Issues and concerns in the management of progressive allograft dysfunction: A narrative review
Nephrologists taking care of dialysis patients are increasingly encountering patients returning to dialysis after a failed transplant. These patients have a different pathophysiology and their medical issues differ from transplant-naïve dialysis patients. Prolonged cumulative immunosuppression and l...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Indian Journal of Transplantation |
| Subjects: | |
| Online Access: | http://www.ijtonline.in/article.asp?issn=2212-0017;year=2022;volume=16;issue=1;spage=42;epage=47;aulast=Anandh |
| Summary: | Nephrologists taking care of dialysis patients are increasingly encountering patients returning to dialysis after a failed transplant. These patients have a different pathophysiology and their medical issues differ from transplant-naïve dialysis patients. Prolonged cumulative immunosuppression and long-term exposure to chronic kidney disease (CKD) pathology are major factors responsible for increased complications and mortality. Often, their CKD-related issues are managed suboptimally as the emphasis is mostly on endeavors related to protecting allograft function. Managing their immunosuppression and allograft-related symptomatology poses serious challenges. There is also a dilemma as to whether the failed allograft should be left in situ or not. Considerate and appropriate decisions are required when these kidney allograft failure patients are offered re-transplantation. This review aims to address the major issues faced by transplant nephrologists in managing patients with allograft failure. |
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| ISSN: | 2212-0017 2212-0025 |