Pan JS, Erickson KF, Mandayam S, Winkelmayer WC, Navaneethan SD, Ramanathan V. Trends in the causes of death among kidney transplant recipients in the United States (1996–2014). Am J Nephrol. 2018;48:472–81.

    PubMed  Google Scholar 

  66. Gaston RS, Kasiske BL, Fieberg AM, Leduc R, Cosio FC, Gourishankar S, Halloran P, Hunsicker L, Rush D, Matas AJ. Use of cardioprotective medications in kidney transplant recipients. Am J Transplant. 2009;9:1811–5.

    CAS  PubMed  Google Scholar 

  67. Holdaas H, Fellström B, Jardine AG, et al. Effect of fluvastatin on cardiac outcomes in renal transplant recipients: a multicentre, randomised, placebo-controlled trial. Lancet. 2003;361:2024–31.

    CAS  PubMed  Google Scholar 

  68. Palmer SC, Navaneethan SD, Craig JC, Perkovic V, Johnson DW, Nigwekar SU, Hegbrant J, Strippoli GF. HMG CoA reductase inhibitors (statins) for kidney transplant recipients. Cochrane Database Syst Rev. 2014;1:CD005019. https://doi.org/10.1002/14651858.CD005019.pub4.

    Article  Google Scholar 

  69. Wanner C, Tonelli M, Kidney Disease: Improving Global Outcomes Lipid Guideline Development Work Group Members. KDIGO clinical practice guideline for lipid management in CKD: summary of recommendation statements and clinical approach to the patient. Kidney Int. 2014;85:1303–9.

    CAS  PubMed  Google Scholar 

  70. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71(6):e13–e115. https://doi.org/10.1161/HYP.0000000000000065.

    Article  CAS  PubMed  Google Scholar 

  71. Porrini E, Moreno JM, Osuna A, et al. Prediabetes in patients receiving tacrolimus in the first year after kidney transplantation: a prospective and multicenter study. Transplantation. 2008;85:1133–8.

    CAS  PubMed  Google Scholar 

  72. Heisel O, Heisel R, Balshaw R, Keown P. New onset diabetes mellitus in patients receiving calcineurin inhibitors: a systematic review and meta-analysis. Am J Transplant. 2004;4:583–95.

    PubMed  Google Scholar 

  73. Kelly WD, Lillehei RC, Merkel FK, Idezuki Y, Goetz FC. Allotransplantation of the pancreas and duodenum along with the kidney in diabetic nephropathy. Surgery. 1967;61:827–37.

    CAS  PubMed  Google Scholar 

  74. Gruessner RWG, Gruessner AC. The current state of pancreas transplantation. Nat Rev Endocrinol. 2013;9:555–62.

    CAS  PubMed  Google Scholar 

  75. Gruessner RWG, Sutherland DER, Kandaswamy R, Gruessner AC. Over 500 solitary pancreas transplants in nonuremic patients with brittle diabetes mellitus. Transplantation. 2008;85:42–7.

    PubMed  Google Scholar 

  76. Nathan DM, Fogel H, Norman D, Russell PS, Tolkoff-Rubin N, Delmonico FL, Auchincloss H, Camuso J, Cosimi AB. Long-term metabolic and quality of life results with pancreatic/renal transplantation in insulin-dependent diabetes mellitus. Transplantation. 1991;52:85–91.

    CAS  PubMed  Google Scholar 

  77. Gruessner AC, Sutherland DER, Gruessner RWG. Long-term outcome after pancreas transplantation. Curr Opin Organ Transplant. 2012;17:100–5.

    PubMed  Google Scholar 

  78. Gruessner RWG, Sutherland DER, Gruessner AC. Mortality assessment for pancreas transplants. Am J Transplant. 2004;4:2018–26.

    PubMed  Google Scholar 

  79. Fioretto P, Steffes MW, Sutherland DE, Goetz FC, Mauer M. Reversal of lesions of diabetic nephropathy after pancreas transplantation. N Engl J Med. 1998;339:69–75.

    CAS  PubMed  Google Scholar 

  80. Navarro X, Sutherland DE, Kennedy WR. Long-term effects of pancreatic transplantation on diabetic neuropathy. Ann Neurol. 1997;42:727–36.

    CAS  PubMed  Google Scholar 

  81. Jukema JW, Smets YFC, van der Pijl JW, Zwinderman AH, Vliegen HW, Ringers J, Reiber JHC, Lemkes HHPJ, van der Wall EE, de Fijter JW. Impact of simultaneous pancreas and kidney transplantation on progression of coronary atherosclerosis in patients with end-stage renal failure due to type 1 diabetes. Diabetes Care. 2002;25:906–11.

    PubMed  Google Scholar 

  82. Rogers J, Farney AC, Orlando G, Farooq U, Al-Shraideh Y, Stratta RJ. Pancreas transplantation with portal venous drainage with an emphasis on technical aspects. Clin Transpl. 2014;28:16–26.

    Google Scholar 

  83. El-Hennawy H, Stratta RJ, Smith F. Exocrine drainage in vascularized pancreas transplantation in the new millennium. World J Transplant. 2016;6:255–71.

    PubMed  PubMed Central  Google Scholar 

  84. Bloom RD, Olivares M, Rehman L, Raja RM, Yang S, Badosa F. Long-term pancreas allograft outcome in simultaneous pancreas-kidney transplantation: a comparison of enteric and bladder drainage. Transplantation. 1997;64:1689–95.

    CAS  PubMed  Google Scholar 

  85. Dillman JR, Elsayes KM. Imaging of pancreas transplant. In: Elsayes KM, editor. Cross-sectional imaging of the abdomen and pelvis. New York: Springer; 2015.

    Google Scholar 

  86. Kandaswamy R, Stock PG, Gustafson SK, Skeans MA, Urban R, Fox A, Odorico JS, Israni AK, Snyder JJ, Kasiske BL. OPTN/SRTR 2017 annual data report: pancreas. Am J Transplant. 2019;19:124–83.

    PubMed  Google Scholar 

  87. Bazerbachi F, Selzner M, Boehnert MU, Marquez MA, Norgate A, McGilvray ID, Schiff J, Cattral MS. Thymoglobulin versus basiliximab induction therapy for simultaneous kidney-pancreas transplantation: impact on rejection, graft function, and long-term outcome. Transplantation. 2011;92:1039–43.

    CAS  PubMed  Google Scholar 

  88. Bechstein WO, Malaise J, Saudek F, et al. Efficacy and safety of tacrolimus compared with cyclosporine microemulsion in primary simultaneous pancreas-kidney transplantation: 1-year results of a large multicenter trial. Transplantation. 2004;77:1221–8.

    CAS  PubMed  Google Scholar 

  89. Redfield RR, Kaufman DB, Odorico JS. Diagnosis and treatment of pancreas rejection. Curr Transplant Rep. 2015;2:169–75.

    CAS  PubMed  PubMed Central  Google Scholar 

  90. Dong M, Parsaik AK, Kremers W, et al. Acute pancreas allograft rejection is associated with increased risk of graft failure in pancreas transplantation. Am J Transplant. 2013;13:1019–25.

    CAS  PubMed  Google Scholar 

  91. Niederhaus SV, Leverson GE, Lorentzen DF, Robillard DJ, Sollinger HW, Pirsch JD, Torrealba JR, Odorico JS. Acute cellular and antibody-mediated rejection of the pancreas allograft: incidence, risk factors and outcomes. Am J Transplant. 2013;13:2945–55.

    CAS  PubMed  Google Scholar 

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  1. Department of Medicine, Division of Nephrology, University of Washington, Seattle, WA, USA

    Cary H. Paine & Iris C. De Castro

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    Christopher J. Wong

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Paine, C.H., De Castro, I.C. (2020). Primary Care of the Adult Kidney Transplant and Kidney-Pancreas Transplant Recipient. In: Wong, C. (eds) Primary Care of the Solid Organ Transplant Recipient. Springer, Cham. https://doi.org/10.1007/978-3-030-50629-2_4

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