Assessment of the Potential Transplant Recipient

Chapter

Abstract

Renal transplantation transforms life expectancy in patients with end-stage renal disease (Fig. 66.1). All patients who are considered for renal transplantation require rigorous preoperative assessment in order to ensure their fitness to undergo surgery under general anaesthesia and to optimise the therapeutic impact of a scarce and precious resource. This chapter will review the practical aspects of delivering such an assessment with reference to available evidence and guidelines [1, 2].

Keywords

Obesity Hepatitis Tacrolimus Amyloidosis Lamivudine 

References

  1. 1.
    Dudley C, Harden P. Clinical practice guidelines. Assessment of the potential kidney transplant recipient. 5th ed. UK Renal Association; 2010. http://www.renal.org/docs/default-source/guidelines-resources/Assessment_of_the_Potential_Kidney_Transplant_Recipient_-_Final_Version_12_January_2011.pdf?sfvrsn=0.
  2. 2.
    Kidney Disease: Improving Global Outcomes Transplant Work G. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant. 2009;9 Suppl 3:S1–155.Google Scholar
  3. 3.
    Wong G, Howard K, Chapman JR, et al. Comparative survival and economic benefits of deceased donor kidney transplantation and dialysis in people with varying ages and co-morbidities. PLoS One. 2012;7(1):e29591.PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Wang LW, Fahim MA, Hayen A, et al. Cardiac testing for coronary artery disease in potential kidney transplant recipients: a systematic review of test accuracy studies. Am J Kidney Dis. 2011;57(3):476–87.PubMedCrossRefGoogle Scholar
  5. 5.
    Lentine KL, Hurst FP, Jindal RM, et al. Cardiovascular risk assessment among potential kidney transplant candidates: approaches and controversies. Am J Kidney Dis. 2010;55(1):152–67.PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Welsh RC, Cockfield SM, Campbell P, Hervas-Malo M, Gyenes G, Dzavik V. Cardiovascular assessment of diabetic end-stage renal disease patients before renal transplantation. Transplantation. 2011;91(2):213–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Kasiske BL, Malik MA, Herzog CA. Risk-stratified screening for ischemic heart disease in kidney transplant candidates. Transplantation. 2005;80(6):815–20.PubMedCrossRefGoogle Scholar
  8. 8.
    Lewis MS, Wilson RA, Walker KW, et al. Validation of an algorithm for predicting cardiac events in renal transplant candidates. Am J Cardiol. 2002;89(7):847–50.PubMedCrossRefGoogle Scholar
  9. 9.
    De Lima JJ, Sabbaga E, Vieira ML, et al. Coronary angiography is the best predictor of events in renal transplant candidates compared with noninvasive testing. Hypertension. 2003;42(3):263–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Hage FG, Smalheiser S, Zoghbi GJ, et al. Predictors of survival in patients with end-stage renal disease evaluated for kidney transplantation. Am J Cardiol. 2007;100(6):1020–5.PubMedCrossRefGoogle Scholar
  11. 11.
    Sharma R, Pellerin D, Gaze DC, et al. Dobutamine stress echocardiography and the resting but not exercise electrocardiograph predict severe coronary artery disease in renal transplant candidates. Nephrol Dial Transplant. 2005;20(10):2207–14.PubMedCrossRefGoogle Scholar
  12. 12.
    Boden WE, O’Rourke RA, Teo KK, et al. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med. 2007;356(15):1503–16.PubMedCrossRefGoogle Scholar
  13. 13.
    McFalls EO, Ward HB, Moritz TE, et al. Coronary-artery revascularization before elective major vascular surgery. N Engl J Med. 2004;351(27):2795–804.PubMedCrossRefGoogle Scholar
  14. 14.
    Ricotta JJ, Aburahma A, Ascher E, et al. Updated Society for Vascular Surgery guidelines for management of extracranial carotid disease. J Vasc Surg. 2011;54(3):e1–31.PubMedCrossRefGoogle Scholar
  15. 15.
    Currie IC, Wilson YG, Baird RN, Lamont PM. Detection of sub-critical arterial stenoses by hyperaemic Doppler. Eur J Vasc Endovasc Surg. 1996;11(1):29–35.PubMedCrossRefGoogle Scholar
  16. 16.
    Brekke IB, Lien B, Sodal G, et al. Aortoiliac reconstruction in preparation for renal transplantation. Transpl Int. 1993;6(3):161–3.PubMedCrossRefGoogle Scholar
  17. 17.
    AbuRahma AF, Jarrett K, Hayes DJ. Clinical implications of power Doppler three-dimensional ultrasonography. Vascular. 2004;12(5):293–300.PubMedCrossRefGoogle Scholar
  18. 18.
    El-Zoghby ZM, Stegall MD, Lager DJ, et al. Identifying specific causes of kidney allograft loss. Am J Transplant. 2009;9(3):527–35.PubMedCrossRefGoogle Scholar
  19. 19.
    Zimmerhackl LB, Besbas N, Jungraithmayr T, et al. Epidemiology, clinical presentation, and pathophysiology of atypical and recurrent hemolytic uremic syndrome. Semin Thromb Hemost. 2006;32(2):113–20.PubMedCrossRefGoogle Scholar
  20. 20.
    Canaud G, Zuber J, Sberro R, et al. Intensive and prolonged treatment of focal and segmental glomerulosclerosis recurrence in adult kidney transplant recipients: a pilot study. Am J Transplant. 2009;9(5):1081–6.PubMedCrossRefGoogle Scholar
  21. 21.
    Hickson LJ, Gera M, Amer H, et al. Kidney transplantation for primary focal segmental glomerulosclerosis: outcomes and response to therapy for recurrence. Transplantation. 2009;87(8):1232–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Little MA, Dupont P, Campbell E, Dorman A, Walshe JJ. Severity of primary MPGN, rather than MPGN type, determines renal survival and post-transplantation recurrence risk. Kidney Int. 2006;69(3):504–11.PubMedCrossRefGoogle Scholar
  23. 23.
    Shapiro R, Kaplan B. Native renal cysts and dialysis duration are risk factors for renal cell carcinoma in renal transplant recipients. Am J Transplant. 2011;11(1):10.PubMedCrossRefGoogle Scholar
  24. 24.
    Penn I. The effect of immunosuppression on pre-existing cancers. Transplantation. 1993;55(4):742–7.PubMedCrossRefGoogle Scholar
  25. 25.
    Johnson SR, Cherikh WS, Kauffman HM, Pavlakis M, Hanto DW. Retransplantation after post-transplant lymphoproliferative disorders: an OPTN/UNOS database analysis. Am J Transplant. 2006;6(11):2743–9.PubMedCrossRefGoogle Scholar
  26. 26.
    Milburn H, Ashman N, Davies P, et al. Guidelines for the prevention and management of Mycobacterium tuberculosis infection and disease in adult patients with chronic kidney disease. Thorax. 2010;65(6):557–70.PubMedCrossRefGoogle Scholar
  27. 27.
    Katz LH, Fraser A, Gafter-Gvili A, Leibovici L, Tur-Kaspa R. Lamivudine prevents reactivation of hepatitis B and reduces mortality in immunosuppressed patients: systematic review and meta-analysis. J Viral Hepat. 2008;15(2):89–102.PubMedGoogle Scholar
  28. 28.
    Chung RT, Feng S, Delmonico FL. Approach to the management of allograft recipients following the detection of hepatitis B virus in the prospective organ donor. Am J Transplant. 2001;1(2):185–91.PubMedCrossRefGoogle Scholar
  29. 29.
    Lee LY, Tong CY, Wong T, Wilkinson M. New therapies for chronic hepatitis C infection: a systematic review of evidence from clinical trials. Int J Clin Pract. 2012;66(4):342–55.PubMedCrossRefGoogle Scholar
  30. 30.
    Morales JM, Campistol JM, Dominguez-Gil B, et al. Long-term experience with kidney transplantation from hepatitis C-positive donors into hepatitis C-positive recipients. Am J Transplant. 2010;10(11):2453–62.PubMedCrossRefGoogle Scholar
  31. 31.
    Trullas JC, Cofan F, Tuset M, et al. Renal transplantation in HIV-infected patients: 2010 update. Kidney Int. 2011;79(8):825–42.PubMedCrossRefGoogle Scholar
  32. 32.
    Stock PG, Barin B, Murphy B, et al. Outcomes of kidney transplantation in HIV-infected recipients. N Engl J Med. 2010;363(21):2004–14.PubMedCentralPubMedCrossRefGoogle Scholar
  33. 33.
    Hoshida Y, Li T, Dong Z, et al. Lymphoproliferative disorders in renal transplant patients in Japan. Int J Cancer. 2001;91(6):869–75.PubMedCrossRefGoogle Scholar
  34. 34.
    Kovesdy CP, Czira ME, Rudas A, et al. Body mass index, waist circumference and mortality in kidney transplant recipients. Am J Transplant. 2010;10(12):2644–51.PubMedCrossRefGoogle Scholar
  35. 35.
    Potluri K, Hou S. Obesity in kidney transplant recipients and candidates. Am J Kidney Dis. 2010;56(1):143–56.PubMedCrossRefGoogle Scholar
  36. 36.
    Renders L, Frisman M, Ufer M, et al. CYP3A5 genotype markedly influences the pharmacokinetics of tacrolimus and sirolimus in kidney transplant recipients. Clin Pharmacol Ther. 2007;81(2):228–34.PubMedCrossRefGoogle Scholar
  37. 37.
    Gervasini G, Garcia M, Macias RM, Cubero JJ, Caravaca F, Benitez J. Impact of genetic polymorphisms on tacrolimus pharmacokinetics and the clinical outcome of renal transplantation. Transpl Int. 2012;25(4):471–80.PubMedCrossRefGoogle Scholar
  38. 38.
    Power RE, Hickey DP, Little DM. Urological evaluation prior to renal transplantation. Transplant Proc. 2004;36(10):2962–7.PubMedCrossRefGoogle Scholar
  39. 39.
    Oliver M, Woywodt A, Ahmed A, Saif I. Organ donation, transplantation and religion. Nephrol Dial Transplant. 2011;26(2):437–44.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.Department of MedicineImperial College LondonLondonUK
  2. 2.UCL Centre for NephrologyRoyal Free HospitalLondonUK

Personalised recommendations