Optimal Immunosuppression Strategy in the Sensitized Kidney Transplant Recipient

Olaso, Danae; Manook, Miriam; Moris, Demetrios; Knechtle, Stuart J.; Kwun, Jean

doi:10.3390/jcm10163656

Cited by 7 publications

(6 citation statements)

References 160 publications

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“… 19 Use of primary nonsensitized adult recipients and appropriate immunosuppression was associated with improved graft survival. 20 Previous reviews of functional isotopic renography of allografts from donors <15 kg showed an initial rapid growth, followed by continuous growth and attaining adult volume within 18 months. 21 …”

mentioning

confidence: 99%

Kidney Volume Growth and Kidney Function of En Bloc Pediatric Kidney Transplants: A Case Series

Menchaca¹,

Tulla²,

Samra³

et al. 2023

Kidney Medicine

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mentioning

confidence: 99%

Kidney Volume Growth and Kidney Function of En Bloc Pediatric Kidney Transplants: A Case Series

Menchaca¹,

Tulla²,

Samra³

et al. 2023

Kidney Medicine

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“…Optimal immunosuppression: Research on determining the most effective immunosuppressive regimens that balance graft protection and infection risk reduction is critical. Optimizing immunosuppression is a complex challenge in the care of transplant recipients, and understanding the best approaches can lead to improved patient outcomes and reduced UTI risk [ 79 ].…”

Section: Reviewmentioning

confidence: 99%

Comprehensive Review of Urinary Tract Infections in Renal Transplant Recipients: Clinical Insights and Management Strategies

Bharuka,

Meshram,

Munjewar

2024

Cureus

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Urinary tract infections (UTIs) pose a significant challenge in the care of renal transplant recipients. This comprehensive review explores this population's multifaceted landscape of UTIs, emphasizing the importance of early diagnosis and tailored management strategies. Renal transplant recipients face an elevated risk of UTIs due to immunosuppression, altered urinary tract anatomy, and complex comorbidities. Complications of UTIs can lead to graft dysfunction and systemic illness, underscoring the need for effective management. The emergence of multidrug-resistant uropathogens adds complexity to treatment, highlighting the importance of targeted antibiotic therapy. Antibiotics are the most commonly prescribed drugs for UTIs, with nitrofurantoin, fosfomycin, amoxicillin, and amoxicillin-clavulanate potassium being some of the commonly used antibiotics. However, the emergence of multidrug-resistant uropathogens has led to the exploration of alternative treatments, such as bacteriophage therapy, as a potential alternative against multidrug-resistant uropathogenic bacteria. Analgesics such as phenazopyridine can be prescribed to relieve discomfort associated with UTIs. Estrogen therapy has also been suggested as a potential treatment option for UTIs, particularly in postmenopausal women. Trimethoprim-sulfamethoxazole or trimethoprim is recommended as first-line therapy for uncomplicated UTIs. The choice of drug and therapy for UTIs depends on the severity of the infection, the causative organism, and the presence of antibiotic resistance. Preventive measures encompass pre-transplant evaluation, perioperative strategies, post-transplant follow-up, and vaccination. A multidisciplinary approach involving transplant specialists, infectious disease experts, pharmacists, and patient engagement is vital for successful care. The future of UTI management lies in ongoing research, exploring personalized medicine, novel therapies, and innovative prevention strategies. By implementing these strategies and advancing research, healthcare providers can improve graft and patient survival, enhancing the quality of care for renal transplant recipients.

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“…Patients with previous sensitization events against antihuman leukocyte antigens (HLA) often have circulating anti-HLA antibodies [7]. Following organ transplantation, sensitized patients have higher rates of antibody-mediated rejection (AMR) compared to those who are non-sensitized.…”

Section: Graft Failurementioning

confidence: 99%

Kidney Transplantation Is The Most Common Form Of Solid Organ Transplantation

Franjić

2023

J Urol Res

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Optimal Immunosuppression Strategy in the Sensitized Kidney Transplant Recipient

Cited by 7 publications

References 160 publications

Kidney Volume Growth and Kidney Function of En Bloc Pediatric Kidney Transplants: A Case Series

Kidney Volume Growth and Kidney Function of En Bloc Pediatric Kidney Transplants: A Case Series

Comprehensive Review of Urinary Tract Infections in Renal Transplant Recipients: Clinical Insights and Management Strategies

Kidney Transplantation Is The Most Common Form Of Solid Organ Transplantation

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