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Kidney Transplantation Key Concepts
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Post-Transplant Monitoring
Post-transplant monitoring is crucial to assess kidney function, detect complications, and adjust immunosuppression. This involves regular check-ups, blood tests, and sometimes biopsies to ensure the longevity of the transplanted kidney.
Living vs. Deceased Donation
Living donation involves a living person donating a kidney, while deceased donation comes from an individual who has died. Living donor kidneys often last longer and function better, and they are available sooner than deceased donor kidneys.
Transplant Rejection
Transplant rejection occurs when the recipient's immune system attacks the transplanted kidney. There are different types, including hyperacute, acute, and chronic rejection, each requiring prompt intervention to preserve the graft.
Kidney Paired Donation (KPD)
Kidney paired donation is a transplant option for candidates with a living donor who is not a match. Pairs of donors and recipients are matched to allow for compatible transplants across the group, thereby increasing the chance of successful transplantation.
Cold Ischemia Time
Cold ischemia time refers to the duration a kidney is kept on ice from the time it is removed from the donor to the time it is transplanted into the recipient. Minimizing cold ischemia time is crucial to reduce organ deterioration and improve transplant success.
Calcineurin Inhibitors
Calcineurin inhibitors are a class of immunosuppressive drugs that are commonly used to prevent organ rejection in kidney transplant recipients by inhibiting T-cell activation. Tacrolimus and cyclosporine are two examples of calcineurin inhibitors.
Immunosuppression
Immunosuppression is the medical suppression of the immune response to prevent the body from rejecting the transplanted kidney. Immunosuppressants must be taken for life, with doses adjusted based on the risk of rejection versus the risk of infection.
Panel Reactive Antibody (PRA) Level
The PRA level measures the percentage of the population against which a transplant recipient has antibodies. A higher PRA level can indicate an increased risk for rejection and can affect wait times for a kidney.
HLA Matching
HLA matching involves comparing the human leukocyte antigens of the donor and recipient to ensure compatibility and reduce the risk of transplant rejection. Optimal HLA matching can improve transplantation outcomes by minimizing immune responses.
Delayed Graft Function (DGF)
Delayed graft function is a condition in which the transplanted kidney does not function immediately and requires dialysis support in the first week after transplantation. DGF is associated with a higher risk of acute rejection and reduced graft survival.
Donor-Recipient Crossmatch Test
A crossmatch test is performed before kidney transplantation to determine whether the recipient has antibodies against the donor's cells, potentially leading to immediate rejection of the transplanted organ.
Graft Surveillance
Graft surveillance is the ongoing monitoring of transplant kidney health through blood tests, imaging, and sometimes biopsies. It is critical for the early detection and treatment of graft dysfunction.
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