Multiple myeloma (MM) is the most common malignancy causing ESRD. Renal disease is frequently related to the characteristics of the monoclonal immunoglobulin produced, which can lead to 3 general pathological findings: “cast nephropathy’, light chain deposition disease or…
A number of years ago, I was at a lecture given by a transplant surgeon from London. He was discussing the dangers surrounding living unrelated kidney transplantation and he told the story of a member of a royal…
I’ve had the privilege of being a part of the care team for several patients who have participated in Stanford’s Immune Tolerance program here in Palo Alto. The idea behind the program is pretty cool: create chimerism (the…
Renal allograft rupture has been defined as a split in the renal capsule, associated with haemorrhage, when no identifiable injury was noted at the time of harvesting. Renal allograft rupture is a rare, but life-threatening, complication of renal…
Recently, a patient presented to the transplant service with diarrhea and dehydration. He had been trying unsuccessfully to manage his diarrhea at home and was admitted for intravenous fluids. During his work-up, his tacrolimus levels were noted to…
Hepatitis C virus (HCV) infection affects more than 180 million people globally, may lead to renal disease and is prevalent in 11-49% of patients with end-stage renal disease, depending on geographical location. With that picture in mind, we…
I would like to direct your attention to a landmark paper in transplantation just published on the NEJM two weeks ago. We have previously discussed the terms used to characterize sensitized patients and the most common protocols to…
The evaluation of a dialysis patient for possible kidney transplantation is a great challenge. On one side, we know that if the patient continues on dialysis, his yearly mortality will be around 20%. On the other hand, kidney…
We are facing a conundrum in post-transplant lipid management after the recent warning from the FDA, which updated the label of simvastatin. This drug is now contraindicated in patients taking cyclosporine due to the potential for liver dysfunction…
The use of the protocol transplant biopsy is a divisive topic: some units see a protocol program as necessary for proper management post-transplantation, whilst others deride the whole concept as unnecessary. So who is right? Protocol biopsies are…
