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 |
| _version_ | 1811271743656951808 |
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| author | Urmila Anandh Pradeep Deshpande |
| author_facet | Urmila Anandh Pradeep Deshpande |
| author_sort | Urmila Anandh |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-12T22:26:35Z |
| format | Article |
| id | doaj.art-b5e29c58612a4acc96323baf56557628 |
| institution | Directory Open Access Journal |
| issn | 2212-0017 2212-0025 |
| language | English |
| last_indexed | 2024-04-12T22:26:35Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Transplantation |
| spelling | doaj.art-b5e29c58612a4acc96323baf565576282022-12-22T03:14:08ZengWolters Kluwer Medknow PublicationsIndian Journal of Transplantation2212-00172212-00252022-01-01161424710.4103/ijot.ijot_114_20Issues and concerns in the management of progressive allograft dysfunction: A narrative reviewUrmila AnandhPradeep DeshpandeNephrologists 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.http://www.ijtonline.in/article.asp?issn=2212-0017;year=2022;volume=16;issue=1;spage=42;epage=47;aulast=Anandhallograft failureallograft nephrectomygraft intolerance syndrome |
| spellingShingle | Urmila Anandh Pradeep Deshpande Issues and concerns in the management of progressive allograft dysfunction: A narrative review Indian Journal of Transplantation allograft failure allograft nephrectomy graft intolerance syndrome |
| title | Issues and concerns in the management of progressive allograft dysfunction: A narrative review |
| title_full | Issues and concerns in the management of progressive allograft dysfunction: A narrative review |
| title_fullStr | Issues and concerns in the management of progressive allograft dysfunction: A narrative review |
| title_full_unstemmed | Issues and concerns in the management of progressive allograft dysfunction: A narrative review |
| title_short | Issues and concerns in the management of progressive allograft dysfunction: A narrative review |
| title_sort | issues and concerns in the management of progressive allograft dysfunction a narrative review |
| topic | allograft failure allograft nephrectomy graft intolerance syndrome |
| url | http://www.ijtonline.in/article.asp?issn=2212-0017;year=2022;volume=16;issue=1;spage=42;epage=47;aulast=Anandh |
| work_keys_str_mv | AT urmilaanandh issuesandconcernsinthemanagementofprogressiveallograftdysfunctionanarrativereview AT pradeepdeshpande issuesandconcernsinthemanagementofprogressiveallograftdysfunctionanarrativereview |