Trending Clinical Topics for April 2019

Ryan Syrek


April 26, 2019

Trending Clinical Topic of the Week (April 6-12): Kidney Transplant

A groundbreaking donor, new guidelines, and a potential replacement for invasive testing in certain patients helped make kidney transplant this week's top trending clinical topic. In late March of this year, Nina Martinez became the first living person with HIV in the United States to donate a kidney to a recipient with HIV. The celebration that has surrounded the event is as much about progress made in transplantation as it is about overall progress in HIV care. As far back as 2010, researchers demonstrated that people with HIV had high survival rates after transplantation. Given that people with HIV are more likely to develop end-stage renal disease (ESRD) and require new kidneys, Martinez's milestone moment is particularly significant.    

New tools have also become available for those caring for patients who have had or need a kidney transplant. The American Society of Transplantation Infectious Diseases Community of Practice recently released guidelines on screening and treatment of BK polyomavirus (BKPyV) infection of solid organ transplants. These include the recommendation that all kidney transplant recipients should undergo monthly screening for BKPyV DNAemia for the first 9 months following transplantation, and then every 3 months until 2 years post-transplant. A new renal biopsy index for kidney allografts has also been introduced recently. The model is intended to help providers determine the need to perform 1-year surveillance biopsy in deceased-donor kidney transplant recipients. Because kidney biopsy is such an invasive test, avoiding it when possible in certain patients would be welcome news. From a pioneering donor to new information designed to help recipients, kidney transplantation was certainly in the news, and that helped make it this week's top trending clinical topic.

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