Special Issue "Clinical Complications 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: 30 November 2020.

Special Issue Editor

Prof. Dr. Stefan Reuter
Website
Guest Editor
Department of Medicine D, University Clinics Münster, Albert-Schweitzer Campus 1, 48149 Münster, Germany
Interests: kidney transplantation; immunosuppression; tacrolimus metabolism; transplant rejection; renal imaging

Special Issue Information

Dear Colleagues,

Despite enormous advances in immunosuppression and surgical kidney transplant techniques in recent decades, kidney transplant recipients frequently develop transplantation-associated health issues that have to be managed in clinical routine by transplant physicians every day. Clinical complications range from surgical issues over metabolic and cardiovascular disorders to infections and cancer. Moreover, we have to handle adverse effects of immunosuppressive agents as well as a re-occurrence of the underlying kidney disease. Unfortunately, complications may start early after (e.g., new onset of diabetes mellitus, infections, and rejections) or even during transplantation (such as hemorrhage), but some need to be taken care of especially at late stages (e.g., skin cancer/malignancy, interstitial fibrosis and tubular atrophy, and cardiovascular events).

In this Special Issue of the Journal of Clinical Medicine, we will address the whole spectrum of clinically relevant complications that occur in kidney transplant recipients. As complications directly impact on the health and the outcome of transplant recipients, this Special Issue should increase the awareness as well as the knowledge of transplant physicians and researchers to these issues.

Potential topics include but are not limited to the following:

  • Antibody-mediated rejection (acute and chronic) of the kidney graft;
  • Cellular rejection (acute and chronic) after renal transplantation;
  • (Inflammatory) allograft fibrosis: (inflammatory) interstitial fibrosis and tubular atrophy (chronic allograft nephropathy);
  • BK virus nephropathy of the allograft;
  • Cytomegalovirus infection of the kidney transplant recipient;
  • Urinary tract infections after renal transplantation;
  • Vaccination after kidney transplantation;
  • Arterial hypertension after renal transplantation;
  • Cardiovascular risk and cardiovascular events in kidney transplant recipients;
  • Mineral bone disease after kidney transplantation;
  • Malignancy after kidney transplantation;
  • Adverse effects of immunosuppressive drugs;
  • Management of surgical complications after renal transplantation;
  • Lymphoceles after kidney transplantation;
  • Diabetes mellitus in kidney transplant recipients/new onset of diabetes after renal transplantation;
  • Recurrent glomerulonephritis after kidney transplantation;
  • Skin cancer after kidney transplantation;
  • Fungal infections of the kidney transplant recipient;
  • Donor-specific antibodies after kidney transplantation;
  • Adherence of the kidney transplant recipient;
  • Pregnancy after kidney transplantation.

Prof. Dr. Stefan Reuter
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 papers will be 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 monthly 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 2000 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

  • Kidney transplantation
  • Immunosuppression
  • Infection
  • Transplant rejection
  • Cancer
  • Cardiovascular events

Published Papers (2 papers)

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Research

Open AccessArticle
Urinary Excretion of 6-Sulfatoxymelatonin, the Main Metabolite of Melatonin, and Mortality in Stable Outpatient Renal Transplant Recipients
J. Clin. Med. 2020, 9(2), 525; https://doi.org/10.3390/jcm9020525 - 14 Feb 2020
Abstract
Melatonin is a multifaceted hormone which rises upon the onset of darkness. Pineal synthesis of melatonin is known to be disturbed in patients with end-stage renal disease, but it is not known if its production is restored to normal after successful renal transplantation. [...] Read more.
Melatonin is a multifaceted hormone which rises upon the onset of darkness. Pineal synthesis of melatonin is known to be disturbed in patients with end-stage renal disease, but it is not known if its production is restored to normal after successful renal transplantation. We hypothesized that urinary excretion of 6-sulfatoxymelatonin, the major metabolite of melatonin, is lower in renal transplant recipients (RTRs) compared to healthy controls and that this is associated with excess mortality. Urinary 6-sulfatoxymelatonin was measured via LC-MS/MS in 701 stable outpatient RTRs and 285 healthy controls. Median urinary 6-sulfatoxymelatonin in RTR was 13.2 nmol/24 h, which was 47% lower than in healthy controls. Urinary 6-sufatoxymelatonin appeared undetectable in the majority of 36 RTRs with diabetic nephropathy as primary renal disease. Therefore, this subgroup was excluded from further analyses. Of the remaining 665 RTRs, during 5.4 years of follow-up, 110 RTRs died, of whom 38 died due to a cardiovascular cause. In Cox-regression analyses, urinary 6-sulfatoxymelatonin was significantly associated with all-cause mortality (0.60 (0.44–0.81), p = 0.001) and cardiovascular mortality (0.49 (0.29–0.84), p = 0.009), independent of conventional risk factors and kidney function parameters. Based on these results, evaluation and management of melatonin metabolism could be considered for improvement of long-term outcomes in RTRs. Full article
(This article belongs to the Special Issue Clinical Complications after Kidney Transplantation)
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Open AccessArticle
Cytomegalovirus Viremia after Living and Deceased Donation in Kidney Transplantation
J. Clin. Med. 2020, 9(1), 252; https://doi.org/10.3390/jcm9010252 - 17 Jan 2020
Abstract
Despite screening, effective anti-viral drugs and risk-balanced prophylaxis, cytomegalovirus (CMV) remains a major cause of morbidity in transplant patients. The objective of this study was to retrospectively analyze the risk factors associated with CMV viremia after kidney transplantation in a large European cohort [...] Read more.
Despite screening, effective anti-viral drugs and risk-balanced prophylaxis, cytomegalovirus (CMV) remains a major cause of morbidity in transplant patients. The objective of this study was to retrospectively analyze the risk factors associated with CMV viremia after kidney transplantation in a large European cohort with standardized valganciclovir prophylaxis in the present era. A special focus was placed on the comparison of living and postmortal donation. We conducted a longitudinal observational study involving 723 adult patients with a total of 3292 patient-years who were transplanted at our center between 2007 and 2015. Valganciclovir prophylaxis was administered over 100 days for CMV+ donors (D) or recipients (R), over 200 days for D+/R−, and none in D−/R−. A CMV+ donor, rejection episodes, and deceased donor transplantation were identified to be associated with increased incidences of CMV viremia. Although we did not find a reduced overall survival rate for patients with CMV viremia, it was associated with worse graft function. Since we observed a relevant number of CMV infections despite prescribing valganciclovir prophylaxis, a pre-emptive strategy in patients with (suspected) adherence restrictions could be favored. Our data can help transplant physicians educate their patients about their individual CMV risk and choose the most appropriate CMV treatment approach. Full article
(This article belongs to the Special Issue Clinical Complications after Kidney Transplantation)
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