Challenges and Opportunities of Kidney Transplantation in Patients with Immune Diseases

A special issue of Transplantology (ISSN 2673-3943).

Deadline for manuscript submissions: closed (15 May 2023) | Viewed by 3910

Special Issue Editor


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Guest Editor
Division of Nephrology, Dialysis and Transplantation, Department of Internal Medicine and IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy
Interests: glomerulonephritis; immunity and inflammatory processes in renal diseases; hemodialysis; kidney transplantation
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Special Issue Information

Dear Colleagues,

In recent years, the world has seen improvements in kidney transplantation management and survival. 

These changes make it possible to propose transplantation to an increased pool of patients, offering the opportunity to improve the quality of life of patients with end-stage renal disease.

On the other hand, the increased number of patients potentially eligible for transplantation may represent a challenge because this group may also include fragile and old subjects and patients with significant comorbidities.

In this regard, one of the most important groups of patients potentially eligible for kidney transplantation is constituted by patients with a history of immune diseases. These may include systemic disorders, such as lupus, systemic sclerosis, or vasculitis, or primary renal diseases, such as proteinuric glomerulonephritis.

Performing kidney transplantation in these patients, especially from a living donor, may be problematic for the difficulty of general medical management and because of the risk of disease recurrence that may hamper graft survival. 

Moreover, immune-mediated diseases may also present as de novo complications after transplantation.

For these reasons, acquiring data on the pathogenesis and management of pre-existing, de novo, or recurrent immune diseases in patients undergoing kidney transplantation may have a relevant clinical impact.

For this Special Issue of Transplantology, we welcome the submission of original research papers, case reports, and review articles focused on the following topics:

  • Kidney transplantation in patients with systemic immune diseases; 
  • Kidney transplantation in patients with lupus;
  • Kidney transplantation in patients with primary glomerular diseases;
  • Living donor kidney transplantation in patients with underlying immune disease;
  • Recurrent immune disease after kidney transplantation;
  • De novo immune disease after kidney transplantation;
  • Prophylactic strategy to prevent recurrence of immune diseases in kidney transplantation;
  • Complications of kidney transplantation in patients with immune disorders;
  • Pathogenesis, clinical presentation, and treatment of acute and chronic kidney graft rejection.

Dr. Pasquale Esposito
Guest Editor

Manuscript Submission Information

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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. Transplantology is an international peer-reviewed open access quarterly journal published by MDPI.

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Keywords

  • kidney transplantation
  • kidney graft rejection
  • immune disease

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Published Papers (1 paper)

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Review

17 pages, 345 KiB  
Review
Recurrent Immunoglobulin A Nephropathy after Kidney Transplant—An Updated Review
by Hwarang S. Han, Michelle L. Lubetzky, Nidharshan S. Anandasivam, Rebecca A. Cox and Brian K. Lee
Transplantology 2023, 4(3), 161-177; https://doi.org/10.3390/transplantology4030016 - 6 Sep 2023
Cited by 1 | Viewed by 3185
Abstract
Immunoglobulin A nephropathy (IgAN) is the commonest glomerulonephritis worldwide, a category that represents the third most frequent cause of end-stage kidney disease (ESKD) in the United States. Kidney transplantation remains the optimal treatment of ESKD, and yet the prospects of IgAN recurrence post-transplant [...] Read more.
Immunoglobulin A nephropathy (IgAN) is the commonest glomerulonephritis worldwide, a category that represents the third most frequent cause of end-stage kidney disease (ESKD) in the United States. Kidney transplantation remains the optimal treatment of ESKD, and yet the prospects of IgAN recurrence post-transplant dampens the enthusiasm for living kidney donation in some instances, in addition to limiting the longevity of the kidney allograft. Moreover, the lack of a standardized method for detecting IgAN recurrence, since not all centers perform protocol allograft biopsies, has led to an underestimation of the extent of the issue. The pathogenesis of de novo IgAN remains conjectural, let alone the pathways for recurrent disease, but is increasingly recognized as a multi-hit injury mechanism. Identification of recurrent disease rests mainly on clinical symptoms and signs (e.g., hematuria, proteinuria) and could only be definitively proven with histologic evidence which is invasive and prone to sampling error. Treatment had relied mainly on nonspecific goals of proteinuria reduction, and in some cases, immunosuppression for active, crescentic disease. More recently, newer targets have the potential to widen the armamentarium for directed therapies, with more studies on the horizon. This review article provides an update on recurrent IgAN post-transplant. Full article
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