BOOK
Medical Care for Kidney and Liver Transplant Recipients, An Issue of Medical Clinics of North America, E-Book
David A. Sass | Alden M. Doyle
(2016)
Additional Information
Book Details
Abstract
Medical Care for Kidney and Liver Transplant Recipients, An Issue of Medical Clinics of North America, E-Book
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Medical Care forKidney and LiverTransplant Recipients | i | ||
| Copyright\r | ii | ||
| CME Accreditation Page | iii | ||
| PROGRAM OBJECTIVE | iii | ||
| TARGET AUDIENCE | iii | ||
| LEARNING OBJECTIVES | iii | ||
| ACCREDITATION | iii | ||
| DISCLOSURE OF CONFLICTS OF INTEREST | iii | ||
| UNAPPROVED/OFF-LABEL USE DISCLOSURE | iii | ||
| TO ENROLL | iv | ||
| METHOD OF PARTICIPATION | iv | ||
| CME INQUIRIES/SPECIAL NEEDS | iv | ||
| MEDICAL CLINICS OF NORTH AMERICA\r | v | ||
| FORTHCOMING ISSUES | v | ||
| July 2016 | v | ||
| September 2016 | v | ||
| November 2016 | v | ||
| RECENT ISSUES | v | ||
| March 2016 | v | ||
| January 2016 | v | ||
| November 2015 | v | ||
| Contributors | vii | ||
| CONSULTING EDITORS | vii | ||
| EDITORS | vii | ||
| AUTHORS | vii | ||
| Contents | xi | ||
| Foreword: Medical Care for Kidney and Liver Transplant Recipients\r | xi | ||
| Preface: Long-Term Care of the Abdominal Organ Transplant Recipient: Pearls for the Primary Care Provider\r | xi | ||
| Liver and Kidney Transplantation: A Half-Century Historical Perspective\r | xi | ||
| From Child-Pugh to Model for End-Stage Liver Disease: Deciding Who Needs a Liver Transplant\r | xi | ||
| Renal Transplantation in Advanced Chronic Kidney Disease Patients\r | xi | ||
| Management of the Liver Transplant Recipient: Approach to Allograft Dysfunction\r | xii | ||
| Acute and Chronic Allograft Dysfunction in Kidney Transplant Recipients\r | xii | ||
| The ABCs of Immunosuppression: A Primer for Primary Care Physicians\r | xii | ||
| Managing Cardiovascular Risk in the Post Solid Organ Transplant Recipient\r | xii | ||
| Diabetes Care After Transplant: Definitions, Risk Factors, and Clinical Management\r | xiii | ||
| De Novo Malignancies After Transplantation: Risk and Surveillance Strategies\r | xiii | ||
| Metabolic Bone Disease in the Post-transplant Population: Preventative and Therapeutic Measures\r | xiii | ||
| Infectious Complications and Vaccinations in the Posttransplant Population\r | xiii | ||
| Selection and Postoperative Care of the Living Donor\r | xiv | ||
| Long-Term Functional Recovery, Quality of Life, and Pregnancy After Solid Organ Transplantation\r | xiv | ||
| Foreword Medical Care for Kidney and Liver Transplant Recipients\r | xv | ||
| Preface\rLong-Term Care of the Abdominal Organ Transplant Recipient: Pearls for the Primary Care Provider | xvii | ||
| Liver and Kidney Transplantation | 435 | ||
| Key points | 435 | ||
| INTRODUCTION | 435 | ||
| EARLY ATTEMPTS AT KIDNEY TRANSPLANTATION | 436 | ||
| SUCCESSFUL KIDNEY TRANSPLANTATION BEGINS | 436 | ||
| TRANSPLANTATION DEBATE DRIVES CHANGES IN LAW AND POLICY | 438 | ||
| NEXT MILESTONES MARKED BY ADVANCES IN IMMUNOSUPPRESSION | 438 | ||
| THE FASCINATING SAGA OF LIVER TRANSPLANTATION: MEMOIRS OF TWO SURGICAL PIONEERS | 439 | ||
| GENESIS OF LIVER TRANSPLANTATION | 440 | ||
| HUMAN LIVER TRIALS OF 1963 | 440 | ||
| LIVER TRANSPLANTATION MORATORIUM AND LATER RESUMPTION | 440 | ||
| NATIONAL INSTITUTES OF HEALTH APPROVAL OF LIVER TRANSPLANTATION AS A “VALID THERAPY” | 441 | ||
| CONVERSION TO TACROLIMUS | 441 | ||
| ORGAN PROCUREMENT AND PRESERVATION | 442 | ||
| DISPARITY BETWEEN ORGAN SUPPLY AND DEMAND | 442 | ||
| THE EVOLUTION OF LIVER ORGAN ALLOCATION AND DISTRIBUTION POLICIES | 443 | ||
| THE EVOLVING ROLE OF TRANSPLANT CENTER | 444 | ||
| THE FUTURE OF TRANSPLANTATION | 445 | ||
| REFERENCES | 445 | ||
| From Child-Pugh to Model for End-Stage Liver Disease | 449 | ||
| Key points | 449 | ||
| INTRODUCTION | 449 | ||
| HISTORICAL PERSPECTIVE: EVOLUTION OF ORGAN ALLOCATION POLICY | 450 | ||
| INDICATIONS FOR TRANSPLANT | 452 | ||
| Indications: Acute Liver Failure | 453 | ||
| Indications: Cirrhosis | 454 | ||
| Indications: Complications of Cirrhosis | 454 | ||
| Indications: Hepatocellular Carcinoma | 455 | ||
| Indications: Cholangiocarcinoma | 456 | ||
| Indications: Other | 456 | ||
| TRANSPLANT EVALUATION PROCESS | 456 | ||
| Cardiopulmonary Evaluation | 457 | ||
| Oncological Evaluation | 459 | ||
| Infectious Disease Evaluation | 459 | ||
| Nutrition | 459 | ||
| Drug/Alcohol Addiction | 460 | ||
| SUMMARY | 460 | ||
| REFERENCES | 460 | ||
| Renal Transplantation in Advanced Chronic Kidney Disease Patients | 465 | ||
| Key points | 465 | ||
| INTRODUCTION | 465 | ||
| KIDNEY ALLOCATION SYSTEM | 465 | ||
| KIDNEY TRANSPLANT WAIT LIST | 466 | ||
| RECIPIENT EVALUATION | 466 | ||
| PATIENT EDUCATION | 467 | ||
| EVALUATION OF FACTORS AFFECTING TRANSPLANT CANDIDACY | 467 | ||
| Cardiovascular Disease | 467 | ||
| Recurrent Glomerulonephritis | 469 | ||
| Peripheral Vascular Disease | 469 | ||
| Cerebrovascular Disease | 469 | ||
| Older Age | 469 | ||
| Active Infection | 471 | ||
| HIV | 471 | ||
| Hepatitis C | 471 | ||
| Hepatitis B | 472 | ||
| Noncompliance and Substance Abuse | 472 | ||
| Obesity | 472 | ||
| Highly Sensitized Patients | 473 | ||
| Repeat Transplanted Candidates | 473 | ||
| Other Important Factors | 473 | ||
| Simultaneous Kidney Pancreas Transplantation | 473 | ||
| SUMMARY | 475 | ||
| REFERENCES | 475 | ||
| Management of the Liver Transplant Recipient | 477 | ||
| Key points | 477 | ||
| INTRODUCTION | 477 | ||
| DEFINITION OF ALLOGRAFT DYSFUNCTION | 478 | ||
| DIFFERENTIAL DIAGNOSIS | 478 | ||
| Less than 1-month Posttransplant | 478 | ||
| Early graft dysfunction | 478 | ||
| Vascular complications | 479 | ||
| Biliary complications | 479 | ||
| Infectious complications | 479 | ||
| Through 12-months Posttransplant | 479 | ||
| Rejection | 479 | ||
| Cytomegalovirus | 480 | ||
| Recurrence of primary liver disease | 480 | ||
| Hepatitis C virus | 480 | ||
| Hepatitis B virus recurrence | 481 | ||
| Alcohol abuse | 481 | ||
| Hepatocellular carcinoma | 481 | ||
| Greater than 1 year Posttransplant | 481 | ||
| EVALUATION, ADJUSTMENT, AND RECURRENCE | 482 | ||
| OTHER CONSIDERATIONS DURING EVALUATION | 482 | ||
| MANAGEMENT | 483 | ||
| SUMMARY | 485 | ||
| REFERENCES | 485 | ||
| Acute and Chronic Allograft Dysfunction in Kidney Transplant Recipients | 487 | ||
| Key points | 487 | ||
| INTRODUCTION | 487 | ||
| SYMPTOMS | 488 | ||
| DIAGNOSTIC TESTING AND IMAGING STUDIES | 488 | ||
| Assessment of Allograft Function | 488 | ||
| Radiographic Imaging of the Kidney Allograft | 490 | ||
| Kidney Allograft Biopsy | 491 | ||
| EARLY POSTTRANSPLANT CAUSES OF ALLOGRAFT DYSFUNCTION (UP TO 6 MONTHS POSTTRANSPLANT) | 491 | ||
| Thrombosis | 492 | ||
| Hyperacute Rejection | 492 | ||
| Delayed Allograft Function and Acute Tubular Necrosis | 492 | ||
| Urinary Leaks | 493 | ||
| Urinary Obstruction | 493 | ||
| Acute Rejection | 494 | ||
| BK Virus Nephropathy | 495 | ||
| Thrombotic Microangiopathy | 495 | ||
| Medication-associated Acute Allograft Dysfunction | 495 | ||
| LATER CAUSES OF ALLOGRAFT DYSFUNCTION | 496 | ||
| Acute Rejection | 496 | ||
| Chronic Antibody-mediated Rejection | 497 | ||
| Transplant Renal Artery Stenosis | 497 | ||
| Recurrent Glomerulonephritis and Native Kidney Disease | 497 | ||
| Chronic Toxicity from Calcineurin Inhibitors and Other Medications | 498 | ||
| SUMMARY | 499 | ||
| REFERENCES | 499 | ||
| The ABCs of Immunosuppression | 505 | ||
| Key points | 505 | ||
| EARLY TRANSPLANTATION | 505 | ||
| EARLY IMMUNOSUPPRESSION | 506 | ||
| ENTER THE CALCINEURIN ERA | 506 | ||
| CURRENT IMMUNOSUPPRESSION | 506 | ||
| IMMUNOSUPPRESSION WITHIN THE IMMUNE SYSTEM | 507 | ||
| Calcineurin Inhibitors | 507 | ||
| Antiproliferative Agents | 509 | ||
| Antimetabolites | 509 | ||
| Mammalian target of rapamycin inhibitors | 510 | ||
| Corticosteroids | 511 | ||
| Costimulation Blockade | 511 | ||
| Antibodies | 512 | ||
| PHARMACOKINETICS | 513 | ||
| COMMONLY PRESCRIBED ADJUNCT AGENTS | 513 | ||
| Antibiotics and Antifungals | 513 | ||
| Antihypertensives | 513 | ||
| Hyperlipidemia | 514 | ||
| Mental Health | 514 | ||
| Over-the-counter Preparations and Herbals | 514 | ||
| Vaccinations and Preventive Health Care | 514 | ||
| COMPLICATIONS ASSOCIATED WITH CHRONIC USE OF IMMUNOSUPPRESSION | 515 | ||
| Nephrotoxicity | 515 | ||
| New-onset Diabetes Mellitus after Transplant | 515 | ||
| Cardiovascular Morbidity/Mortality | 515 | ||
| Malignancy | 517 | ||
| SUMMARY | 517 | ||
| REFERENCES | 517 | ||
| Managing Cardiovascular Risk in the Post Solid Organ Transplant Recipient | 519 | ||
| Key points | 519 | ||
| INTRODUCTION | 519 | ||
| EPIDEMIOLOGY OF CARDIOVASCULAR DISEASE IN SOLID ORGAN TRANSPLANT RECIPIENTS | 520 | ||
| TRADITIONAL AND NONTRADITIONAL RISK FACTORS | 521 | ||
| Hypertension | 521 | ||
| Diabetes Mellitus | 523 | ||
| Hyperlipidemia or Dyslipidemia | 524 | ||
| Tobacco Use | 526 | ||
| Obesity and the Metabolic Syndrome | 527 | ||
| NONTRADITIONAL RISK FACTORS | 527 | ||
| TRANSPLANT-RELATED RISK FACTORS | 527 | ||
| Immunosuppression | 527 | ||
| SUMMARY | 529 | ||
| REFERENCES | 529 | ||
| Diabetes Care After Transplant | 535 | ||
| Key points | 535 | ||
| INTRODUCTION | 535 | ||
| INPATIENT MANAGEMENT OF HYPERGLYCEMIA AFTER TRANSPLANTATION | 536 | ||
| TRANSITION FROM INPATIENT TO OUTPATIENT CARE | 536 | ||
| EVALUATION AND TREATMENT AFTER HOSPITAL DISCHARGE | 537 | ||
| New-Onset Diabetes After Transplantation: Definition and Diagnosis | 537 | ||
| Risk Factors for New-Onset Diabetes After Transplantation | 538 | ||
| Effect of Immunosuppressive Drugs on New-Onset Diabetes After Transplantation | 538 | ||
| Corticosteroids | 538 | ||
| Antiproliferative agents | 538 | ||
| Calcineurin inhibitors | 538 | ||
| Mammalian target of rapamycin inhibitors | 539 | ||
| Belatacept | 539 | ||
| MANAGEMENT STRATEGIES FOLLOWING DISCHARGE | 539 | ||
| GLYCEMIC MANAGEMENT OF HYPERGLYCEMIC TRANSPLANT PATIENTS | 540 | ||
| Metformin | 540 | ||
| Sulfonylureas and Glinides | 542 | ||
| Alpha-glucosidase Inhibitors | 543 | ||
| Thiazolidinediones | 543 | ||
| Dipeptidyl Peptidase-4 Inhibitors | 543 | ||
| Glucagon-like peptide 1 receptor agonists | 543 | ||
| Sodium-glucose Cotransporter 2 Inhibitors | 544 | ||
| Insulin | 544 | ||
| Additional Considerations | 544 | ||
| SUMMARY | 545 | ||
| REFERENCES | 545 | ||
| De Novo Malignancies After Transplantation | 551 | ||
| Key points | 551 | ||
| INTRODUCTION | 551 | ||
| INCIDENCE AND MORTALITY | 552 | ||
| RISK FACTORS FOR ALL MALIGNANCIES | 553 | ||
| SPECIFIC MALIGNANCIES | 553 | ||
| Skin Cancer | 553 | ||
| Posttransplant Lymphoproliferative Disorder | 555 | ||
| Solid Organ Tumors | 556 | ||
| Head and neck cancer | 556 | ||
| Lung cancer | 556 | ||
| Renal cell carcinoma, bladder, and prostate cancer | 558 | ||
| Hepatocellular carcinoma | 559 | ||
| Colorectal cancer | 559 | ||
| Anogenital malignancies | 560 | ||
| Breast cancer | 560 | ||
| SURVEILLANCE STRATEGIES | 560 | ||
| SUMMARY | 561 | ||
| REFERENCES | 561 | ||
| Metabolic Bone Disease in the Post-transplant Population | 569 | ||
| Key points | 569 | ||
| INTRODUCTION | 569 | ||
| EPIDEMIOLOGY: BONE MINERAL DENSITY AND FRACTURE RISK | 570 | ||
| CAUSES OF POST-TRANSPLANT BONE DISEASE | 570 | ||
| Pretransplantation | 570 | ||
| Risks also seen in the general population | 570 | ||
| Risks contributed by underlying diseases to bone abnormalities | 571 | ||
| Diabetes mellitus | 571 | ||
| Systemic lupus erythematosus | 571 | ||
| Human immunodeficiency virus disease | 571 | ||
| Medications associated with osteoporosis | 571 | ||
| Chronic kidney disease–mineral and bone disorder | 571 | ||
| Hepatic osteodystrophy | 572 | ||
| Post-transplantation | 572 | ||
| Simultaneous pancreas-kidney transplantation | 573 | ||
| Immunosuppressive drugs | 573 | ||
| Glucocorticoids | 573 | ||
| Calcineurin inhibitors | 574 | ||
| Other immunosuppressive agents | 575 | ||
| New-onset diabetes after transplantation | 575 | ||
| MONITORING AND INVESTIGATING POST-TRANSPLANT BONE DISEASE | 575 | ||
| Biochemistry | 575 | ||
| Kidney | 575 | ||
| Liver | 575 | ||
| Bone Biomarkers | 576 | ||
| Imaging | 576 | ||
| Bone Biopsy | 577 | ||
| TREATMENT | 577 | ||
| General | 577 | ||
| Pretransplantation | 577 | ||
| Post-transplantation | 578 | ||
| Steroid withdrawal and avoidance | 579 | ||
| Hormone replacement therapy | 579 | ||
| Pharmaceutical intervention | 579 | ||
| OSTEONECROSIS/AVASCULAR NECROSIS | 581 | ||
| SUMMARY | 581 | ||
| REFERENCES | 581 | ||
| Infectious Complications and Vaccinations in the Posttransplant Population | 587 | ||
| Key points | 587 | ||
| INTRODUCTION | 587 | ||
| GENERAL PRINCIPLES OF INFECTIONS AFTER LIVER OR KIDNEY TRANSPLANTATION | 588 | ||
| It Is More Difficult to Recognize an Infection in Transplant Recipients | 588 | ||
| There Are a Wide Variety of Infections That a Transplant Recipient Is at Risk for, Both Common and Uncommon | 588 | ||
| There Are Important Limitations in Diagnostic Tools Among Transplant Recipients | 588 | ||
| The Treatment of Many Infections After Liver and Kidney Transplant May Be Toxic and Complex and May Require Invasive Procedures | 589 | ||
| RISK FACTORS FOR INFECTIONS AFTER KIDNEY AND LIVER TRANSPLANT | 589 | ||
| Latent and Active Infections in the Recipient | 589 | ||
| Latent and Active Infections in the Donor | 590 | ||
| Operative Complications and Organ Quality | 590 | ||
| Immunosuppressive Therapies | 590 | ||
| TIMELINE OF INFECTIONS AFTER LIVER AND KIDNEY TRANSPLANT | 590 | ||
| INFECTIONS IN THE FIRST MONTH POSTTRANSPLANT | 591 | ||
| INFECTIONS BETWEEN 1 AND 6 MONTHS POSTTRANSPLANT | 592 | ||
| INFECTIONS AFTER 6 MONTHS POSTTRANSPLANT | 593 | ||
| DISEASE PREVENTION: PROPHYLAXIS AND VACCINES | 594 | ||
| Prophylaxis | 594 | ||
| Vaccination in the Transplant Recipient | 595 | ||
| Vaccination of Close Contacts of the Transplant Recipient | 595 | ||
| REFERENCES | 596 | ||
| Selection and Postoperative Care of the Living Donor | 599 | ||
| Key points | 599 | ||
| INTRODUCTION | 599 | ||
| PATIENT PREPARATION | 601 | ||
| INDICATIONS/CONTRAINDICATIONS | 601 | ||
| Age | 601 | ||
| Obesity | 604 | ||
| Hypertension | 604 | ||
| At Risk for Diabetes | 604 | ||
| Controversies for Potential Liver Donors | 604 | ||
| After Procedure Care | 605 | ||
| Outcomes and Evidence | 605 | ||
| Risks Specific to Kidney Donation | 605 | ||
| Risks Specific to Liver Donation | 608 | ||
| REFERENCES | 608 | ||
| Long-Term Functional Recovery, Quality of Life, and Pregnancy After Solid Organ Transplantation | 613 | ||
| Key points | 613 | ||
| INTRODUCTION | 614 | ||
| FUNCTIONAL RECOVERY | 614 | ||
| Cognitive Function | 614 | ||
| Physical Function | 614 | ||
| Employment | 615 | ||
| HEALTH-RELATED QUALITY OF LIFE | 615 | ||
| PREGNANCY IN KIDNEY AND LIVER TRANSPLANT RECIPIENTS | 617 | ||
| Female Fertility and Contraception After Transplantation | 617 | ||
| Timing of Pregnancy | 617 | ||
| Teratogenic Risk of Immunosuppressive Drugs | 618 | ||
| Pregnancy Outcomes in Kidney Transplant Recipients | 618 | ||
| Maternal and newborn outcomes | 618 | ||
| Graft function | 618 | ||
| Pregnancy Outcomes in Liver Transplant Recipients | 621 | ||
| Maternal and newborn outcomes | 621 | ||
| Graft function | 621 | ||
| Labor and Delivery and Postnatal Care | 621 | ||
| Breastfeeding | 622 | ||
| Management Options | 623 | ||
| Male Transplant Recipients and Parenthood | 624 | ||
| Long-Term Follow-Up of Offspring | 624 | ||
| SUMMARY | 624 | ||
| ACKNOWLEDGMENTS | 625 | ||
| REFERENCES | 625 | ||
| Index | 631 |