Kidney Transplantation: Challenging the Future


by

Massimiliano Veroux

DOI: 10.2174/97816080514411120101
eISBN: 978-1-60805-144-1, 2012
ISBN: 978-1-60805-424-4



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Indexed in: Web of Science, Scopus.

Table of Contents

Foreword

- Pp. i

Alessandro Nanni Costa

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Preface

- Pp. ii

Massimiliano Veroux

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List of Contributors

- Pp. iii-vi (4)

Massimiliano Veroux and Pierfrancesco Veroux

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Immunological Basis of Acute and Chronic Kidney Rejection

- Pp. 3-19 (17)

Guido Sireci

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The Clinical Evaluation of the Renal Transplant Candidate

- Pp. 20-26 (7)

Pietro Castellino, Luca Zanoli and Annamaria Zoccolo

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High-Risk Recipients in Kidney Transplantation

- Pp. 27-46 (20)

Neha Patel and Nicole A. Weimert

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ABO-Incompatible Renal Transplantation

- Pp. 47-55 (9)

Kazunari Tanabe

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Pre-Transplant Histological Evaluation in Kidney Transplantation

- Pp. 56-62 (7)

Lidia Puzzo and Enrico Vasquez

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Renal Transplantation from Expanded Criteria "Marginal" Donors

- Pp. 63-70 (8)

Burcin Ekser

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Kidney Transplantation from Donors with Hepatitis

- Pp. 71-84 (14)

Massimiliano Veroux, Daniela Corona and Pierfrancesco Veroux

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Perioperative Anaesthesiologic Management During Kidney Transplantation

- Pp. 85-97 (13)

Massimiliano Sorbello, Laura Parrinello, Jessica Giuseppina Maugeri, Alessandro Laudani, Mirko Tindaro Sidoti and Gianluigi Morello

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Surgical Techniques of Living Donor Nephrectomy

- Pp. 98-127 (30)

Ugo Boggi, Fabio Vistoli, Carlo Moretto, Marco Del Chiaro, Chiara Croce, Stefano Signori, Nelide De Lio, Vittorio Perrone and Gabriella Amorese

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A Market in Organs

- Pp. 128-143 (16)

Miran Epstein

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Pediatric Renal Transplantation

- Pp. 144-167 (24)

Kar-Hui Ng, Wee-Song Yeo and Hui-Kim Yap

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Diagnostic Challenges in Kidney Transplantation

- Pp. 168-185 (18)

Kevin Herman, Abid Irshad, Susan Ackerman and Mehwish Shazly

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Immunosuppression in Kidney Transplantation

- Pp. 186-207 (22)

Giuseppe Grandaliano, Vincenzo Losappio and Annamaria Maiorano

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Minimization of Immunosuppression

- Pp. 208-218 (11)

Joshua J. Augustine and Donald E. Hricik

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Protocol Biopsies in Renal Transplantation

- Pp. 219-226 (8)

David Rush

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Quality of Life After Kidney Transplantation

- Pp. 227-240 (14)

Kris Denhaerynck, Fabienne Dobbels, Jürg Steiger and Sabina De Geest

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Graft-Transmitted Infection in Kidney Transplantation

- Pp. 241-250 (10)

Laetitia Albano, Marie-France Mamzer, Fanny Lanternier, Christophe Legendre and Olivier Lortholary

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Infectious Complications of Kidney Transplantation

- Pp. 251-272 (22)

Paolo Antonio Grossi and Daniela Dalla Gasperina

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Impact of Polyomavirus BK and Cytomegalovirus on the Kidney Allograft

- Pp. 273-288 (16)

Ilkka Helanterä, Adrian Egli, Petri Koskinen, Hans H. Hirsch and Irmeli Lautenschlager

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Epidemiology of Cancers After Kidney Transplantation and Role of Viral Infections

- Pp. 289-301 (13)

Pierluca Piselli, Enrico Girardi, Diego Serraino, Vincenzo Puro, Claudia Cimaglia and Giuseppe Ippolito

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Post-Transplant Cancer: Diagnostic and Therapeutic Management

- Pp. 302-311 (10)

Giuseppe Giuffrida, Daniela Corona and Massimiliano Veroux

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Cardiovascular Disease and Renal Transplantation

- Pp. 312-323 (12)

Emily P. McQuarrie, Alan G. Jardine, Bengt C. Fellström and Hallvard Holdaas

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Glomerulonephritis After Kidney Transplantation

- Pp. 324-339 (16)

Bela Ivanyi, Dejan Dobi, Eva Kemeny and Edit Szederkenyi

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Chronic Renal Allograft Dysfunction

- Pp. 340-353 (14)

Roberto Marcén

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Pregnancy and Kidney Transplantation

- Pp. 354-369 (16)

Lisa A. Coscia, Carolyn H. McGrory and Vincent T. Armenti

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Clinical Tolerance in Kidney Transplantation

- Pp. 370-377 (8)

Tatsuo Kawai and A. Benedict Cosimi

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Xenotransplantion: Perspectives on the Future

- Pp. 378-389 (12)

Burcin Ekser

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Index

- Pp. 390-391 (2)

Massimiliano Veroux and Pierfrancesco Veroux

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Foreword

During the last 30 years the progress in transplantation has been impressive. Advances in surgery and medicine and the development of new immunosuppressive drugs have allowed that thousands of patients could be transplanted successfully.

Over 1 million people worldwide have received an organ and some of them have already survived more than 25 years.

However the shortage of organ donors remains the major obstacle preventing the full development of transplant services and imposes a severe limit to the number of patients who benefit from this form of therapy. The shortage of organs increases the gap between the number of available organs and the patients on waiting lists; that’s the reason why, patients who respond to a specific profile have more chances to be recorded on waiting list.

As such, multidirectional efforts are required to expand donor pool. Nowadays one more therapeutic option is represented by transplantation of organs from living donors; living donation is demonstrated to be associated with superior results for the recipient, and relatively benign long-term outcomes for donors.

It is important to remember that organ donation, both from living and dead donor, is an expression of self-giving to another person, the recipient, characterizing every voluntary transplantation primarily as an interpersonal action. The act of organ donation can be seen as offering a gift; the reason is that the giver wants to benefit the recipient, acting freely, and nothing being expected in return for the donation.

“Challenging the future” is a “must” for every worker in transplant field and for every citizen: research on immunology, improvement on surgical techniques, enhancement on procurement and allocation of organs, spread communication to create a culture of donation represent the main way to imagine a future where more people can be transplanted and can rely on a better quality of life.

Dr. Alessandro Nanni Costa
Director
Italian National Transplant Centre
Rome
Italy


Preface

Kidney transplantation is worldwide considered the best replacement therapy in patients with end-stage renal disease. However, although impressive improvements in surgical techniques and in the management of immunosuppression, long-term results have not significantly changed over the last decades.

The purpose of this book is not to be a comprehensive review on kidney transplantation, but it would overview the recent acquisitions in the field of kidney transplantation, by offering to clinicians the future directions and the possible fields of research to improve the long term outcome.

The book is divided into 27 chapters. The first part of the book is devoted to the basic principles of immunity and organ transplantation and the clinical evaluation of potential recipient. Moreover, in this section are discussed the most recent strategies to increase the donor pool trying to offer a kidney transplantation to a growing number of patients. The second part of the book is devoted to the immunosuppression. In these two chapters, the authors present an overview on the immunosuppressive management of kidney transplant recipients, with particular emphasis on the minimization of immunosuppression. The third part of the book is devoted to the complications of immunosuppression and to the psychological aspects of transplantation. This section is particularly detailed, and offers a complete point of view on the consequences and benefits of kidney transplantation. Last section is devoted to the future. The clinical tolerance and xenotransplantation are not still the present, but the authors illustrate the fields of application of these fundamental aspects of organ transplantation.

The authors and editors have tried to select an appropriate mix of citations, but it has not been possible to cite all the relevant articles. Apologies are due to those authors whose works we have failed to cite.

Our goal was to provide the most recent acquisitions in a practical manner. We hope that we have succeeded.

Special thanks to all the authors for their excellent and enthusiastic collaboration and special thanks to our patients to whom are dedicated all our efforts.

Massimiliano Veroux, MD, PhD
University Hospital of Catania
Catania
Italy

List of Contributors

Editor(s):
Massimiliano Veroux
Vascular Surgery and Organ Transplantation Unit
University Hospital of Catania
Italy




Co-Editor(s):
Pierfrancesco Veroux
Vascular Surgery and Organ Transplantation Unit
University Hospital of Catania
Italy




Contributor(s):
Susan Ackerman
Medical University of South Carolina
Charleston
South Carolina
USA


Vincent T. Armenti
Department of Surgery
Thomas Jefferson University
Philadelphia
USA


Joshua Augustine
Department of Medicine
University Hospitals Case Medical Center and Case Western Reserve University
Cleveland
Ohio
USA


Ugo Boggi
Operative Unit Chirurgia Generale e Trapianti nell'Uremico e nel Diabetico
University Hospital of Pisa
Italy


Pietro Castellino
Department of Medicine
University Hospital of Catania, University of Catania
Italy


Claudia Cimaglia
Department of Epidemiology
National Institute for Infectious Diseases “L. Spallanzani”
Rome
Italy


Daniela Corona
Vascular Surgery and Organ Transplant, Department of Surgery
Transplantation and Advanced Technologies
University Hospital of Catania
Italy


Lisa A. Coscia
Department of Surgery
Thomas Jefferson University
Philadelphia
USA


Benedict Cosimi
Massachusetts General Hospital
Transplant Center, Harvard Medical School
Boston
USA


Chiara Croce
Operative Unit Chirurgia Generale e Trapianti nell'Uremico e nel Diabetico
University Hospital of Pisa
Italy


Daniela Dalla Gasperina
Department of Clinical Medicine
Section of Infectious Diseases, University of Insubria
Varese
Italy


Sabina De Geest
Institute of Nursing Science, University of Basel, Basel
Switzerland and Center for Health Services and Nursing Research
Katholieke Universiteit Leuven
Leuven
Belgium


Nelide De Lio
Operative Unit Chirurgia Generale e Trapianti nell'Uremico e nel Diabetico
University Hospital of Pisa
Italy


Marco Del Chiaro
Operative Unit Chirurgia Generale e Trapianti nell'Uremico e nel Diabetico
University Hospital of Pisa
Italy


Kris Denhaerynck
Institute of Nursing Science, University of Basel
Basel
Switzerland


Fabienne Dobbels
Center for Health Services and Nursing Research
Katholieke Universiteit Leuven
Leuven
Belgium


Dejan Dobi
Department of Pathology
University of Szeged
Szeged
Hungary


Adrian Egli
Transplantation Virology,Switzerland and Department of Medicine
Department of Biomedicine, University of Basel
Institute for Medical Microbiology, University Hospital Basel
Switzerland


Burcin Ekser
Kidney and Pancreas Transplantation Unit
Department of Surgery and Organ Transplantation
Padua
Italy


Miran Epstein
Barts and The London School of Medicine and Dentistry
Queen Mary University of London
UK


Bengt Fellström
Department of Nephrology
University of Uppsala
Sweden


Enrico Girardi
Department of Epidemiology
National Institute for Infectious Diseases “L. Spallanzani”
Rome
Italy


Giuseppe Giuffrida
Vascular Surgery and Organ Transplant, Department of Surgery
Transplantation and Advanced Technologies
University Hospital of Catania
Italy


Giuseppe Grandaliano
Nephrology, Dialysis and Transplantation Unit
Department of Emergency and Organ Transplantation
University of Bari
Italy


Paolo Antonio Grossi
Department of Clinical Medicine, Section of Infectious Diseases
University of Insubria
Varese
Italy


Ilkka Helantera
Department of Medicine, Division of Nephrology Meilahti
Transplant Unit Research Laboratory, Transplantation and Liver Surgery Clinic
Helsinki University Hospital
University of Helsinki
Helsinki
Finland


Kevin Herman
Medical University of South Carolina, Charleston
South Carolina
USA


Hans Hirsch
Department of Biomedicine, Department of Internal Medicine
University of Basel, Transplantation Virology, Institute for Medical Microbiology
Switzerland and Infectious diseases
Hospital Epidemiology, University Hospital Basel
Switzerland


Hallvard Holdaas
Department of Nephrology
University of Oslo
Norway


Donald Hricik
Department of Medicine
University Hospitals Case Medical Center and Case Western Reserve University
Cleveland
Ohio
USA


Giuseppe Ippolito
Department of Epidemiology
National Institute for Infectious Diseases “L. Spallanzani”
Rome
Italy


Abid Irshrad
Medical University of South Carolina, Charleston
South Carolina
USA


Bela Ivanyi
Department of Pathology
University of Szeged
Szeged
Hungary


Alan Jardine
Department of Nephrology
University of Glasgow
UK


Tatsuo Kawai
Massachusetts General Hospital
Transplant Center, Harvard Medical School
Boston
USA


Eva Kemeny
Department of Pathology
University of Szeged
Szeged
Hungary


Andrea Laudani
University Hospital of Catania
Anaesthesia and Intensive Care
Italy


Petri Koskinen
Department of Medicine
Division of Nephrology ; Helsinki University Hospital
Helsinki
Finland


Irmeli Lautenschlager
Department of Virology, Helsinki University Hospital
Transplant Unit Research Laboratory, Transplantation and Liver Surgery Clinic
Helsinki University Hospital
Helsinki
Finland


Vincenzo Losappio
Nephrology, Dialysis and Transplantation Unit
Department of Emergency and Organ Transplantation
University of Bari
Italy


Annamaria Maiorano
Nephrology, Dialysis and Transplantation Unit
Department of Emergency and Organ Transplantation
University of Bari
Italy


Roberto Marcen
Department of Nephrology. Ramon y Cajal Hospital
University of Alcalá de Henares
Spain


Jessica Maugeri
Anaesthesia and Intensive Care
University Hospital of Catania
Italy


Carolyn H McGrory
Department of Surgery
Thomas Jefferson University
Philadelphia
USA


Emily McQuarrie
Department of Nephrology
University of Glasgow
UK


Gianluigi Morello
Vittorio Emanuele Hospital
Gela
Italy


Carlo Moretto
Operative Unit Chirurgia Generale e Trapianti nell'Uremico e nel Diabetico
University Hospital of Pisa
Italy


Kar-Hui Ng
Department of Pediatrics
Yong Loo Lin School of Medicine, National University of Singapore and University Children’s Medical Institute
National University Health System
Singapore


Laura Parrinello
Anaesthesia and Intensive Care
University Hospital of Catania
Italy


Neha Patel
Northwestern Memorial Hospital
USA


Vittorio Perrone
Operative Unit Chirurgia Generale e Trapianti nell'Uremico e nel Diabetico
University Hospital of Pisa
Italy


Pierluca Piselli
Department of Epidemiology
National Institute for Infectious Diseases “L. Spallanzani”
Rome
Italy


Vincenzo Puro
Department of Epidemiology
National Institute for Infectious Diseases “L. Spallanzani”
Rome
Italy


Lidia Puzzo
Histopathology Unit, Department GF Ingrassia
University Hospital of Catania
Italy


David Rush
Transplant Manitoba Adult Kidney Program
University of Manitoba
Winnipeg
MB
Canada


Diego Serraino
Unità di Epidemiologia e Biostatistica
IRCCS Centro di Riferimento Oncologico
Avian
Italy


Mirko Sidoti
Anaesthesia and Intensive Care
University Hospital of Catania
Italy


Guido Sireci
Dipartimento di Biopatologia e Metodologie Biomediche
University of Palermo
Italy


Massimiliano Sorbello
Anaesthesia and Intensive Care
University Hospital of Catania
Italy


Mehwish Shazly
Medical University of South Carolina, Charleston
South Carolina
USA


Stefano Signori
Operative Unit Chirurgia Generale e Trapianti nell'Uremico e nel Diabetico
University Hospital of Pisa
Italy


Jurg Steiger
Department of Transplant Immunology and Nephrology
University Hospital Basel
Basel
Switzerland


Edit Szederkenyi
Renal Transplantation Unit, Clinics of Surgery
University of Szeged
Szeged
Hungary


Kazunari Tanabe
Department of Urology
Tokyo Women’s Medical University
Tokyo
Japan


Enrico Vasquez
Histopathology Unit, Department GF Ingrassia
University Hospital of Catania
Italy


Massimiliano Veroux
Vascular Surgery and Organ Transplant, Department of Surgery
Transplantation and Advanced Technologies
University Hospital of Catania
Italy


Pierfrancesco Veroux
Vascular Surgery and Organ Transplant, Department of Surgery
Transplantation and Advanced Technologies
University Hospital of Catania
Italy


Fabio Vistoli
Operative Unit Chirurgia Generale e Trapianti nell'Uremico e nel Diabetico
University Hospital of Pisa
Italy


Nicole Weimert
Medical University of South Carolina
USA


Hui-Kim Yap
Department of Pediatrics, Yong Loo Lin School of Medicine
National University of Singapore and University Children’s Medical Institute
National University Health System
Singapore


Wee-Song Yeo
Department of Pediatrics, Yong Loo Lin School of Medicine
National University of Singapore and University Children’s Medical Institute
National University Health System
Singapore


Luca Zanoli
Department of Medicine
University Hospital of Catania, University of Catania
Italy


Annamaria Zoccolo
Department of Medicine
University Hospital of Catania, University of Catania
Italy




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