Dr Dilushi Wijayaratne, MBBS, MDSpecialist NephrologistUniversity of Colombo, Sri Lanka@Dilushiwijay The preoperative cardiac evaluation of kidney transplant candidates is a blurry area. Guidelines are variable and clinical practice is frequently reflexive or defensive rather than evidence-based. In this…
Hyperoxaluria can cause a spectrum of disease ranging from urinary stone disease (USD), chronic kidney disease (CKD), end stage kidney disease (ESKD) to systemic deposition of oxalate leading to end organ damage. It can be broadly divided into…
During my first year of fellowship, I always found myself interested in the pharmacology of the multiple immunosuppression meds, however, finding concise yet thorough sources of information on them was nearly impossible. Luckily, we have a very fellow…
The ethics surrounding organ transplantation is a highly debated topic. Although kidney transplantation has been around for many decades- shifting needs, cultural norms, and resource limitations have led to varying practices worldwide, bringing several ethical principles into the…
Kidneys are the most commonly transplanted organ, with over 440,000 transplanted in the U.S. since 1988 (UNOS data). In 2018 alone, there have already been 27,281 kidney transplants. Outcomes from kidney transplants, especially from living donors, are increasingly…
A 20-year-old female had Henoch-Schönlein purpura since age 9 leading to ESRD. She underwent kidney transplantation in 2018 from a live donor (mother) and received induction immunosuppression with thymoglobulin (100 mg once) followed by maintenance with tacrolimus (6…
Azathioprine is one of the oldest immunosuppressant medications, which has been used in the field of solid organ transplantation over the past 5 decades. It is metabolized into its inactive forms by the enzyme thiopurine methyltransferease (TPMT). Genetic…
The ELITE-Symphony study enshrined standard triple therapy immunosuppression of tacrolimus, mycophenolic acid and prednisolone, for renal transplant recipients. We get familiar with these agents relatively quickly in our renal training, but what about the other less common agents…
In renal transplant recipients with allograft dysfunction, differentiating between a viral infection or acute cellular rejection as the etiology of interstitial nephritis can be difficult – especially as they can commonly occur concurrently. We recently saw a 40-year-old woman who received a…
CMV infection still remains one of the most common and unpredictable complications in transplant recipients, and the negative consequences in terms of graft lost and recipient survival are well known. In this setting, I would like to present…
