Focus On Transplantation

Donor Kidney Acceptance Practices and Wait-listed Patients

Each year, nearly 5000 people in the United States and more than 3000 in Europe die while waiting for a kidney transplant. The shortage of organs available for transplant is a major public health issue, due to wait-listed patient mortality as well as increased healthcare costs of maintaining patients with end-stage renal disease (ESRD) on chronic dialysis. However, more than ... Read More »

HCV Status and Kidney Transplantation Outcomes

In the general population in the United States, the prevalence of hepatitis C virus (HCV) is ~1%; the prevalence among patients on hemodialysis ranges between 3% and 14%. Current US practice guidelines call for screening of all dialysis patients for HCV infection by testing for anti-HCV antibody and, more recently, HCV RNA to confirm chronic infection. For many patients with ... Read More »

Associations between Trans-fatty Acids and Survival in Renal Transplant Recipients

Trans-fatty acids (TFAs), unsaturated fatty acids, occur naturally in ruminant fats and dairy products; TFAs are produced by biohydrogenation in ruminant gut. However, according to Anupam Chandra, MD, and colleagues most TFAs in modern diets are found in industrial processed food, created by hydrogenating vegetable and fish oils. Margarines, crackers, and deep-fried foods contain partially hydrogenated TFAs due to properties ... Read More »

Metabolic Acidosis and Risk for Cardiovascular Events Following Transplantation

Of the 135,436 kidneys transplanted between 2008 and 2015, an estimated 20% will be lost within 5 years. An additional 35,000 kidney transplants will be lost by 2025, which will result in significant morbidity, mortality, and public health costs. Patient death, primarily due to cardiovascular disease, accounts for nearly half of the failed transplanted kidneys. The other 50% are lost ... Read More »

Incidence of Nonmelanoma Skin Cancer Varies by Treatment Modality in Transplant Recipients

The most common form of cancer in recipients of solid organ transplants is nonmelanoma skin cancer (NMSC), which is reportedly more common in recipients of renal transplants than in patients receiving maintenance dialysis. Patients on maintenance dialysis are also at increased risk of NMSC, including patients with high comorbidity and those on the active transplant waiting list. There are few ... Read More »

Stroke Risk and Predictors in Kidney Transplant Recipients

Kidney transplantation is the gold standard treatment for patients with end-stage renal disease (ESRD). The prevalence of mortality and major cardiovascular events in kidney transplant recipients has declined in recent years, and is lower among transplant recipients than in a matched chronic kidney disease (CKD) population. However, kidney transplant recipients continue to have an increased mortality and cardiovascular event risk ... Read More »

Using the Hume Formula to Estimate Body Composition

Aberrant body composition, notably muscle and protein-energy wasting, and elevated levels of adiposity, are common characteristics of chronic kidney disease (CKD). Malnutrition, reductions in physical function, and quality of life are negatively affected by abnormal body composition; in addition, there is an association between abnormal body composition and increased risk for adverse clinical outcomes and mortality. Estimates are that 9% ... Read More »

Prognostic Importance of Atrial Fibrillation in Kidney Transplant Recipients

Atrial fibrillation (AF) affects three to six million people in the United States, and nearly 30 million people worldwide. AF is associated with higher risk of mortality and adverse cardiovascular events including stroke. Among patients with end-stage renal disease (ESRD), the prevalence of AF is particularly high compared to the general population. In addition, the 1-year mortality risk of patients ... Read More »

INTENT Trial Examines Intervention to Prevent Excessive Weight Gain Post-Transplant

Recipients of kidney transplant have markedly improved outcomes compared with patients on dialysis; however, survival among kidney transplant recipients is significantly reduced compared with age-matched general population. The reduction in survival is due, in large part, to an increase in the risk of cardiovascular disease. Weight gain, obesity, and diabetes are risk factors for cardiovascular disease, and there is an ... Read More »