Abstract
Due to the successes of kidney transplantation, patients are surviving long-term with their allografts. In addition to care of the allograft and administration of immunosuppressive medications, common medical conditions should be recognized and managed appropriately. With constraints on transplant centers and patient considerations of finance and geography, community providers will play an ever increasing role in the care of the kidney transplant recipient. Guidelines for understanding and managing common medical conditions as they relate to cardiovascular disease, chronic kidney disease, transplant related issues, and general health maintenance are reviewed in this chapter.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
US Renal Data System 2017 annual data report: epidemiology of kidney disease in the United States. AJKD. 2018 Mar;71(3):S1–S676.
Wolfe RA, Ashby VB, Milford EL, Ojo AO, Ettenger RE, Agodoa LY, et al. 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 Dec;341(23):1725–30.
Kasiske BL. Ischemic heart disease after renal transplantation. Kidney Int. 2002 Jan;61(1):356–69.
Ojo AO. Cardiovascular complications after renal transplantation and their prevention. Transplantation. 2006 Sept;82(5):603–11.
Neale J, Smith AC. Cardiovascular risk factors following renal transplant. World J Transplant. 2015 Dec;5(4):183–95.
Campistol JM, Romero R, Paul J, Gutierrez-Dalmau A. Epidemiology of arterial hypertension in renal transplant patients: changes over the last decade. Nephrol Dial Transplant. 2004 Jun;19(Suppl 3):iii62–6.
Kasiske BL, Anjum S, Shah R, Skogen J, Kandaswamy C, Danielson B, et al. Hypertension after kidney transplantation. Am J Kidney Dis. 2004 Jun;43(6):1071–81.
Becker GJ, et al. Kidney disease: Improving global outcomes (KDIGO) blood pressure work group. KDIGO clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Inter. 2012;2(Suppl):337–414.
Kobashigawa JA, Kasiske BL. Hyperlipidemia in solid organ transplantation. Transplantation. 1997 Feb;63(3):331–8.
Wanner C, Tonelli M, The 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 Jun;85(6):1303–9.
Jardine AG, Holdaas H, Fellstrom B, Cole E, Nyberg G, Gronhagen-Riska C, et al. Fluvastatin prevents cardiac death and myocardial infarction in renal transplant recipients: post-hoc subgroup analyses of the ALERT study. Am J Transplant. 2004 Jun;4(6):988–95.
Kasiske B, Cosio FG, Beto J, Bolton K, Chavers BM, Grimm R Jr, et al. Clinical practice guidelines for managing dyslipidemias in kidney transplant patients: a report from the managing dyslipidemias in chronic kidney disease work group of the national kidney foundation kidney disease outcomes quality initiative. Am J Transplant. 2004;4(Suppl 7):13–53.
Puthenparumpil JJ, Keough-Ryan T, Kiberd M, Lawen J, Kiberd BA. Treatment of hypercholesterolemia with ezetimibe in the kidney transplant population. Transplant Proc. 2005 Mar;37(2):1033–5.
Sharif A, Cohney S. Post-transplantation diabetes: state of the art. Lancet Diabetes Endocrinol. 2016 Apr;4:337349.
Kasiske BL, Snyder JJ, Gilbertson D, Matas AJ. Diabetes mellitus after kidney transplantation in the United States. Am J Transplant. 2003 Feb;3(2):178–85.
Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003 Jan;26(Suppl 1):S5–20.
Wilkinson A, Davidson J, Dotta F, Home PD, Keown P, Kiberd B, et al. Guidelines for the treatment and management of new-onset diabetes after transplantation. Clin Transpl. 2005 Jun;19(3):291–8.
Vanrenterghem Y, Ponticelli C, Morales JM, Abramowicz D, Baboolal K, Eklund B, et al. Prevalence and management of anemia in renal transplant recipients: a European survey. Am J Transplant. 2003 Jul;3(7):835–45.
Kasiske BL, Vazquez MA, Harmon WE, Brown RS, Danovitch GM, Gaston RS, et al. Recommendations for the outpatient surveillance of renal transplant recipients. American society of transplantation. J Am Soc Nephrol. 2000 Oct;11(Suppl 15):S1–86.
Blosser CD, Bloom RD. Posttransplant anemia in solid organ recipients. Transplant Rev (Orlando). 2010 Apr;24(2):89–98.
Rigatto C. Anemia, renal transplantation, and the anemia paradox. Semin Nephrol. 2006 Jul;26(4):307–12.
KDIGO Anemia Work Group. KDIGO clinical practice guideline for anemia in chronic kidney disease. Kidney Int Suppl. 2012 Aug;2(4):279–335.
Naylor KL, Li AH, Lam NN, Hodsman AB, Jamal SA, Garg AX. Fracture risk in kidney transplant recipients: a systematic review. Transplantation. 2013 Jun;95(12):1461–70.
Versele EB, Van Laecke S, Dhondt AW, Verbeke F, Vanholder R, Van Biesen W, Nagler EV. Bisphosphonates for preventing bone disease in kidney transplant recipients: a meta-analysis of randomized controlled trials. Transplant Int. 2016 Feb;29(2):153–64.
Meier-Kriesche HU, Schold JD, Kaplan B. Long-term renal allograft survival: have we made significant progress or is it time to rethink our analytic and therapeutic strategies? Am J Transplant. 2004 Aug;4:1289–95.
Karthikeyan V, Karpinski J, Nair RC, Knoll G. The burden of chronic kidney disease in renal transplant recipients. Am J Transplant. 2004 Feb;4(2):262–9.
Halloran PF, Melk A, Barth C. Rethinking chronic allograft nephropathy: the concept of accelerated senescence. J Am Soc Nephrol. 1999 Jan;10(1):167–81.
Artz MA, Hilbrands LB, Borm G, Assmann KJ, Wetzels JF. Blockade of the renin-angiotensin system increases graft survival in patients with chronic allograft nephropathy. Nephrol Dial Transplant. 2004 Nov;19(11):2852–7.
Lin J, Valeri AM, Markowitz GS, D'Agati VD, Cohen DJ, Radhakrishnan J. Angiotensin converting enzyme inhibition in chronic allograft nephropathy. Transplantation. 2002 Mar;73(5):783–8.
Nankivell BJ, Borrows RJ, Fung CL, O'Connell PJ, Allen RD, Chapman JR. The natural history of chronic allograft nephropathy. N Engl J Med. 2003 Dec;349(24):2326–33.
Mulay AV, Hussain N, Fergusson D, Knoll GA. Calcineurin inhibitor withdrawal from sirolimus-based therapy in kidney transplantation: a systematic review of randomized trials. Am J Transplant. 2005 Jul;5(7):1748–56.
Mulay AV, Cockfield S, Stryker R, Fergusson D, Knoll GA. Conversion from calcineurin inhibitors to sirolimus for chronic renal allograft dysfunction: a systematic review of the evidence. Transplantation. 2006 Nov;82(9):1153–62.
Masso P, Henderson L, Chapman JR, Craig JC, Webster AC. Belatacept for kidney transplant recipients. Cochrane Database Syst Rev. 2014 Nov;11:CD010699.
Chadban S. Glomerulonephritis recurrence in the renal graft. J Am Soc Nephrol. 2001 Feb;12(2):394–402.
Humar A, Lebranchu Y, Vincenti F, Blumberg EA, Punch JD, Limaye AP, et al. The efficacy and safety of 200 days valganciclovir cytomegalovirus prophylaxis in high-risk kidney transplant recipients. Am J Transplant. 2010 May;10(5):1228–37.
Kumar D. Immunizations following solid-organ transplantation. Curr Opin Infect Dis. 2014 Aug;27(4):329–35.
Kotton CN, Ryan ET, Fishman JA. Prevention of infection in adult travelers after solid organ transplantation. Am J Transplant. 2005 Jan;5(1):8–14.
Doycheva I, Amer S, Watt KD. De novo malignancies after transplantation: risk and surveillance strategies. Med Clin North Am. 2016 May;100(3):551–67.
Mittal A, Colegio OR. Skin cancers in organ transplant recipients. Am J Transplant. 2017 Oct;17(10):2509–30.
Karia PS, Azzi JR, Heher EC, Hills VM, Schmults CD. Association of sirolimus use with risk for skin cancer in a mixed-organ cohort of solid-organ transplant recipients with a history of cancer. JAMA Dermatol. 2016 May;152(5):533–40.
Dierickx D, Habermann TM. Post-transplantation lymphoproliferative disorders in adults. NEJM. 2018 Feb;378(6):549–62.
Acuna SA, Huang JW, Scott AL, Micic S, Daly C, Brezden-Masley C, Kim SJ, Baxter NN. Cancer screening recommendations for solid organ transplant recipients: a systematic review of clinical practice guidelines. Am J Transplant. 2017 Jan;17(1):103–14.
McKay DB, Josephson MA, Armenti VT, August P, Coscia LA, Davis CL, et al. Reproduction and transplantation: report on the AST consensus conference on reproductive issues and transplantation. Am J Transplant. 2005 Jul;5(7):1592–9.
Josephson MA, McKay DB. Women and transplantation: fertility, sexuality, pregnancy, contraception. Adv Chronic Kidney Dis. 2013 Sept;20(5):433–40.
Zuber J, Anglicheau D, Elie C, Bererhi L, Timsit MO, Mamzer-Bruneel MF, Ciroldi M, et al. Sirolimus may reduced fertility in male renal transplant recipients. Am J Transplant. 2008 Jul;8(7):1471–9.
Constantinescu S, Pai A, Coscia L, Davison JM, Moritz MJ, Armenti VT. Breast-feeding after transplantation. Best Pract Res Clin Obstet Gynaecol. 2014 Nov;28(8):1163–73.
Potluri K, Hou S. Obesity in kidney transplant recipients and candidates. Am J Kidney Dis. 2010 Jul;56(1):143–56.
Sung RS, Althoen M, Howell TA, Ojo AO, Merion RM. Excess risk of renal allograft loss associated with cigarette smoking. Transplantation. 2001 Jun 27;71(12):1752–7.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Schaefer, H.M. (2021). Long-Term Management of the Kidney Transplant Recipient. In: Hakim, N., Haberal, M., Maluf, D. (eds) Transplantation Surgery. Springer Specialist Surgery Series. Springer, Cham. https://doi.org/10.1007/978-3-030-55244-2_12
Download citation
DOI: https://doi.org/10.1007/978-3-030-55244-2_12
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-55243-5
Online ISBN: 978-3-030-55244-2
eBook Packages: MedicineMedicine (R0)