Purpose Of Review: Despite improvement in short-term renal allograft survival in recent years, renal transplant recipients (RTR) have poorer long-term allograft outcomes. Allograft function slowly declines with periods of stable function similar to natural progression of chronic kidney disease in nontransplant population. Nearly all RTR transitions to failing renal allograft (FRG) period and require transition to dialysis. Conservative chronic kidney disease management before transition to end-stage renal disease is an increasingly important topic; however, there is limited data in RTR regarding how to delay dialysis initiation with conservative management.
Recent Findings: Since immunological and nonimmunological factors unique to RTR contribute to decline in allograft function, therapies to slow progression of FRG should take both sets of factors into account. Renal replacement therapy either incremental dialysis or rekidney transplantation should be explored. This required taking benefits and risks of continuing immunosuppressive medications into account when allograft nephrectomy may be necessary.
Summary: FRG may benefit from various interventions to slow progression of worsening allograft function. Until there are stronger evidence to guide interventions to preserve renal function, extrapolating evidence from nontransplant patients and clinical judgment are necessary. The goal is to provide individualized care for conservative management of RTR with FRG.
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http://dx.doi.org/10.1097/MNH.0000000000000572 | DOI Listing |
J Transplant
December 2024
Medical College of Georgia, Augusta University Hospital and Medical Center, 1120 15th Street, Augusta AD 3401, Georgia.
Donor-derived cell-free DNA (dd-cfDNA) in the peripheral blood of allograft recipients has shown to early identify allograft injury. In this study, we assessed the factors that influence the amount of circulating dd-cfDNA during the first month postkidney transplant as well as its longitudinal trend. A consecutive series of 98 adult kidney transplant recipients at a single center between July 2018 and January 2020 were included in this study.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Medical Sciences, Infectious Diseases, University of Turin, Turin, Italy.
After allogeneic HSCT (allo-HSCT), the diversity of the intestinal microbiota significantly decreases. The changes can be rapid and are thought to be caused by chemotherapy, antibiotics, or intestinal inflammation. Most patients are exposed to prophylactic and therapeutic antibiotics during neutropenia and several patients are colonized by ESBL bacteria.
View Article and Find Full Text PDFJ Sex Med
January 2025
Department of Urology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, 06973, Republic of Korea.
Background: Dehydrated human amnion/chorion membrane (dHACM) has shown potential in enhancing neurovascular recovery and functional outcomes in robot-assisted radical prostatectomy (RARP).
Aim: To evaluate the effects of dHACM on continence recovery, sexual function, and oncological outcomes in patients undergoing RARP.
Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines, analyzing data from PubMed, Cochrane, and EMBASE.
J Clin Pathol
January 2025
Department of Pathology, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, USA.
Aims: In cystic fibrosis lung transplant recipients (LTRs), graft dysfunction due to acute infections, rejection or chronic lung allograft dysfunction (CLAD) is difficult to distinguish. Characterisation of the airway inflammatory milieu could help detect and prevent graft dysfunction. We speculated that an eosinophil or neutrophil-rich milieu is associated with higher risk of CLAD.
View Article and Find Full Text PDFAm J Phys Med Rehabil
January 2025
RN, PhD, Post-Baccalaureate Program in Nursing, School of Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan.
Objective: Amnion allograft injections have emerged as potential regenerative therapy for degenerative musculoskeletal diseases. In this study, we conducted a systematic review and meta-analysis to evaluate the effectiveness of amnion allograph injections in patients with degenerative musculoskeletal diseases.
Design: A search was conducted across the PubMed, Embase, Cochrane, and Web of Science databases to identify studies reporting on amnion allograft injections in patients with degenerative musculoskeletal diseases.
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