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Transplant nephrology   

Questions discussed in this category

How would you treat a kidney transplant patient with both biopsy-proven BK nephropathy and recurrent membranous glomerulonephritis with nephrotic range proteinuria?
1 Answer available
How do you manage tacrolimus-related psychosis?
2 Answers available
Would you order a repeat DEXA scan 1 year later for a kidney transplant patient who had an initial DEXA scan within the first 6 months post-transplant showing osteopenia but no history of fractures, and who has been stable on glucocorticoid-free immunosuppressive therapy?
1 Answer available
How do you approach treatment for patients with proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) with end-stage renal disease who are considering kidney transplant?
Most patients with PGNMID have no detectable disease in their marrow or blood and urine protein cannot adequately be monitored.
1 Answer available
How do you counsel patients who experience diarrhea from mycophenolate mofetil (Cellcept)?
Do you generally recommend anti-diarrheals, dietary modifications, or consider this an unacceptable side effect and move to other therapies? 
2 Answers available
Are there instances when you use letermovir without the addition of acyclovir when managing a kidney transplant recipient for CMV prophylaxis?
2 Answers available
Do you recommend switching from tacrolimus to cyclosporine in a kidney transplant patient diagnosed with PTLD?
Bustami et al., PMID 14678038
4 Answers available
Do you recommend non-bypass bariatric surgeries over intestinal bypass procedures for kidney transplant-eligible candidates to prevent oxalate nephropathy, given the higher risk of kidney oxalate deposition with intestinal bypass?
2 Answers available
Should all kidney transplant patients be started on statin therapy post operatively given their increased risk of CVD?
At what doses do you start? and how do you titrate therapy?
1 Answer available
Do you taper steroids more aggressively to decrease the risk of developing new-onset diabetes after transplantation in kidney transplant recipients who had pretransplant impaired fasting glucose?
2 Answers available
How would you approach management of a patient with ESRD on the transplant list who is found to have high titer APS labs (ACL, B2GP1, LAC)?
1 Answer available
Should HCQ be continued in an asymptomatic SLE patient who has received renal transplant?
If a patient has received a kidney transplant for SLE-LN and is stable and doing well. Managed by their transplant team and on chronic immunosuppressi...
2 Answers available
Do you routinely use markers or tests other than serum creatinine when estimating GFR to determine if patients with liver failure, not on dialysis, meet criteria for a simultaneous liver-kidney transplant?
3 Answers available
How would you approach post-operative VTE prophylaxis for renal transplant in patients with a prior history of provoked VTE?
Are there specific guidelines for managing this patient population?
1 Answer available
Would you transition from IV to oral antibiotics in a solid organ transplant recipient with uncomplicated gram-negative bacteremia?
Nussbaum et al., PMID 38195100
1 Answer available
What policies do you take regarding legalized recreational marijuana or medical marijuana use in transplant patients?
1 Answer available
Do you require lupus patients with ESKD or advanced CKD to be on minimal immunosuppression around the time of kidney transplantation?
1 Answer available
Is there a BMI cutoff for which you no longer recommend kidney transplantation in a patient with end stage kidney disease and obesity?
3 Answers available
What is your approach to prednisone use in a kidney transplant recipient with allograft failure, residual allograft function, and an ongoing dialysis requirement for more than one year?
2 Answers available
How frequently do you recommend skin cancer screens in your patients with kidney transplants who are on immunosuppression?
3 Answers available
What is the role of APOL1 genotyping in the evaluation of a living kidney donor?
1 Answer available
Would you consider a BRCA carrier patient for kidney transplantation?
5 Answers available
Do you make adjustments to the immunosuppressive regimen for kidney transplant recipients on tacrolimus who develop posterior reversible encephalopathy syndrome (PRES)?
2 Answers available
How has the introduction of lumasiran affected the need for combined liver and kidney transplantation in patients with ESKD related to primary hyperoxaluria type 1?
2 Answers available
Would you recommend starting an SGLT2i in a patient with a kidney transplant and moderately increased albuminuria?
2 Answers available
What considerations do you take when evaluating a patient for kidney transplantation who has a history of kidney disease and an abdominal aortic aneurysm treated with past stenting?
1 Answer available
What is your approach for a kidney transplant patient who develops proteinuria after everolimus initiation?
1 Answer available
In which patients awaiting a kidney transplant do you evaluate for primary hyperoxaluria given the high risk of allograft dysfunction following transplantation?
1 Answer available
What is your strategy for managing immunosuppression in patients with a kidney transplant who develop metastatic cancer?
3 Answers available
What are your top takeaways from ASN 2023?
2 Answers available
Would you recommend complement testing in a kidney transplant recipient with chronic antibody-mediated rejection and biopsy-proven thrombotic microangiopathy to determine the need for eculizumab?
1 Answer available
Do you recommend performing surveillance kidney allograft biopsies in your asymptomatic kidney transplant recipients?
3 Answers available
Do you recommend ligation of a functional arteriovenous fistula after kidney transplantation?
2 Answers available
What is your approach to a living kidney donor evaluation for a patient with normal kidney function who wishes to donate to their monozygotic twin who has ESKD due to an autoimmune disorder?
1 Answer available
Would you consider a patient with spina bifida and end stage kidney disease secondary to reflux nephritis with an ileal conduit for a kidney transplant?
2 Answers available
Do you recommend noninvasive testing or coronary angiography as the initial test for pre-kidney transplant evaluation of an asymptomatic patient older than 50 years of age with ESKD secondary to diabetic nephropathy and no known history of CAD?
1 Answer available
Would you recommend avoiding PICC line placement in a kidney transplant patient with an estimated GFR of more than 45 ml/min/1.73m2 and no functional AV access?
2 Answers available
Would you perform plasmapheresis for an ABO-incompatible kidney transplant recipient who has titers of 1:16 and a stable creatinine 3 months post-transplant?
2 Answers available
What is your approach to inpatient immunosuppression for a kidney transplant patient on home tacrolimus, prednisone, and mycophenolic acid who cannot tolerate anything by mouth?
2 Answers available
Do you recommend holding cinacalcet after kidney transplantation and monitoring PTH levels before restarting it?
If so, how long would you monitor PTH levels?
1 Answer available
When do you deem it reasonable to transition outpatient management of a kidney transplant patient to general nephrology?
1 Answer available
Do you recommend starting aspirin for a patient with ESKD secondary to lupus nephritis with detected antiphospholipid antibodies on pretransplant workup but no history of a thrombotic event?
3 Answers available
How long would you continue prednisone in an ESKD patient with a failed kidney transplant who develops mild graft pain when steroids are tapered?
1 Answer available
What is your blood pressure goal for the first three months after kidney transplantation?
2 Answers available
What do you use to treat a kidney transplant patient with progressive BK nephropathy despite a maximal decrease in immunosuppression for months?
1 Answer available
How do you approach COVID-19 vaccination in those who underwent kidney transplantation for native kidney glomerular disease?
1 Answer available
Do you routinely advise patients waiting for a kidney transplant to seek referrals at multiple institutions to decrease waiting time?
1 Answer available
Do you use both rituximab and plasmapheresis in patients with recurrent primary FSGS within three months of kidney transplantation?
1 Answer available
What changes to immunosuppressant medications do you adopt for kidney transplant patients who contract COVID-19?
1 Answer available
Would you consider clearing a patient with essential thrombocytosis for a kidney donation?
1 Answer available


Papers discussed in this category

Clinical transplantation, 2017-05
Kidney allograft surveillance biopsy practices across US transplant centers: A UNOS survey.
Transplantation proceedings, 2020 Jun 21
Kidney Graft Surveillance Biopsy Utilization and Trends: Results From a Survey of High-Volume Transplant Centers.
Am J Transplant, 2021 Feb 23
Rituximab for recurrence of primary focal segmental glomerulosclerosis after kidney transplantation: Results of a nationwide study.
Transplantation, 2009 Aug 15
Use of rituximab in focal glomerulosclerosis relapses after renal transplantation.
Am J Transplant, 2019 Jul 01
Two-year outcomes in de novo renal transplant recipients receiving everolimus-facilitated calcineurin inhibitor reduction regimen from the TRANSFORM study.
Transpl Infect Dis, 2020 Jul 14
T-cell adoptive immunotherapy for BK nephropathy in renal transplantation.
Journal of the American Society of Nephrology : JASN, 2014-07
BP, cardiovascular disease, and death in the Folic Acid for Vascular Outcome Reduction in Transplantation trial.
Kidney Int, 2021 Mar
KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease.
Pediatr Transplant, 2018 Dec 09
Effects of the strict control of blood pressure in pediatric renal transplant recipients-ESCORT trial.
N Engl J Med, 2015 Nov 09
A Randomized Trial of Intensive versus Standard Blood-Pressure Control.
Kidney Int, 1998 Jan
Association of chronic kidney graft failure with recipient blood pressure. Collaborative Transplant Study.
Sci Rep, 2019 Jul 19
Intensive blood pressure control is associated with improved patient and graft survival after renal transplantation.
J Rheumatol, 2017 May 15
Longterm Hydroxychloroquine Therapy and Low-dose Aspirin May Have an Additive Effectiveness in the Primary Prevention of Cardiovascular Events in Patients with Systemic Lupus Erythematosus.
JAMA, 2014-02-12
Risk of end-stage renal disease following live kidney donation.
Journal of autoimmunity, 2017 Apr 12
The epigenetic mechanism for discordance of autoimmunity in monozygotic twins.
Kidney international, 2013 Nov 27
Long-term risks for kidney donors.
Transplantation reviews (Orlando, Fla.), 2021 Jun 24
Management of the kidney transplant patient with Cancer: Report from a Multidisciplinary Consensus Conference.
Frontiers in cardiovascular medicine, 2022 Feb 23
Post-transplant Lymphoproliferative Disorder Following Cardiac Transplantation.
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2023 Feb 13
Isolated kidney transplantation under lumasiran therapy in primary hyperoxaluria type 1: a report of five cases.
Oncology research, 2018-04-10
Normalization of Elevated Tumor Marker CA27-29 After Bilateral Lung Transplantation in a Patient With Breast Cancer and Idiopathic Pulmonary Fibrosis.
Balkan journal of medical genetics : BJMG, 2023 May 02
Pathogenic/Likely Pathogenic Variant Patients with Breast, Ovarian, and Other Cancers.
Therapeutic drug monitoring, 2022 Jun 01
Drug-Drug Interactions Between Mycophenolic Acid and Proton Pump Inhibitors: A Systematic Review and Meta-Analysis.
Lancet Oncol,
Daratumumab plus pomalidomide and dexamethasone versus pomalidomide and dexamethasone alone in previously treated multiple myeloma (APOLLO): an open-label, randomised, phase 3 trial.
Transplant international : official journal of the European Society for Organ Transplantation, 2019 Oct 07
Predicting skin cancer in organ transplant recipients: development of the SUNTRAC screening tool using data from a multicenter cohort study.
Addiction (Abingdon, England), 2024 May 22
Changes in self-reported cannabis use in the United States from 1979 to 2022.
Journal of the American Heart Association, 2024 Feb 28
Association of Cannabis Use With Cardiovascular Outcomes Among US Adults.
Frontiers in pharmacology, 2024 May 22
Systematic review of drug-drug interactions of delta-9-tetrahydrocannabinol, cannabidiol, and .
J Acad Consult Liaison Psychiatry, 2023 Nov-Dec
Delayed-Onset Psychosis Secondary to Tacrolimus Neurotoxicity After Lung Transplant: A Case Report and Systematic Review.
Case reports in nephrology and dialysis, 2021 Aug 04
When Paranoia Comes with the Treatment: Psychosis Associated with Tacrolimus Use.
The primary care companion for CNS disorders, 2022 Dec 08
Psychosis Associated With Tacrolimus at Therapeutic Serum Levels.
Transplantation direct, 2023 Jul 12
The Association of Tacrolimus Formulation on Cerebral Blood Flow and Cognitive Function.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2024 Jul 19
Oral Antibiotics for Treatment of Gram-Negative Bacteremia in Solid Organ Transplant Recipients: A Propensity Score Weighted Retrospective Observational Study.
European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes, 2021 Dec 06
Antithrombotic Management in Adult Kidney Transplantation: A European Survey Study.
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2021 Aug 01
Estimating Glomerular Filtration Rate in Cirrhosis Using Creatinine-Based and Cystatin C-Based Equations: Systematic Review and Meta-Analysis.
Kidney international, 2018-07
Proliferative glomerulonephritis with monoclonal immunoglobulin G deposits is associated with high rate of early recurrence in the allograft.
BMC nephrology, 2019-02-14
Complete biopsy-proven resolution of deposits in recurrent proliferative glomerulonephritis with monoclonal IgG deposits (PGNMIGD) following rituximab treatment in renal allograft.
Clinical transplantation, 2020 Nov 22
Hydroxychloroquine and maintenance immunosuppression use in kidney transplant recipients: Analysis of linked US registry and claims data.
Arthritis care & research, 2023 Nov 28
Reference Range of Hydroxychloroquine Blood Levels That Can Reduce Odds of Active Lupus and Prevent Flares.
Annals of surgery, 2008-10
A prospective, randomized, double-blind, placebo-controlled multicenter trial comparing early (7 day) corticosteroid cessation versus long-term, low-dose corticosteroid therapy.
Kidney360, 2022 Aug 25
Bariatric Surgery Decreases Barriers for Kidney Transplant: Are There Other Weight-Loss Options?
Circulation, 2019-06-18
2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

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