The Complex Evolution of Kidney Transplantation – Pre-Transplant Donor and Recipient Assessment, Transplant Surgery, Immunosuppression, High-Risk Transplants and Management of Post-Transplant Complications

Wai Hon Lim (Editor)
Department of Renal Medicine, Sir Charles Gairdner Hospital Hospital Avenue, Nedlands
Western Australia

Series: Organ Transplantation Research Horizons, Renal, Metabolic and Urologic Disorders
BISAC: MED055000

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Special issue: Resilience in breaking the cycle of children’s environmental health disparities
Edited by I Leslie Rubin, Robert J Geller, Abby Mutic, Benjamin A Gitterman, Nathan Mutic, Wayne Garfinkel, Claire D Coles, Kurt Martinuzzi, and Joav Merrick

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There has been a substantial increase in the number of patients with end-stage renal disease worldwide over the last few decades. In Australia, over 2400 patients with end-stage renal disease started renal replacement therapy in 2011 with nearly 11,000 patients currently receiving dialysis treatment at the end of 2011. According to Kidney Health Australia, the costs of treating end-stage kidney disease from 2009 to 2020 is estimated to be around $12 billion, highlighting the fact that kidney disease is a major financial burden to the community.

Kidney transplantation confers a survival benefit in patients with end-stage renal disease but transplantation has become increasingly more complex over the last decade. With the greater understanding of transplant immunology along with the introduction of more potent induction and maintenance immunosuppression, clinicians are now in a better position to more accurately stratify each transplant candidate’s immunological risk as well as the ability to safely transplant high-immunological risk transplant candidates. At present, blood group incompatible transplantation and desensitization of highly-sensitized patients are considered standard practice in most transplanting centers achieving acceptable graft and patient outcomes. Even though marginal kidney donors are associated with poorer graft outcomes, there is considerable focus on the acceptance and optimal utilization of these kidney donors, particularly with ongoing shortages of organ donors worldwide.

This book covers all major aspects of kidney transplantation and was put together with the hope of providing the readers with in-depth and current knowledge of important aspects of kidney transplantation, including donor and recipient assessments, innovative surgical techniques and understanding of surgical complications, the evolution of immunological techniques to identify anti-human leukocyte antigen antibodies, the management and preparation of high-risk transplant candidates for transplantation as well as the management of longer-term complications after kidney transplantation.

Contributors to the book are all experts in the field of kidney transplantation and their dedication and efforts have ensured that this book is easy to read and understand and contains the most up-to-date literature relevant in clinical practice. Although kidney transplantation remains a highly specialized field of medicine, transplantation often involves a coordinated multidisciplinary approach involving physicians of other disciplines including immunologists, surgeons and pathologists; transplant coordinators; nurses; scientists and allied health care workers. I do hope that this book will be of interest and provide a reference point to everyone involved in kidney transplantation. (Imprint: Nova Biomedical )

Dedication

Preface

Chapter 1. Donor Assessment and the Impact of Donor Factors on Transplant Outcomes
(John Kanellis and William R. Mulley, Departments of Nephrology and Medicine, Monash Medical Centre, Monash University, Clayton, Victoria, Australia)

Chapter 2. Assessment and Determination of Transplant Candidate Suitability
(William R. Mulley and John Kanellis, Departments of Nephrology and Medicine, Monash Medical Centre, Monash University, Clayton, Victoria, Australia

Chapter 3. The Living Kidney Donor
(Abu Abraham and Neil Boudville, Department of Renal Medicine, Royal Perth Hospital, Perth, Australia, and others)

Chapter 4. Surgical Techniques of Live Donor Nephrectomy and Deceased Donor Kidney Procurement
(Frederico Furriel and Gustavo Gomes, Department of Urology and Renal Transplantation, Coimbra University Hospital, Coimbra, Portugal)

Chapter 5. Urologic Complications of Kidney Transplantation and the Use of Ureteral Stents
(Matthew Whang and Sachin Patil, Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, USA)

Chapter 6. Non-Urological Surgical Complications after Kidney Transplantation
(Bulang He, School of Surgery, the University of Western Australia)

Chapter 7. Introduction to Immunosuppressive Agents in Renal Transplantation
(Andrea Viecelli, Samantha Chua, Germaine Wong and Wai Lim, Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia, and others)

Chapter 8. Induction Therapy in Kidney Transplantation
(Sook Wei Ng, Hannah Hessamodini, Andrea Viecelli, Germaine Wong and Wai Hon Lim, Department of Renal Medicine, Sir Charles Gairdner Hospital and School of Medicine and Pharmacology, University of Western Australia, Perth, Australia, and others)

Chapter 9. Immunosuppressive Agents in Kidney Transplantation
(Andrea Viecelli, Samantha Chua, Germaine Wong and Wai Lim, Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia, and others)

Chapter 10. Pharmacokinetic, Pharmacogenetic and Pharmacodynamic Monitoring of Tacrolimus, Mycophenolate and Oral Corticosteroids in Adult Kidney Transplantation
(K.A. Barraclough, C.E. Staatz and N.M. Isbel, Department of Nephrology, University of Queensland at the Princess Alexandra Hospital, Brisbane, Australia, and others)

Chapter 11. ABO-Blood Group Incompatible Kidney Transplantation
(Kate R. Wyburn, Collaborative Transplant Research Group, Royal Prince Alfred Hospital, University of Sydney, Sydney, New South Wales, Australia)

Chapter 12. The Evolution of HLA-Matching in Kidney Transplantation
(Hung Do Nguyen, Rebecca Lucy Williams, Germaine Wong and Wai Hon Lim, Department of Renal Medicine, Sir Charles Gairdner Hospital and School of Medicine and Pharmacology, University of Western Australia, Perth, Australia, and others)

Chapter 13. The Management of Highly Sensitized Kidney Transplant Candidates
(Shyam Dheda, Siew Chong, Rebecca Lucy Williams, Germaine Wong and Wai Hon Lim, Department of Renal Medicine, Sir Charles Gairdner Hospital and School of Medicine and Pharmacology, University of Western Australia, Perth, Australia)

Chapter 14. Complexities and Controversies in the Diagnosis of Acute and Chronic Antibody-Mediated Rejection
(Daniel D. Wong, Ramela Rajakaruna and Dominic V. Spagnolo, Department of Anatomical Pathology, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, Western Australia)

Chapter 15. Treatment of Acute and Chronic Antibody Mediated Rejection
(Shyam Dheda, Germaine Wong and Wai Hon Lim, Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia, and others)

Chapter 16. Clinico-Pathologic Diagnosis and Management of Chronic Allograft Damage
(Ramyasuda Swaminathan, Ashley Irish and Rajalingam Sinniah, Royal Perth Hospital, Perth, Western Australia, and others)

Chapter 17. Management of Post-Transplant Bone Disease
(Wai Hon Lim, Hannah Hessamodini, Andrea Viecelli and Germaine Wong, Department of Renal Medicine, Sir Charles Gairdner Hospital and School of Medicine and Pharmacology, University of Western Australia, Perth, Australia, and others)

Chapter 18. New Onset of Diabetes Mellitus after Transplantation
(Steve Chadban and Honda Ko, Royal Prince Alfred and University of Sydney, Sydney, Australia)

Chapter 19. BK Virus Infection Following Kidney Transplantation
(David C. Langsford, Prue Hill and David J. Goodman, Department of Nephrology, Si Vincent’s Hospital, University of Melbourne, Melbourne, Australia)

Chapter 20. Cytomegalovirus Infection Following Kidney Transplantation
(Nick E. Barraclough, Prue Hill and David J. Goodman, Department of Nephrology, Si Vincent’s Hospital, University of Melbourne, Melbourne, Australia)

Chapter 21. Cancer in Kidney Transplant Recipients
(Wai Hon Lim and Germaine Wong, Department of Renal Medicine, Sir Charles Gairdner Hospital and School of Medicine and Pharmacology, University of Western Australia, Perth, Australia, and others)

Chapter 22. Immunological Monitoring of the Kidney Transplant Recipient
(Aron Chakera and Christopher A. O’Callaghan, Renal Unit, Sir Charles Gairdner Hospital, Perth, Western Australia and others)

Index

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