Review: Management of patients with kidney allograft failure

Late allograft loss in kidney transplant recipients remains a common problem and is associated with high mortality and morbidity. The management of patients with a failed kidney allograft includes a few major dilemmas: when to start dialysis, what is the optimal management regarding immunosuppressio...

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Published inTransplantation reviews (Philadelphia, Pa.) Vol. 32; no. 3; pp. 178 - 186
Main Authors Bunthof, Kim L.W., Hazzan, Marc, Hilbrands, Luuk B.
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.07.2018
WB Saunders
SeriesTransplantation Reviews
Subjects
Allografts
Graft Rejection - diagnosis
Graft Rejection - etiology
Graft Rejection - therapy
Humans
Immunosuppressive Agents - therapeutic use
Kidney Transplantation - adverse effects
Life Sciences
Nephrectomy
Renal Dialysis
Renal Insufficiency - diagnosis
Renal Insufficiency - etiology
Renal Insufficiency - therapy
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Summary:Late allograft loss in kidney transplant recipients remains a common problem and is associated with high mortality and morbidity. The management of patients with a failed kidney allograft includes a few major dilemmas: when to start dialysis, what is the optimal management regarding immunosuppression, and should an allograft nephrectomy be performed. In suitable candidates for a repeated transplantation there are additional matters to take in consideration. In this review we will discuss these dilemmas by providing an overview of current evidence and gaps in our knowledge. As many of these issues are incompletely resolved, we conclude that more studies are needed to improve the management of patients with a failed kidney allograft.
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ISSN:0955-470X
1557-9816
DOI:10.1016/j.trre.2018.03.001