Focus on Transplantation

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 »

Transplant Outcomes in Patients with C3 Glomerulopathy: A Case Series

C3 glomerulopathy (C3G) is a rare, progressive disease that commonly leads to end-stage renal disease (ESRD). C3G is a form of glomerulonephritis (GN) associated with dysregulation of the alternative complement pathway. C3 dominance with minimal or absent immunoglobulin deposition on immunofluorescence staining is the defining histological finding for C3G. Findings on light microscopy include patterns of membranoproliferative GN (MPGN), mesangioproliferative ... Read More »

Costs of Immunosuppressive Drugs Decreased after Approval of Generic Versions

For patients with end-stage organ failure, solid organ transplantation is life-saving and cost-effective; however, transplant recipients require use of immunosuppressive agents for the rest of their lives to maintain a functioning graft. In 2000, the average cost for immunosuppressive medications was between $10,000 and $14,000 annually. Generic versions of some commonly prescribed agents, including tacrolimus, mycophenolate mofetil, and mycophenolate sodium, ... Read More »

May June 2019: Transplantation Abstract Roundup

Renal Transplantation among Patients with ESRD Due to Lupus Nephritis Annals of Internal Medicine. 2019;170(4):240-247. Rates of premature death are high among patients with end-stage renal disease (ESRD) due to lupus nephritis (ESRD-LN). April Jorge, MD, and colleagues conducted a nationwide cohort study designed to examine the potential effect on survival of renal transplant among patients with ESRD-LN in the ... Read More »

Maternal and Fetal Outcomes in Pregnant Kidney Transplant Recipients

Due to disruption of hypothalamic gonadal axis, women with end-stage renal disease (ESRD) have impaired fertility, resulting in a very low incidence of conception in women on dialysis (range, 0.9% to 7%). In some cases, recipients of kidney transplantation experience a rapid restoration of fertility, making transplantation the optimal treatment for women with ESRD who wish to become pregnant. There ... 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 »

Recurrent Diabetic Nephropathy in Transplant Recipients

San Diego—There are few data on recurrent diabetic nephropathy in kidney transplant recipients. Aleksandra Kukla, MD, and colleagues at the Mayo Clinic in Rochester, Minnesota, conducted a study designed to identify the incidence, timing, and severity of recurrent diabetic nephropathy in transplant recipients with pretransplant type 1 and type 2 diabetes. Results of the study were reported during a poster ... 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 »

New Hypertension Targets Improve Patient and Graft Survival

San Diego—Utilizing data from SPRINT (Systolic Blood pressure Intervention Trial), American national guidelines reduced the blood pressure goal from 140.90 mm Hg to 130/80 mm HG for subjects with increased cardiovascular risk, including patients with chronic kidney disease (CKD). There are few data available on whether renal transplant recipients benefit from the reduced blood pressure goals. Nikolaos Pagonas, MD, and ... 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 »