Eculizumab is a humanized monoclonal antibody (mAb) that binds the complement protein C5 blocking its cleavage into C5a and C5b, thereby preventing the formation of the C5b-9, the Membrane Attack Complex (MAC). Eculizumab is FDA approved for the…
Prior HBV infection is not a contraindication to kidney transplantation. It is critical to evaluate patients with serologies and HBV DNA viral load prior to transplant. Most patients should also undergo liver transplant biopsy to exclude significant fibrosis/cirrhosis. Patients with…
A 42-year-old man developed AKI during his recent hospitalization due to presumed sepsis. He was started on vancomycin and levofloxacin as empirical therapy. When renal was consulted 7 days after admission, creatinine level had peaked at 4.39 mg/dl…
The BK polyomavirus is a small, non-enveloped DNA virus, which is an ongoing concern for the transplant population as it primarily causes clinical disease in immunocompromised hosts, leading to BK-associated nephropathy (BKN) and graft loss. Primary infection of…
Tacrolimus extended-release capsules were approved in the US by the Food and Drug Administration (FDA) in July 2013. The development of this new formulation garnered interest due to a possible improvement in immunosuppressive medication compliance. This formulation has…
Being a parent is probably one of the most desirable and difficult tasks in life. While ESRD is associated with a high rate of infertility related to hormonal changes and anovulation, most patients undergoing renal transplantation resume menstrual…
Organ donation from HIV positive patients has been prohibited in the USA since 1988. Pre-transplant screening for HIV is mandatory using nuclear amplification test (NAT), though false negative results during “window period” are a potential concern in donor…
Most kidney transplant centers in the United States utilize induction agents as part of their immunosupression protocols. The reasoning behind is that induction therapy has been shown to reduce the rate of acute rejection, however no trial has…
A 24 year-old ESRD patient secondary to IgA nephropathy has been on HD for almost one year. His mother is a potential donor for living related kidney transplant. The condition seemed perfect—zero mismatch on HLA, no PRA, no…
Ultrafiltration failure is a frequent clinical problem in PD patients. The most common etiologies are: fast peritoneal membrane transport, loss of peritoneal surface membrane and high lymphatic absorption. Mechanical and anatomical etiologies are occasionally seen. Rule of 4’s…
