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Clinical Management of Patients Before and After Kidney Transplantation
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Clinical Management of Patients Before and After Kidney Transplantation

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 July 2026 | Viewed by 744

Special Issue Editor

Dr. Izabela Zakrocka

E-Mail Website
Guest Editor
Department of Nephrology, Medical University of Lublin, Lublin, Poland
Interests: nephrology; dialysis; chronic kidney disease; transplantation; pharmacology; uremic toxins
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Chronic kidney disease remains a leading cause of poor quality of life and premature death in the general population. High cardiovascular risk of patients with impaired kidney function is a diagnostic and therapeutic challenge due to nonspecific clinical presentation and limited response to standard therapeutic agents. Patients with severe kidney function deterioration are at an extremely high risk of complications due to disease- and kidney replacement therapy-related factors. Kidney transplantation is the golden standard of treatment of patients with end-stage kidney disease. Compared to other forms of kidney replacement therapies, solid organ transplantation offers significantly higher quality of life and overall survival. Despite advancements in diagnostic procedures, especially targeted towards graft rejection diagnosis and prediction of graft survival, as well as increased availability of anti-rejection and antimicrobial agents, with specific affinity against immunosuppression-related pathogens, kidney graft survival is still limited. A tight cooperation between specialists in various disciplines, especially in internal medicine, nephrology, surgery, pathology, pharmacology, and diagnostic laboratory is necessary to closely monitor patients and graft survival. In this Special Issue, we aim to highlight difficulties in pre- and post-transplant care of kidney graft recipients from a perspective of multiple medical fields. Additionally, this Special Issue aims to present emerging and evolving approaches in the monitoring and management of post-transplant complications, and to discuss future directions in the care of kidney transplant recipients.

Dr. Izabela Zakrocka
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 250 words) can be sent to the Editorial Office for assessment.

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 function
  • kidney replacement therapy
  • kidney transplantation
  • kidney graft survival
  • post-transplant complications

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Published Papers (1 paper)

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Research

12 pages, 1445 KB  
Article
Hypothermic Machine Perfusion Allows Safe Delay in Kidney Transplantation After Cold Storage
by Michal Macech, Tadeusz R. Grochowiecki, Ewa Wojtaszek, Slawomir Nazarewski, Tomasz Glogowski, Andrii Mondryk, Michal S. Proczka, Milena N. Michalska, Jolanta Malyszko and Zbigniew Galazka
J. Clin. Med. 2026, 15(6), 2173; https://doi.org/10.3390/jcm15062173 - 12 Mar 2026
Viewed by 508
Abstract
Background/Objectives: Static cold storage (SCS) remains the standard method of kidney preservation. As a referral transplant center, we frequently receive kidneys initially preserved with SCS and subsequently initiate prolonged hypothermic machine perfusion (HMP) to extend allocation time and optimize recipient matching. The [...] Read more.
Background/Objectives: Static cold storage (SCS) remains the standard method of kidney preservation. As a referral transplant center, we frequently receive kidneys initially preserved with SCS and subsequently initiate prolonged hypothermic machine perfusion (HMP) to extend allocation time and optimize recipient matching. The clinical impact of this sequential preservation strategy remains incompletely defined. To compare outcomes between kidneys preserved with SCS followed by prolonged HMP (SCS+HMP) and SCS alone. Methods: This single-center retrospective study included 200 adult recipients of kidney transplants from brain-dead donors (67 SCS+HMP; 133 SCS). Outcomes were primary graft non-function (PNF), delayed graft function (DGF), patient and death-censored graft survival, and renal function over 24 months. Univariable and multivariable analyses identified predictors of DGF. Propensity score matching was performed to adjust for baseline imbalances. Results: In the SCS+HMP group, grafts underwent a median of 244 min of SCS followed by 1300 min of HMP, resulting in longer total cold ischemia time than SCS alone (1545 vs. 1104 min; p < 0.001). After matching, 51 pairs (n = 102) were analyzed. In the matched cohort, PNF occurred in 2 patients (3.9%) in the SCS+HMP group and 3 patients (5.9%) in the SCS group (p = 1.0). DGF occurred less frequently in the SCS+HMP group than in the SCS group (17.6% vs. 39.2%; p = 0.027). In multivariable Firth penalized logistic regression, HMP was independently associated with lower odds of DGF (OR 0.34; 95% CI 0.13–0.82). During the 24-month follow-up, patient survival, death-censored graft survival, and creatinine trajectories were comparable between groups. Conclusions: Sequential HMP after initial SCS enables extended preservation and was associated with a lower incidence of delayed graft function. This strategy does not compromise patient survival, death-censored graft survival, or renal function at 24 months. Full article
(This article belongs to the Special Issue Clinical Management of Patients Before and After Kidney Transplantation)
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