PMID- 12430096
OWN - NLM
STAT- MEDLINE
DCOM- 20030501
LR  - 20191106
IS  - 0270-9295 (Print)
IS  - 0270-9295 (Linking)
VI  - 22
IP  - 6
DP  - 2002 Nov
TI  - Pretransplant evaluation of renal transplant candidates.
PG  - 515-25
AB  - Kidney transplantation should be strongly considered for all medically suitable 
      patients with chronic and end-stage renal disease (ESRD). Improvements in 
      outcomes after renal transplantation have resulted in a more liberal selection of 
      patients. High-risk category patients including human immunodeficiency virus 
      (HIV)-positive, highly sensitized patients, T-cell positive cross-match, and ABO 
      blood group-incompatible patients are now considered potential renal transplant 
      candidates. Unfortunately, the demand for kidney transplants far exceeds the 
      supply of available organs, causing a persistent increase in the number of 
      patients on the waiting list with a parallel increase in the waiting time for a 
      cadaveric kidney transplant. This has 2 major consequences. First, patients on 
      the waiting list are getting sicker and older. Second, living donors have assumed 
      increasing importance in renal transplantation. Pre-existing morbidities 
      including malignancies, cardiovascular disease, infections, and coagulopathies 
      should be extensively evaluated before proceeding to transplantation. Special 
      attention should be given to cardiovascular risk factors because the leading 
      cause of death after renal transplant is cardiovascular disease. A full 
      immunologic evaluation with ABO blood group determination, human leukocyte 
      antigen (HLA) typing, screening for antibody to HLA phenotypes, and 
      cross-matching need to be gathered before transplantation to avoid 
      antibody-mediated hyperacute rejection or to proceed with specific protocols in 
      highly sensitized or in positive T-cell cross-match patients. With the increased 
      rate of donation from living donors, regular follow-up evaluation of kidney 
      donors is recommended to detect hypertension or proteinuria in those who may 
      develop it.
CI  - Copyright 2002, Elsevier Science (USA). All rights reserved.
FAU - Gallon, Lorenzo G
AU  - Gallon LG
AD  - Departments of Medicine and Surgery, Feinberg School of Medicine of Northwestern 
      University, Chicago, IL 60611, USA. L-Gallon @nwu.edu
FAU - Leventhal, Joseph R
AU  - Leventhal JR
FAU - Kaufman, Dixon B
AU  - Kaufman DB
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Semin Nephrol
JT  - Seminars in nephrology
JID - 8110298
SB  - IM
MH  - *Histocompatibility Testing
MH  - Humans
MH  - Kidney Failure, Chronic/surgery
MH  - *Kidney Transplantation/immunology
MH  - *Living Donors
MH  - *Patient Selection
MH  - Postoperative Complications
MH  - Recurrence
MH  - Tissue and Organ Procurement
MH  - Waiting Lists
RF  - 72
EDAT- 2002/11/14 04:00
MHDA- 2003/05/02 05:00
CRDT- 2002/11/14 04:00
PHST- 2002/11/14 04:00 [pubmed]
PHST- 2003/05/02 05:00 [medline]
PHST- 2002/11/14 04:00 [entrez]
AID - S0270929502500681 [pii]
AID - 10.1053/snep.2002.35966 [doi]
PST - ppublish
SO  - Semin Nephrol. 2002 Nov;22(6):515-25. doi: 10.1053/snep.2002.35966.