The key aspect of the workup for a potential kidney transplant donor is ensuring that donation does not result in future health problems for the donor. For the most part, this boils down to determining whether or not…
A relatively new immunosuppressant agent–originally approved for treatment of refractory rheumatoid arthritis but now gaining steam as an anti-rejection medication for kidney transplant recipients–is abatacept (marketed under the trade name Orencia by Bristol-Myers-Squibb. Its mechanism of action is…
I’m reporting LIVE from the American Society of Nephrology convention in Philadelphia, PA. I’ll be blogging from here as time & internet connectivity permit. The conference starts in earnest tomorrow morning. Until then: common drug interactions for TACROLIMUS…
I saw a patient in the renal transplant clinic today for evaluation to get onto the kidney transplant list, as he is just around the corner to starting dialysis (actually, he may actually start tonight since his routine…
In this month’s C-JASN, “The Declaration of Istanbul” is presented. Recently a group of world leaders of the transplant community held a meeting in Istanbul, Turkey during which the general topic of discussion was the ethics of…
The acronym NODAT stands for “new onset diabetes after transplant”. Diabetes is one of the many complications which occur in the post-renal transplant setting. The reasons for this are manifold. Transplant recipients who require long-term steroids will obviously…
Rituxan is seeing a lot of use these days. Although technically only having formal indications for rheumatoid arthritis and non-Hodgkin’s lymphoma, it is being used for a number of off-label indications, and in general the results seem to…
Post-transplant lymphoproliferative disorder (PTLD) occurs in < 1% of kidney transplant recipients, but can often be a serious complication. In essence, PTLD is a form of lymphoma which occurs due to decreased immune surveillance as a result of...
An interesting scenario of “acquired” anti-GBM disease can occur when a patient with Alport’s Syndrome gets a renal transplant. Patients with Alport’s Syndrome–a cause of hematuria with progressive renal failure and hearing loss–have mutations in genes encoding certain…
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…
