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Updates on Renal Transplantation and Its Complications
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Updates on Renal Transplantation and Its Complications

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

Deadline for manuscript submissions: 20 May 2025 | Viewed by 3398

Special Issue Editors

Prof. Dr. Nada Kanaan

E-Mail Website
Guest Editor
Division of Nephrology, Department of Internal Medicine, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, 1200 Brussels, Belgium
Interests: kidney transplantation; infections; cancer; genetics; ADPKD; hepatitis; mineral bone disease
Prof. Dr. Arnaud Devresse

E-Mail Website
Guest Editor
1. Surgery and Abdominal Transplant Unit, Department of Surgery, University Clinics Saint Luc, Université Catholique de Louvain, 1200 Brussels, Belgium
2. Department of Nephrology, University Clinics Saint-Luc, Université Catholique de Louvain, 1200 Brussels, Belgium
Interests: kidney transplantation; primary hyperoxaluria; infections; mineral bone disease

Special Issue Information

Dear Colleagues,

Despite good short-term results, long-term patient and graft survival after renal transplantation has not improved significantly over the past decades. Physicians and patients still face the challenges of immunological hurdles, infections, cancers and metabolic complications related to the burden of immunosuppression.

For hypersensitized patients, an exciting treatment has emerged with Ig-G-degrading enzymes, enabling them to access kidney transplantation after a long waiting period. Machine perfusion technology has also improved in recent years, leading to the reduction of the negative impact of ischemia-reperfusion injury. New therapeutic agents in the field of diabetes with proven efficacy in slowing the progression of chronic kidney disease are also promising for controlling cardiovascular risk factors and protecting allograft function in kidney transplant recipients.

In this Special Issue, we seek reviews and original articles that highlight the recent advances in the understanding and management of complications encountered after kidney transplantation. Unraveling the pathophysiology and adequate management will help improve long-term outcomes.

Prof. Dr. Nada Kanaan
Prof. Dr. Arnaud Devresse
Guest Editors

Manuscript Submission Information

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Keywords

  • cardiovascular complications
  • infections
  • CMV
  • EBV
  • viral hepatitis
  • mineral bone disease
  • cancer
  • rejection
  • post-transplant diabetes
  • immunosuppression

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Published Papers (2 papers)

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Research

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12 pages, 1199 KiB  
Article
Basiliximab vs. No Induction Therapy in Kidney Transplant Recipients with a Low Immunological Risk Profile Receiving Tacrolimus/Mycophenolate/Steroids Maintenance Immunosuppression
by Florian Lacave, Christophe de Terwangne, Tom Darius, Antoine Buemi, Michel Mourad, Yannick France, Joana Cardoso Coelho, Guillaume Fernandes, Eric Goffin, Arnaud Devresse and Nada Kanaan
J. Clin. Med. 2024, 13(20), 6151; https://doi.org/10.3390/jcm13206151 - 16 Oct 2024
Viewed by 1509
Abstract
Background: Induction therapy with basiliximab is recommended in kidney transplant (KT) recipients with a low immunological risk (LIR) profile. Whether basiliximab is associated with a decreased risk of acute rejection (AR) and graft loss is controversial. Methods: In our institution, LIR [...] Read more.
Background: Induction therapy with basiliximab is recommended in kidney transplant (KT) recipients with a low immunological risk (LIR) profile. Whether basiliximab is associated with a decreased risk of acute rejection (AR) and graft loss is controversial. Methods: In our institution, LIR patients (absence of anti-HLA antibodies before KT) are inducted with basiliximab in case of living-donor KT, while deceased-donor KT recipients receive no induction. Maintenance immunosuppression is similar, including a combination of tacrolimus (Tac), mycophenolate (MPA) and steroids. In this single-center retrospective study, we included all adult LIR patients who underwent KT between 1 January 2015 and 31 December 2022. Results: Of the 471 patients included, 354 received no induction and 117 received basiliximab. The median (IQR) number of HLA A-B-DR mismatches was 3 (2–3) and 2 (2–4) in the no induction group and the basiliximab group, respectively. The cumulative incidences in the no induction group vs. the basiliximab group of acute rejection and graft loss over 5 years post-KT were similar at 8.9% vs. 7.8% (p = 0.8) and 8.5% vs. 4.2% (p = 0.063), respectively. In multivariable Cox regression analysis, delayed graft function emerged as an independent risk factor for acute rejection (hazard ratio [HR] 2.75, 95% confidence interval [CI] 1.23–6.13, p = 0.014) and graft loss (HR 9.32, CI 4.10–21.1, p < 0.001). Conclusions: Basiliximab did not provide any advantage in terms of rate of acute rejection and graft survival within 5 years post KT compared with a strategy without induction therapy in patients with a low immunological risk profile receiving triple maintenance immunosuppression Tac/MPA/steroids. Full article
(This article belongs to the Special Issue Updates on Renal Transplantation and Its Complications)
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Review

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11 pages, 1227 KiB  
Review
Recent Insights in Noninvasive Diagnostic for the Assessment of Kidney and Cardiovascular Outcome in Kidney Transplant Recipients
by Peyman Falahat, Uta Scheidt, Daniel Pörner and Sebastian Schwab
J. Clin. Med. 2024, 13(13), 3778; https://doi.org/10.3390/jcm13133778 - 27 Jun 2024
Viewed by 1272
Abstract
Kidney transplantation improves quality of life and prolongs survival of patients with end-stage kidney disease. However, kidney transplant recipients present a higher risk for cardiovascular events compared to the general population. Risk assessment for graft failure as well as cardiovascular events is still [...] Read more.
Kidney transplantation improves quality of life and prolongs survival of patients with end-stage kidney disease. However, kidney transplant recipients present a higher risk for cardiovascular events compared to the general population. Risk assessment for graft failure as well as cardiovascular events is still based on invasive procedures. Biomarkers in blood and urine, but also new diagnostic approaches like genetic or molecular testing, can be useful tools to monitor graft function and to identify patients of high cardiovascular risk. Many biomarkers have been introduced, whereas most of these biomarkers have not been implemented in clinical routine. Here, we discuss recent developments in biomarkers and diagnostic models in kidney transplant recipients. Because many factors impact graft function and cardiovascular risk, it is most likely that no biomarker will meet the highest demands and standards. We advocate to shift focus to the identification of patients benefitting from molecular and genetic testing as well as from analysis of more specific biomarkers instead of finding one biomarker fitting to all patients. Full article
(This article belongs to the Special Issue Updates on Renal Transplantation and Its Complications)
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