Document Detail


Do protocol transplant biopsies improve kidney transplant outcomes?
MedLine Citation:
PMID:  23042026     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: The research undertaken on 'protocol' renal transplant biopsies has provided a rich, if not the richest, approach to better understanding of the immune and nonimmune impacts upon the transplant. The purpose of this review is to detail how the direct benefit to the patient also lies in these renamed 'surveillance' biopsies.
RECENT FINDINGS: Undertaken at fixed time points after transplantation, biopsy provides individual diagnoses with which the clinician can vary immunosuppression both in intensity and in the type of agent used to modify pathological processes early in their course. Initial nonfunction from acute tubular necrosis, subclinical cellular and humoral rejection, calcineurin inhibitor nephrotoxicity, BK virus nephropathy and recurrent glomerulonephritis are all important diagnoses for which early intervention provides better therapeutic outcomes than delaying until they are clinically evident.
SUMMARY: This review provides the recent evidence that has convinced many transplant units to embark upon surveillance programmes for their patients in order to individualize their immunosuppression and thus gain better outcomes.
Authors:
Jeremy R Chapman
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in nephrology and hypertension     Volume:  21     ISSN:  1473-6543     ISO Abbreviation:  Curr. Opin. Nephrol. Hypertens.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-18     Completed Date:  2013-03-29     Revised Date:  2013-05-02    
Medline Journal Info:
Nlm Unique ID:  9303753     Medline TA:  Curr Opin Nephrol Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  580-6     Citation Subset:  IM    
Affiliation:
Department of Renal Medicine, Westmead Hospital, University of Sydney, Sydney, New South Wales, Australia. Jeremy_chapman@wsahs.nsw.gov.au
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MeSH Terms
Descriptor/Qualifier:
Biopsy / adverse effects,  methods*
Clinical Protocols*
Graft Rejection / immunology,  pathology*,  prevention & control
Humans
Immunosuppressive Agents / adverse effects
Kidney / drug effects,  immunology,  pathology*
Kidney Diseases / immunology,  pathology*
Kidney Transplantation / adverse effects*,  immunology
Postoperative Complications / immunology,  pathology*
Predictive Value of Tests
Risk Assessment
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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