Kidney transplant in the next decade: Strategies, challenges and vision of the future

Hernández, Domingo; Caballero, Abelardo

doi:10.1016/j.nefroe.2022.04.008

Cited by 4 publications

(4 citation statements)

References 69 publications

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“…However, its financial coverage is creating a problem in developing countries. Despite the complex coordination efforts and recruiting rules, support is mandatory from scientific societies, healthcare administration, and pharmaceutical companies[ 59 ].…”

Section: Challenges Against Kidney Transplantation Programsmentioning

confidence: 99%

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Challenges to establishing and maintaining kidney transplantation programs in developing countries: What are the coping strategies?

Gadelkareem,

Abdelgawad,

Mohammed

et al. 2024

World J Methodol

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Kidney transplantation (KT) is the optimal form of renal replacement therapy for patients with end-stage renal diseases. However, this health service is not available to all patients, especially in developing countries. The deceased donor KT programs are mostly absent, and the living donor KT centers are scarce. Single-center studies presenting experiences from developing countries usually report a variety of challenges. This review addresses these challenges and the opposing strategies by reviewing the single-center experiences of developing countries. The financial challenges hamper the infrastructural and material availability, coverage of transplant costs, and qualification of medical personnel. The sociocultural challenges influence organ donation, equity of beneficence, and regular follow-up work. Low interests and motives for transplantation may result from high medicolegal responsibilities in KT practice, intense potential psychosocial burdens, complex qualification protocols, and low productivity or compensation for KT practice. Low medical literacy about KT advantages is prevalent among clinicians, patients, and the public. The inefficient organizational and regulatory oversight is translated into inefficient healthcare systems, absent national KT programs and registries, uncoordinated job descriptions and qualification protocols, uncoordinated on-site investigations with regulatory constraints, and the prevalence of commercial KT practices. These challenges resulted in noticeable differences between KT services in developed and developing countries. The coping strategies can be summarized in two main mechanisms: The first mechanism is maximizing the available resources by increasing the rates of living kidney donation, promoting the expertise of medical personnel, reducing material consumption, and supporting the establishment and maintenance of KT programs. The latter warrants the expansion of the public sector and the elimination of non-ethical KT practices. The second mechanism is recruiting external resources, including financial, experience, and training agreements.

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Section: Challenges Against Kidney Transplantation Programsmentioning

confidence: 99%

“…These centers are mostly from developed countries with high costs. However, novel models have been introduced to reduce the cost issues[ 59 , 61 ]. On the other hand, many experiments in developing countries reported the presence of deficient numbers of nephrologists with expertise in KT.…”

Section: Challenges Against Kidney Transplantation Programsmentioning

confidence: 99%

Challenges to establishing and maintaining kidney transplantation programs in developing countries: What are the coping strategies?

Gadelkareem,

Abdelgawad,

Mohammed

et al. 2024

World J Methodol

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“…The World Health Organization’s Global Observatory on Donation and Transplantation reported 100,097 kidney transplants worldwide in 2019. 3 However, recipients encounter numerous post-transplant complications and must maintain lifelong immunosuppressive therapy, which, despite an excellent initial graft survival rate of 96–98%, often leads to unsatisfactory long-term outcomes with a diminished 10-year graft survival rate. 4 Research indicates that lifestyle factors are modifiable health-risk factors that can negatively impact the prognosis of renal transplant recipients.…”

Section: Introductionmentioning

confidence: 99%

Health-Promoting Lifestyle and Its Predictors in Renal Transplant Recipients in Hunan, China: A Cross-Sectional Study

Chen,

Ding,

Zhuo

et al. 2024

PPA

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“…The total success of RT is hugely dependent on the proper use of immunosuppressive therapy. Kidney transplantation and associated immunosuppressive therapy have greatly evolved [ 4 ]. From the early 1960s, azathioprine and steroids were the backbones of immunosuppression in RT [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Prescribing Pattern and Safety of Immunosuppressants in Renal Transplant Patients: An Observational Study

Ragavanandam,

Sudha,

Yadav

2023

Cureus

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Background: Renal transplantation is a life-saving procedure and contributes to a better quality of life in patients with end-stage renal disease. The discovery and use of immunosuppressants to prevent and treat allograft rejection are responsible for the improved outcome after the transplant. Long-term usage of these drugs warrants special monitoring and follow-up of the adverse drug reactions developed during the post-transplant period. This study analyzes the prescribing pattern and severity and outcome of adverse drug reactions of immunosuppressants in renal transplant patients. Materials and methods: A cross-sectional, observational study was done in patients more than 18 years of age who have undergone renal transplantation and receiving immunosuppressants in the Department of Nephrology in a tertiary care hospital. Results: During the two-month study period, 150 post-transplant patients were screened for adverse drug reactions, and the prescription pattern was also studied. Immunosuppressive therapy was given as induction and maintenance therapy. The short-term induction therapy regimen was based on the type of donor (injection basiliximab or anti-thymocyte globulin). The long-term maintenance therapy comprises triple therapy of tacrolimus, mycophenolate mofetil, and prednisolone in 102 (68%) patients and cyclosporine, mycophenolate mofetil, prednisolone in 37 (25%) patients. A total of 116 adverse drug reactions were reported in 82 patients. The pattern of the adverse drug reactions showed urinary tract infections in 26 (17.3%) patients on tacrolimus-based regimen and hypertension in 20 (13.3%) patients on tacrolimus and cyclosporine-based regimen. Causality assessment using the World Health Organization causality assessment scale showed that the observed reactions were of probable 42 (36%) and possible 74 (64%) categories. Conclusions: Long-term intake of immunosuppressive drugs is essential to improve the quality of life in renal transplant individuals and it is essential to monitor adverse drug reactions of these drugs through vigilant self-reporting and pharmacovigilance practices.

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Kidney transplant in the next decade: Strategies, challenges and vision of the future

Cited by 4 publications

References 69 publications

Challenges to establishing and maintaining kidney transplantation programs in developing countries: What are the coping strategies?

Challenges to establishing and maintaining kidney transplantation programs in developing countries: What are the coping strategies?

Health-Promoting Lifestyle and Its Predictors in Renal Transplant Recipients in Hunan, China: A Cross-Sectional Study

Prescribing Pattern and Safety of Immunosuppressants in Renal Transplant Patients: An Observational Study

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