Focus on Transplantation

Interventions Improve Adherence to Tacrolimus after Transplantation

Nonadherence to immunosuppression medications among kidney transplantation recipients can cause rejection and transplant loss. There is a high barrier to adherence during the first year post-transplantation due to the need to take multiple medications with various adverse effects as well as frequent dose changes. Younger age and further time from transplant are associated with lower adherence to the immunosuppression medication ... Read More »

Referral for Transplantation as Quality-of-Care Indicator

Kidney transplantation is associated with better patient outcomes and lower costs than dialysis; however, only <3% of patients with end-stage renal disease (ESRD) receive a kidney transplant before initiation of dialysis therapy and <30% of prevalent patients with ESRD have a functioning transplant. At present, there are no pay-for-performance indicators related to transplantation in the Centers for Medicare & Medicaid ... Read More »

Outcomes in Transplant Recipients Treated with RAS Blockade Agents

In 2013, there were more than 100,000 cases of end-stage renal disease (ESRD) in the United States and the prevalence is increasing by 21,000 each year, making ESRD a major public health problem. The optimal renal replacement therapy is kidney transplantation; however, long-term outcomes are less than optimal, with 10-year transplant rates of 45% for recipients of deceased donor kidneys. ... Read More »

Evaluating Intrarenal Vasculature after Renal Transplantation with Doppler Ultrasound

Chicago—Doppler ultrasound, which facilitates the global evaluation of intrarenal vasculature, is a valuable, noninvasive tool for the diagnosis of complications in renal transplantation. Amir Shabaka, MD, and colleagues recently conducted a retrospective study designed to examine the evolution of renal graft hemodynamics in the immediate postoperative period following transplantation as well as early periods post-transplant. The researchers reported study results ... Read More »

Body Composition and Frailty after Transplant

Chicago—Recent studies have suggested that frailty is a risk factor for poor outcomes following kidney transplantation. Patients with preoperative fraility are at increased risk for early hospital readmission, delayed graft function, and mortality, regardless of their age. One component of frailty after kidney transplantation is weight loss; however, changes in lean and fat mass are not fully accounted for by ... Read More »

Long-Term Survival in Transplant Recipients Undergoing Heart Surgery

Chicago Researchers at a university hospital in Norway evaluated results of open heart surgery in kidney transplant recipients from 1989 to 2015. Bartlomiei J. Witczak, MD, and colleagues reported results of the analysis during a poster session at Kidney Week 2016 in a poster titled Outcomes after Open Heart Surgery in Kidney Transplant Recipients and Matched Controls. During the study ... Read More »

Employed Patients More Likely to Have Transplant List Status

Chicago The optimal long-term treatment option for patients with end-stage renal disease (ESRD) who are on hemodialysis is often kidney transplantation. Qualifications for placement on the active transplant list include patient motivation and engagement with the process. Researchers, led by Deborah S. Evans, recently conducted an analysis to assess transplant status among employed versus unemployed ESRD patients. Results were reported ... Read More »

Statin Use Suboptimal among Post-Transplant Veterans

Chicago Treatment guidelines from Kidney Disease, Improving Global Outcomes (KDIGO) and Kidney Disease Outcomes Quality Initiative (KDOQI) recommend statin medications for kidney transplant recipients. However, data from some empirical studies indicate that statins are underutilized on that patient population. Arouna Senthilkumar, MD, and colleagues recently conducted a retrospective analysis of data from the US Department of Veterans Affairs Healthcare System ... Read More »

Medication Adherence among Teen and Young Adult Transplant Recipients

Chicago Adherence to immunosuppressive medication in adolescent and young adult kidney transplant recipients is poorer than in children. However, there are few data on whether adherence varies between males and females, or by age, in adolescents and young adults. Julie Boucquemont, MD, and Bethany J. Foster, MD, conducted an analysis of data from the 3-month run-in period (with no intervention) ... Read More »

Nonwhite Organ Transplant Recipients at High Risk for Skin Cancer

In 2015, approximately 13,000 nonwhite (black, Asian, Hispanic, Pacific Islander) individuals received an organ transplant; this population has a higher incidence of new skin cancers compared with comparable nontransplant recipients. This risk increases over time with continued exposure to immunosuppression regimens. Squamous cell carcinoma (SCC) is increased 65-fold, basal cell carcinoma (BCC) is increased 10-fold, and melanoma is increased 3-fold ... Read More »