Fast Five Quiz: Kidney Transplant Rejection Risk and Monitoring

Phuong-Thu Pham, MD, FASN

Disclosures

May 19, 2022

Chronic kidney disease (CKD) and renal tumors are indications for kidney transplantation, according to Collins and colleagues. However, a tumor-free waiting period may be required prior to transplantation. Metastatic cancer is a contraindication to transplantation. HIV seropositive is not a contraindication for kidney transplantation. However, patients must meet the following criteria:

  1. CD4 count > 200/mL for at least 6 months

  2. Undetectable HIV-1 RNA

  3. No major infectious or neoplastic complications

They must also be stable on antiretroviral therapy for at least 3 months, per Collins and colleagues. It should be noted that specific recommendations may vary from center to center.

Diabetes is the primary cause of ESRD for adult patients on the kidney transplant waiting list in the United States. Collins and colleagues estimated that only about 25% of adult patients receiving dialysis are referred for evaluation for kidney transplantation. In a study to evaluate the nephrologists' perception about factors they consider important in excluding patients from being referred for kidney transplant evaluation, inadequate patient's social support, limited patient education, and age > 65 years were found to be important deterrents. Combined kidney-pancreas transplantation is the treatment of choice for patients with type 1 diabetes and CKD.

Learn more about the indications for kidney transplantation.

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