Clinical Challenges in Renal Transplant Rejection

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

Deadline for manuscript submissions: closed (20 March 2024) | Viewed by 1165

Special Issue Editor


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Guest Editor
Department of Nephrology, Transplantation and Internal Medicine, Slaski Uniwersytet Medyczny w Katowicach, Katowice, Poland
Interests: kidney transplant; renal transplant rejection; immunosuppression

Special Issue Information

Dear Colleagues,

Although great advances in renal transplant surgery have been made, rejection among transplant recipients remains a major health issue. When transplanting tissue or cells from a donor that are genetically different from those of the recipient, an immune response will be triggered against the transplanted graft. The introduction of immunosuppressants has allowed transplanted kidneys to survive for a longer period of time, but episodes of rejection still occur, leading to graft loss. Several factors have been identified to increase the risk of rejection, but the mechanisms triggering the immune response are still poorly understood. The Special Issue examines the challenges posed by chronic rejection, a long-term process that can ultimately lead to graft failure. Furthermore, we hope to highlight the current understanding of the mechanisms underlying transplant rejection, as well as novel diagnostic and therapeutic strategies being employed to address this clinical challenge. This Issue emphasizes the need for early detection and intervention to prevent or slow down the progression of chronic rejection.

In this Special Issue of the Journal of Clinical Medicine, we welcome original articles and reviews that explore different aspects of the rejection of kidney allografts. Since there are many challenges to achieving successful outcomes for renal transplants, we hope to help physicians and researchers deal with them.

Prof. Dr. Grzegorz Piecha
Guest Editor

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Keywords

  • renal transplant
  • kidney transplantation
  • renal allograft
  • acute rejection
  • chronic rejection
  • kidney transplant rejection prevention

Published Papers (1 paper)

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Research

12 pages, 825 KiB  
Article
Predicting Kidney Transplantation Outcomes from Donor and Recipient Characteristics at Time Zero: Development of a Mobile Application for Nephrologists
by Miguel Ángel Pérez Valdivia, Jorge Calvillo Arbizu, Daniel Portero Barreña, Pablo Castro de la Nuez, Verónica López Jiménez, Alberto Rodríguez Benot, Auxiliadora Mazuecos Blanca, Mª Carmen de Gracia Guindo, Gabriel Bernal Blanco, Miguel Ángel Gentil Govantes, Rafael Bedoya Pérez and José Luis Rocha Castilla
J. Clin. Med. 2024, 13(5), 1270; https://doi.org/10.3390/jcm13051270 - 23 Feb 2024
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Abstract
(1) Background: We report on the development of a predictive tool that can estimate kidney transplant survival at time zero. (2) Methods: This was an observational, retrospective study including 5078 transplants. Death-censored graft and patient survivals were calculated. (3) Results: Graft loss was [...] Read more.
(1) Background: We report on the development of a predictive tool that can estimate kidney transplant survival at time zero. (2) Methods: This was an observational, retrospective study including 5078 transplants. Death-censored graft and patient survivals were calculated. (3) Results: Graft loss was associated with donor age (hazard ratio [HR], 1.021, 95% confidence interval [CI] 1.018–1.024, p < 0.001), uncontrolled donation after circulatory death (DCD) (HR 1.576, 95% CI 1.241–2.047, p < 0.001) and controlled DCD (HR 1.567, 95% CI 1.372–1.812, p < 0.001), panel reactive antibody percentage (HR 1.009, 95% CI 1.007–1.011, p < 0.001), and previous transplants (HR 1.494, 95% CI 1.367–1.634, p < 0.001). Patient survival was associated with recipient age (> 60 years, HR 5.507, 95% CI 4.524–6.704, p < 0.001 vs. < 40 years), donor age (HR 1.019, 95% CI 1.016–1.023, p < 0.001), dialysis vintage (HR 1.0000263, 95% CI 1.000225–1.000301, p < 0.01), and male sex (HR 1.229, 95% CI 1.135–1.332, p < 0.001). The C-statistics for graft and patient survival were 0.666 (95% CI: 0.646, 0.686) and 0.726 (95% CI: 0.710–0.742), respectively. (4) Conclusions: We developed a mobile app to estimate survival at time zero, which can guide decisions for organ allocation. Full article
(This article belongs to the Special Issue Clinical Challenges in Renal Transplant Rejection)
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