Renal association clinical practice guideline in post-operative care in the kidney transplant recipient

Abstract

These guidelines cover the care of patients from the period following kidney transplantation until the transplant is no longer working or the patient dies. During the early phase prevention of acute rejection and infection are the priority. After around 3–6 months, the priorities change to preservation of transplant function and avoiding the long-term complications of immunosuppressive medication (the medication used to suppress the immune system to prevent rejection). The topics discussed include organization of outpatient follow up, immunosuppressive medication, treatment of acute and chronic rejection, and prevention of complications. The potential complications discussed include heart disease, infection, cancer, bone disease and blood disorders. There is also a section on contraception and reproductive issues.Immediately after the introduction there is a statement of all the recommendations. These recommendations are written in a language that we think should be understandable by many patients, relatives, carers and other interested people. Consequently we have not reworded or restated them in this lay summary. They are graded 1 or 2 depending on the strength of the recommendation by the authors, and AD depending on the quality of the evidence that the recommendation is based on.

Relationship Between Tacrolimus Dosage and Renal Function, Acute Rejection and Early Infections, Single Center Experience

“…Pero es innegable su toxicidad e infecciones asociadas a la inmunosupresión 7,11 . presentándose un sólo caso de rechazo agudo celular.…”

“…• Función demorada del injerto (FDI): elevación de niveles de creatinina que requiere de hemodiálisis dentro de la primera semana 9,10 Rechazo agudo (RA): determinado por biopsia renal según la clasificación BANFF 2013 11 .…”

Chapter 3 Demographic and Biochemistry Profile of Kidney Transplant Recipients in the UK in 2016:

“…The UK Renal Association (RA) guideline for the care of kidney transplant recipients recommends that 'Blood pressure should be <130/80 mmHg (or <125/75 mmHg if proteinuria)' [7]. This blood pressure (BP) target is Completeness of blood pressure data continued to be variable with some centres unable to report.…”

“…A list of the Renal Association recommended audit measures which were relevant to the transplant population in 2016 are given in appendix 1 of this chapter [7]. Several of the audit measures are not currently reported by the UKRR in the annual report; the reasons behind this are varied, but predominantly relate to a high proportion of incomplete data or that the relevant variable is not currently within the specified UKRR dataset.…”

Meltdose Tacrolimus Pharmacokinetics

“…Its action is associated strongly with blood concentration and therefore the actual guidelines recommended therapeutic drug monitoring [1].…”