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Review
. 2023 Feb 1;28(1):55-63.
doi: 10.1097/MOT.0000000000001039. Epub 2022 Dec 9.

How to maximize graft survival

Mary Ann Lim  1 , Roy D Bloom
Affiliations
Review

How to maximize graft survival

Mary Ann Lim et al. Curr Opin Organ Transplant. .

Abstract

Purpose of review: Kidney transplant failure results in significant patient morbidity and mortality, increased financial burden and exacerbates the organ shortage faced by kidney transplant candidates. The different strategies to maximize graft survival in kidney transplant recipients is presented in this review.

Recent findings: Maximizing kidney graft survival requires optimizing immunosuppression, preventing and managing recurrent disease and using general chronic kidney disease strategies to slow allograft injury. Herein, we review: 1) strategies to tailor immunosuppression to the individual patient to avoid over and underimmunosuppression, and avoid immunosuppression-related drug toxicities, 2) latest findings in the following recurrent diseases: focal segmental glomerulosclerosis, membranous nephropathy, complement-mediated kidney disease and monoclonal gammopathy of renal significance, and, 3) approaches to slow allograft injury including BP control, and the use of antiproteinuric agents and SGLT-2 inhibitors.

Summary: The last two decades has seen significant improvement in allograft outcomes resulting from advances in immunosuppression. With the federal government's renewed focus on kidney disease and transplantation, and recent advances in biomarkers, genetic testing, big data analytics and machine learning, we hope to see further outcome improvements in the next decade.

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References

    1. Wolfe RA, Ashby VB, Milford EL, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med 1999; 341:1725–1730.
    1. Merion RM, Ashby VB, Wolfe RA, et al. Deceased-donor characteristics and the survival benefit of kidney transplantation. JAMA 2005; 294:2726–2733.
    1. Landreneau K, Lee K, Landreneau MD. Quality of life in patients undergoing hemodialysis and renal transplantation: a meta-analytic review. Nephrol Nurs J 2010; 37:37–44.
    1. Tucker EL, Smith AR, Daskin MS, et al. Life and expectations postkidney transplant: a qualitative analysis of patient responses. BMC Nephrol 2019; 20:175.
    1. Axelrod DA, Schnitzler MA, Xiao H, et al. An economic assessment of contemporary kidney transplant practice. Am J Transplant 2018; 18:1168–1176.