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Kidney Transplantation and Rehabilitation: Current Updates and Perspectives
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Kidney Transplantation and Rehabilitation: Current Updates and Perspectives

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: 10 June 2025 | Viewed by 3226

Special Issue Editor

Dr. Zoltán Sándor

E-Mail Website
Guest Editor
Department of Surgery, Clinical Center, University of Pécs, 7622 Pecs, Hungary
Interests: chronic kidney disease; kidney transplantation; transplant rehabilitation; transplant care; physical therapy; occupational therapy; intervention; recovery; quality of life; aftercare

Special Issue Information

Dear Colleagues,

Kidney transplantation remains the gold-standard treatment for end-stage renal disease (ESRD). Compared to chronic dialysis, transplantation results in lower mortality rates and a better quality of life (QOL) for our patients. However, to achieve the desired increase in QOL, our patients need long-term follow-up and individualized rehabilitation. The rising prevalence of ESRD worldwide necessitates the likewise expansion of kidney transplantation, and the expansion of transplantation has been followed by an explosion in the number of patients in need of postoperative care. A multidisciplinary approach incorporating physical, mental, and social assistance is needed to alleviate the disability caused by ESRD. An effective system would ideally allow our patients to lead fulfilling, independent lives and even return to the workforce.

Unfortunately, only a relatively small number of resources and studies are aimed at improving rehabilitation outcomes. A myriad of problems, such as underfunding, understaffing, and low patient compliance undermine the implementation of modern rehabilitation techniques. Too often, this lack of adequate rehabilitation negates the labour behind a successful transplantation.

This Special Issue, we invite authors to submit high-quality, original articles concerning recent advances in the postoperative rehabilitation of kidney transplant recipients. Recognizing the multi-faceted nature of rehabilitation, we welcome articles examining any aspect of QOL.

We look forward to receiving your contributions!

Dr. Zoltán Sándor
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • chronic kidney disease
  • kidney transplantation
  • transplant rehabilitation
  • transplant care
  • physical therapy
  • occupational therapy
  • intervention
  • recovery
  • quality of life
  • aftercare

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Published Papers (2 papers)

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Research

12 pages, 667 KiB  
Article
The Effectiveness of the Surgical Correction of Vesicoureteral Reflux on Febrile Urinary Tract Infections after a Kidney Transplant: A Single-Center Retrospective Study
by Andre E. Varaschin, Gabriella G. Gomar, Amanda M. Rocco, Silvia R. Hokazono, Quelen I. Garlet and Cláudia S. Oliveira
J. Clin. Med. 2024, 13(17), 5295; https://doi.org/10.3390/jcm13175295 - 6 Sep 2024
Cited by 2 | Viewed by 1292
Abstract
Background/Objectives: Vesicoureteral reflux (VUR) is considered one of the major causes of post-renal transplant febrile urinary tract infections (UTI), leading to impaired renal function and the premature loss of the renal graft. We aimed to evaluate whether surgical VUR correction, such as [...] Read more.
Background/Objectives: Vesicoureteral reflux (VUR) is considered one of the major causes of post-renal transplant febrile urinary tract infections (UTI), leading to impaired renal function and the premature loss of the renal graft. We aimed to evaluate whether surgical VUR correction, such as open redo ureteric reimplantation, could be an option for treatment and provide better outcomes in post-transplant care for patients with UTI compared to their pre-VUR correction clinical state. Methods: Our study presents a retrospective analysis of 10 kidney transplant recipients with febrile UTI at the Renal Transplant Service of a Brazilian public hospital from 2010 to 2020. We selected patients who primarily underwent a surgical correction of post-transplant VUR, which was corrected by extravesical reimplantation without a stent in all patients by the same professional surgeon. Results: From 710 patients who received kidney transplants, 10 patients (1.4%) suffered from febrile UTI post-transplant and underwent surgical correction for VUR. Despite the study’s limitations, such as its retrospective nature and limited sample size, the efficacy of open extravesical ureteral reimplantation in reducing post-operative febrile UTI in renal transplant patients was observed. Conclusions: As febrile UTI can contribute significantly to patient mortality after kidney transplantation and VUR emerges as a major cause of post-transplant febrile UTI, it is essential to treat it and consider the surgical outcome. This study emphasizes the timely detection and effective treatment of VUR via extravesical techniques to reduce febrile UTI occurrences post-transplant and it contributes insights into the role of surgical interventions in addressing VUR-related complications post-kidney transplantation. Full article
(This article belongs to the Special Issue Kidney Transplantation and Rehabilitation: Current Updates and Perspectives)
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9 pages, 1036 KiB  
Article
A Modified Switching Procedure from Temporary to Tunneled Central Venous Dialysis Catheters
by Johannes Eberhard, Constantin Bedau, Andrew Genius Chapple, Julia Klein, Christoph Reissfelder, Anna-Isabelle Kaelsch, Andreas Lutz Heinrich Gerken, Sebastian Zach and Kay Schwenke
J. Clin. Med. 2024, 13(12), 3367; https://doi.org/10.3390/jcm13123367 - 7 Jun 2024
Viewed by 1463
Abstract
Background: Tunneled central venous catheters are commonly used for dialysis in patients without a functional permanent vascular access. In an emergent setting, a non-tunneled, temporary central venous catheter is often placed for immediate dialysis. The most critical step in the catheter insertion is [...] Read more.
Background: Tunneled central venous catheters are commonly used for dialysis in patients without a functional permanent vascular access. In an emergent setting, a non-tunneled, temporary central venous catheter is often placed for immediate dialysis. The most critical step in the catheter insertion is venipuncture, which is often a major cause for longer intervention times and procedure-related adverse events. To avoid this critical step when placing a more permanent tunneled catheter, an exchange over a previously placed temporary one can be considered. In this paper, we present a modified switching approach with a separate access site. Methods: In this retrospective analysis of a prospective database, we examined whether this modified technique is non-inferior to a de novo application. Therefore, we included all 396 patients who received their first tunneled dialysis catheter at our site from March 2018 to March 2023. Out of these, 143 patients received the modified approach and 253 the standard de novo ultrasound-guided puncture and insertion. Then, the outcomes of the two groups, including adverse events and infections, were compared by nonparametric tests and multivariable logistic regression. Results: In both groups, the implantations were 100% successful. Catheter explantation due to infection according to CDC criteria was necessary in 18 cases, with no difference between the groups (5.0% vs. 4.4% p = 0.80). The infection rate per 100 days was 0.113 vs. 0.106 in the control group, with a comparable spectrum of bacteria. A total of 12 catheters (3 vs. 9) had to be removed due to a periinterventional complication. An early-onset infection was the reason in two cases (1.3%) in the study group and five in the control group (1.9%). A total misplacement of the catheter occurred in two cases only in the control group. After adjustment for potential confounders via multivariable logistic regression there was not a significant difference in the complication rate (adjusted odds ratio, aOR = 0.53, 95% CI = 0.14–2.03, p = 0.351) but an estimated decreased risk overall based on the average treatment effect of −1.7% in favor of the study group. Conclusions: The present study shows that a catheter exchange leads to no more infections than a de novo placement; hence, it is a feasible method. Moreover, misplacements and control chest X-rays to exclude pneumothorax after venipuncture were completely avoided by exchanging. This approach yields a much lower infection rate than previous reports: 1.3% compared to 2.7% in all existing aggregated studies. The presented approach seems to be superior to existing switching methods. Overall, an exchange can also help to preserve veins for future access, since the same jugular vein is used. Full article
(This article belongs to the Special Issue Kidney Transplantation and Rehabilitation: Current Updates and Perspectives)
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