Continuation of immunosuppression vs. immunosuppression weaning in potential repeat kidney transplant candidates: a care management perspective

Abstract

Management of immunosuppression in patients with a failing or failed kidney transplant requires a complete assessment of their clinical condition. One of the major considerations in determining immunosuppression is whether or not such an individual is considered a candidate for re-transplantation. Withdrawal of immunosuppression in a re-transplant candidate can result in allosensitization and markedly reduce the chances of a repeat transplant. In this review, we summarize the effects of immunosuppression reduction on HLA sensitization, discuss the impacts of allosensitization in these patients, and explore reduction protocols and future directions. Risks of chronic immunosuppression, medical management of the failing allograft, and the effect of nephrectomy are covered elsewhere in this issue.

Perspectives in Immunosuppression Management Following Renal Graft Failure: A Portuguese National Survey

“…This has led to an increased prevalence of patients with graft loss returning to dialysis and relisted to a subsequent kidney transplant. 1 A major challenge for these patients is human leukocyte antigen sensitization, and patients waiting for a retransplant represent the majority of the highly sensitized. 2 In Portugal, there is a major concern about the growing number of patients who are highly sensitized waiting for a kidney transplant.…”