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Medical and Surgical Evaluation of the Adult Kidney Transplant Candidate

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Kidney and Pancreas Transplantation

Part of the book series: Current Clinical Urology ((CCU))

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Abstract

This chapter details the evaluation of the adult patient with advanced kidney disease or ESRD being considered for kidney transplantation. Transplantation involves upfront risks to mortality stemming from a major surgical procedure in a recipient with medical and surgical comorbidity that is compounded by pharmacologic immunosuppression. This complex scenario demands the involvement of a multidisciplinary medical and surgical team to accomplish successful transplantation. The authors present a clinically relevant evidence-based approach to the pre-kidney transplant evaluation.

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References

  1. Wolfe RA, Ashby VB, Milford EL, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. NEJM 1999;341(23):1725–1730.

    Article  CAS  PubMed  Google Scholar 

  2. Dew MA, Switzer GE, Goycoolea JM, et al. Does transplantation produce quality of life benefits? A quantitative analysis of the literature. Transplantation 1997;64(9):1261–1273.

    Article  CAS  PubMed  Google Scholar 

  3. UNOS. United Network of Organ Sharing. Available at http://www.Unos.org

  4. Meier-Kriesche H, Port FK, Ojo AO, et al. Deleterious effect of waiting time on renal transplant outcome. Transpl Proc 2001;33(1–2):1204–1206.

    Article  CAS  Google Scholar 

  5. Mange KC, Joffe MM, Feldman HI. Effect of the use or nonuse of long-term dialysis on the subsequent survival of renal transplants from living donors. NEJM 2001;344(10):726–731.

    Article  CAS  PubMed  Google Scholar 

  6. Augustine JJ, Poggio ED, Clemente M, et al. Hemodialysis vintage, black ethnicity, and pretransplantation antidonor cellular immunity in kidney transplant recipients. J Am Soc Nephrol 2007;18(5):1602–1606.

    Article  PubMed  Google Scholar 

  7. Nogueira JM, Haririan A, Jacobs SC, Cooper M, Weir MR. Cigarette smoking, kidney function, and mortality after live donor kidney transplant. Am J Kidney Dis 2010;55(5):817–819.

    Article  Google Scholar 

  8. Schold JD, Srinivas TR, Kayler LK, Meier-Kriesche HU. The overlapping risk profile between dialysis patients listed and not listed for renal transplantation. Am J Transplant 2008;8(1):58–68.

    CAS  PubMed  Google Scholar 

  9. Meier-Kriesche HU, Cibrik DM, Ojo AO, et al. Interaction between donor and recipient age in determining the risk of chronic renal allograft failure. J Am Geriatr Soc 2002;50(1):14–17.

    Article  PubMed  Google Scholar 

  10. Merion RM, Ashby VB, Wolfe RA, et al. Deceased-donor characteristics and the survival benefit of kidney transplantation. JAMA 2005;294(21):2726–2733.

    Article  CAS  PubMed  Google Scholar 

  11. Schold JD, Meier-Kriesche HU. Which renal transplant candidates should accept marginal kidneys in exchange for a shorter waiting time on dialysis? Clin J Am Soc Nephrol 2006;1(3):532–538.

    Article  PubMed  Google Scholar 

  12. Meier-Kriesche HU, Schold JD, Srinivas TR, Reed A, Kaplan B. Kidney transplantation halts cardiovascular disease progression in patients with end-stage renal disease. Am J Transplant 2004;4(10):1662–1668.

    Article  PubMed  Google Scholar 

  13. Kasiske BL, Cangro CB, Hariharan S, et al. The evaluation of renal transplantation candidates: clinical practice guidelines. Am J Transplant 2001;1(Suppl 2):3–95.

    PubMed  Google Scholar 

  14. Gaston RS, Danovitch GM, Adams PL, et al. The report of a national conference on the wait list for kidney transplantation. Am J Transplant 2003;3(7):775–785.

    Article  PubMed  Google Scholar 

  15. Sheashaa HA, Abbas TM, Hassan NA, et al. Association and prognostic impact of persistent left ventricular hypertrophy after live-donor kidney transplantation: a prospective study. Clin Exp Nephrol 2010;14(1):68–74.

    Article  PubMed  Google Scholar 

  16. de Mattos AM, Siedlecki A, Gaston RS, et al. Systolic dysfunction portends increased mortality among those waiting for renal transplant. J Am Soc Nephrol 2008;19(6):1191–1196.

    Article  PubMed  Google Scholar 

  17. Issa N, Krowka MJ, Griffin MD, Hickson LJ, Stegall MD, Cosio FG. Pulmonary hypertension is associated with reduced patient survival after kidney transplantation. Transplantation 2008;86(10):1384–1388.

    Article  PubMed  Google Scholar 

  18. Patel AD, Abo-Auda WS, Davis JM, et al. Prognostic value of myocardial perfusion imaging in predicting outcome after renal transplantation. Am J Cardiol 2003;92(2):146–151.

    Article  PubMed  Google Scholar 

  19. Linares L, Cofan F, Cervera C, et al. Infection-related mortality in a large cohort of renal transplant recipients. Transplant Proc 2007;39(7):2225–2227.

    Article  CAS  PubMed  Google Scholar 

  20. Rahnavardi M, Hosseini Moghaddam SM, Alavian SM. Hepatitis C in hemodialysis patients: current global magnitude, natural history, diagnostic difficulties, and preventive measures. Am J Nephrol 2008;28(4):628–640.

    Article  PubMed  Google Scholar 

  21. Abbott KC, Bucci JR, Matsumoto CS, et al. Hepatitis C and renal transplantation in the era of modern immunosuppression. J Am Soc Nephrol 2003;14(11):2908–2918.

    Article  PubMed  Google Scholar 

  22. Fabrizi F, Martin P, Dixit V, Bunnapradist S, Dulai G. Hepatitis C virus antibody status and survival after renal transplantation: meta-analysis of observational studies. Am J Transplant 2005;5(6):1452–1461.

    Article  CAS  PubMed  Google Scholar 

  23. Meier-Kriesche HU, Ojo AO, Hanson JA, Kaplan B. Hepatitis C antibody status and outcomes in renal transplant recipients. Transplantation 2001;72(2):241–244.

    Article  CAS  PubMed  Google Scholar 

  24. Hartmann EL, Kitzman D, Rocco M, et al. Physical function in older candidates for renal transplantation: an impaired population. Clin J Am Soc Nephrol 2009;4(3):588–594.

    Article  PubMed  Google Scholar 

  25. Wong G, Chapman JR. Cancers after renal trans­plantation. Transplant Rev (Orlando) 2008;22(2):141–149.

    Article  Google Scholar 

  26. Penn I. Evaluation of transplant candidates with ­pre-existing malignancies. Ann Transplant 1997;2(4):14–17.

    CAS  PubMed  Google Scholar 

  27. Secin FP, Carver B, Kattan MW, Eastham JA. Current recommendations for delaying renal transplantation after localized prostate cancer treatment: are they still appropriate? Transplantation 2004;78(5):710–712.

    Article  PubMed  Google Scholar 

  28. Schold J, Srinivas TR, Sehgal AR, Meier-Kriesche HU. Half of kidney transplant candidates who are older than 60 years now placed on the waiting list will die before receiving a deceased-donor transplant. Clin J Am Soc Nephrol 2009;4(7):1239–1245.

    Article  PubMed  Google Scholar 

  29. Meier-Kriesche HU, Srinivas TR, Kaplan B. Interaction between acute rejection and recipient age on long-term renal allograft survival. Transplant Proc 2001;33(7-8):3425–3426.

    Article  CAS  PubMed  Google Scholar 

  30. US Renal Data System. US Renal Data System, USRDS 2009 Annual Data Report: Atlas of End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2009. Available at http://www.usrds.org. Updated 2009.

  31. Liani M, Salvati F, Tresca E, et al. Arteriovenous ­fistula obstruction and expression of platelet receptors for von Willebrand factor and for fibrinogen (glycoproteins GPib and GPiib/iiia) in hemodialysis patients. Int J Artif Organs 1996;19(8):451–454.

    CAS  PubMed  Google Scholar 

  32. Schold JD, Srinivas TR, Howard RJ, Jamieson IR, Meier-Kriesche HU. The association of candidate mortality rates with kidney transplant outcomes and center performance evaluations. Transplantation 2008;85(1):1–6.

    Article  PubMed  Google Scholar 

  33. Cukor D, Rosenthal DS, Jindal RM, Brown CD, Kimmel PL. Depression is an important contributor to low medication adherence in hemodialyzed patients and transplant recipients. Kidney Int 2009;75(11):1223–1229.

    Article  PubMed  Google Scholar 

  34. Cibrik DM, Kaplan B, Campbell DA, Meier-Kriesche HU. Renal allograft survival in transplant recipients with focal segmental glomerulosclerosis. Am J Transplant 2003;3(1):64–67.

    Article  PubMed  Google Scholar 

  35. 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):1232–1239.

    Article  PubMed  Google Scholar 

  36. Ivanyi B. A primer on recurrent and de novo glomerulonephritis in renal allografts. Nat Clin Pract Nephrol 2008;4(8):446–457.

    Article  PubMed  Google Scholar 

  37. Zipfel PF, Heinen S, Jozsi M, Skerka C. Complement and diseases: defective alternative pathway control results in kidney and eye diseases. Mol Immunol 2006;43(1–2):97–106.

    Article  CAS  PubMed  Google Scholar 

  38. Davin JC, Gracchi V, Bouts A, Groothoff J, Strain L, Goodship T. Maintenance of kidney function following treatment with eculizumab and discontinuation of plasma exchange after a third kidney transplant for atypical hemolytic uremic syndrome associated with a CFH mutation. Am J Kidney Dis 2010;55(4):708–711. Epub 2009 Oct 25.

    Article  PubMed  Google Scholar 

  39. Gallon L, Chhabra D. Anti-CD20 monoclonal antibody (rituximab) for the treatment of recurrent idiopathic membranous nephropathy in a renal transplant patient. Am J Transplant 2006;6(12):3017–3021.

    Article  CAS  PubMed  Google Scholar 

  40. Choy BY, Chan TM, Lai KN. Recurrent glomerulonephritis after kidney transplantation. Am J Transplant 2006;6(11):2535–2542.

    Article  CAS  PubMed  Google Scholar 

  41. McDonald SP, Russ GR. Recurrence of IgA nephropathy among renal allograft recipients from living donors is greater among those with zero HLA mismatches. Transplantation 2006;82(6):759–762.

    Article  CAS  PubMed  Google Scholar 

  42. Srinivas TR, Meier-Kriesche HU. Obesity and kidney transplantation. Contrib Nephrol 2006;151:19–41.

    Article  PubMed  Google Scholar 

  43. Schold JD, Srinivas TR, Guerra G, et al. A “weight-listing” paradox for candidates of renal transplantation? Am J Transplant 2007;7(3):550–559.

    Article  CAS  PubMed  Google Scholar 

  44. Alexander JW, Goodman H. Gastric bypass in chronic renal failure and renal transplant. Nutr Clin Pract 2007;22(1):16–21.

    Article  PubMed  Google Scholar 

  45. Ismail HR, Flechner SM, Kaouk JH, et al. Simultaneous vs. sequential laparoscopic bilateral native nephrectomy and renal transplantation. Trans­plantation 2005;80(8):1124–1127.

    Article  PubMed  Google Scholar 

  46. Ojo AO, Held PJ, Port FK, et al. Chronic renal failure after transplantation of a nonrenal organ. NEJM 2003;349(10):931–940.

    Article  CAS  PubMed  Google Scholar 

  47. Ojo A, Wolfe RA, Agodoa LY, et al. Prognosis after primary renal transplant failure and the beneficial effects of repeat transplantation: multivariate analyses from the United States Renal Data System. Transplantation 1998;66(12):1651–1659.

    Article  CAS  PubMed  Google Scholar 

  48. Thompson JA, Lake JR. The impact of MELD allocation on simultaneous liver-kidney transplantation. Curr Gastroenterol Rep 2009;11(1):76–82.

    Article  PubMed  Google Scholar 

  49. Wadei HM, Geiger XJ, Cortese C, et al. Kidney ­allocation to liver transplant candidates with renal failure of undetermined etiology: role of percutaneous renal biopsy. Am J Transplant 2008;8(12):2618–2626.

    Article  CAS  PubMed  Google Scholar 

  50. Tanriover B, Mejia A, Weinstein J, et al. Analysis of kidney function and biopsy results in liver failure patients with renal dysfunction: a new look to combined liver kidney allocation in the post-MELD era. Transplantation 2008;86(11):1548–1553.

    Article  PubMed  Google Scholar 

  51. Eason JD, Gonwa TA, Davis CL, Sung RS, Gerber D, Bloom RD. Proceedings of Consensus Conference on Simultaneous Liver Kidney Transplantation (SLK). Am J Transplant 2008;8(11):2243–2251.

    Article  CAS  PubMed  Google Scholar 

  52. Lonze BE, Warren DS, Stewart ZA, et al. Kidney transplantation in previous heart or lung recipients. Am J Transplant 2009;9(3):578–585.

    Article  CAS  PubMed  Google Scholar 

  53. Serrano DP, Flechner SM, Modlin CS, Wyner LM, Novick AC. Transplantation into the long-term defunctionalized bladder. J Urol 1996;156(3):885–888.

    Article  CAS  PubMed  Google Scholar 

  54. Rigamonti W, Capizzi A, Zacchello G, et al. Kidney transplantation into bladder augmentation or urinary diversion: long-term results. Transplantation 2005;80(10):1435–1440.

    Article  PubMed  Google Scholar 

  55. Hatch DA, Belitsky P, Barry JM, et al. Fate of renal allografts transplanted in patients with urinary diversion. Transplantation 1993;56(4):838–842.

    Article  CAS  PubMed  Google Scholar 

  56. Kumar V, Julian BA, Deierhoi MH, Curtis JJ. Secondary listing for deceased-donor kidney transplantation does not increase likelihood of engraftment at a large transplant center. Am J Transplant 2009;9(7):1671–1673.

    Article  CAS  PubMed  Google Scholar 

  57. Flechner SM, Conley SB, Brewer ED, Benson GS, Corriere JN,Jr. Intermittent clean catheterization: an alternative to diversion in continent transplant recipients with lower urinary tract dysfunction. J Urol 1983;130:878–81.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Nephrology and Hypertension, Glickman Urologic and Kidney Institute, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Titte R. Srinivas

Authors
  1. Richard A. Fatica
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  2. Stuart M. Flechner
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  3. Titte R. Srinivas
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Corresponding author

Correspondence to Titte R. Srinivas .

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Editors and Affiliations

  1. Glickman Urological & Kidney Institute, Children's Hospital of Cleveland Clinic, Euclid Ave. 9500, Cleveland, 44195, Ohio, USA

    T. R. Srinivas

  2. Glickman Urological & Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue 9500, Cleveland, 44195, Ohio, USA

    Daniel A. Shoskes

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Fatica, R.A., Flechner, S.M., Srinivas, T.R. (2011). Medical and Surgical Evaluation of the Adult Kidney Transplant Candidate. In: Srinivas, T., Shoskes, D. (eds) Kidney and Pancreas Transplantation. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-642-9_8

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  • DOI: https://doi.org/10.1007/978-1-60761-642-9_8

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60761-641-2

  • Online ISBN: 978-1-60761-642-9

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