Final results of last week’s Poll of the Week: only 13% of individuals said they outright disapproved of the proposed Kidney Allocation Score, the scoring system which has been proposed to replace the current system of determining kidney…
The ability to adequately suppress the immune system and prevent allograft rejection has been a true success story over the past several decades. With the advent of drugs such as calcineurin inhibitors, induction agents such as thymoglobulin, azathioprine…
The term “T-regs” is shorthand for “regulatory T-cells”–a subpopulation of T-cells which act to suppress immune system activation and promote tolerance towards self-antigens. Although the existence of T-regs was felt to be controversial up until relatively recently, the…
We all know that there is a drastic shortage of donor kidneys available: in the state of Massachusetts, for instance, the average time on the kidney transplant waiting list we’re quoting to patients is about 5 years…which for…
When somebody receives a kidney transplant, the current strategy is to hit them hard with immunosuppression initially–using potent medications such as thymoglobulin, Cell-Cept, steroids, and tacrolimus at higher levels–and that medication can generally be tapered to much lower…
CMV (cytomegalovirus) infection is quite common in the transplant population, and fortuantely the development and utilization of valganciclovir (Valcyte), an oral prodrug of ganciclovir, as a prophylactic agent has dramatically cut down on the number of CMV infections…
There are many diseases which can recur following renal transplant: examples include IgA Nephropathy (which has a very high rate of recurrence on follow biopsy but is rarely clinically relevant in that it does not cause significant allograft…
Did you know that diarrhea increases the absorption of Prograf (tacrolimus, FK506)? Drug levels must be monitored closely in this setting to avoid tacrolimus-induced allograft toxicity. Tacrolimus is even considered a cause of diarrhea by some, though its…
Leflunomide is a drug I’ve seen used with increasing frequency in the renal transplant world. Marketed under the trade name “Arava”, it is an immunomodulatory agent which works by inhibition of the enzyme dihydroorotate dehydrogenase, one of the…
Interesting transplant case: A 35 year old man with a history of acute myelogenous leukemia, status post a bone marrow transplant from his sister eight years ago and now cured, who developed chronic kidney disease as a result…