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Overview of care of the adult kidney transplant recipient

Anil Chandraker, MD, FASN, FRCP
Section Editor
Daniel C Brennan, MD, FACP
Deputy Editor
Albert Q Lam, MD


Kidney transplantation is the treatment of choice for end-stage renal disease [1]. A successful kidney transplant improves the quality of life and reduces the mortality risk for most patients when compared with maintenance dialysis [2-4]. However, patients require close follow-up after transplantation since they are on complex immunosuppressive regimens that render them susceptible to infection, malignancy, and cardiovascular disease (CVD). In addition, patients often have multiple comorbidities due to, or as a cause of, their underlying end-stage renal disease.

Whereas patients are generally followed by a transplant specialist for the first three to six months following transplant, thereafter they may be seen primarily by a general nephrologist or internist, who is often able to address existing comorbidities. Whether a patient is followed by a transplant nephrologist, general nephrologist, or internist often depends upon the availability of services in proximity to the patient. While many believe that transplant nephrologists should be directly involved in care of transplant recipients for the life of the graft, this is often not practical. Communication between the internist or community-based nephrologist and the transplant center is important for optimal care of the patient, however.

This topic reviews the general medical care of the kidney transplant recipient including recommendations for monitoring allograft function and minimizing the risk of infections, malignancies, bone disease, CVD, and diabetes. Common medical problems encountered after transplantation are also discussed.

Maintenance immunosuppressive therapy, allograft dysfunction, and patient survival following transplantation are discussed separately. (See "Maintenance immunosuppressive therapy in renal transplantation in adults" and "Chronic renal allograft nephropathy" and "Patient survival after renal transplantation".)

Specific complications of transplantation are discussed separately. (See "Urinary tract infection in renal transplant recipients" and "Hepatitis B virus infection in renal transplant recipients" and "Lipid abnormalities after renal transplantation" and "Prevention and management of BK virus-induced (polyomavirus-induced) nephropathy in kidney transplantation" and "Hepatitis C infection in kidney transplant candidates and recipients" and "Hepatitis C virus infection in kidney donors" and "Hypertension after renal transplantation".)


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Literature review current through: Nov 2016. | This topic last updated: Fri Nov 25 00:00:00 GMT+00:00 2016.
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