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Chapter-03 Kidney Transplant Recipient Evaluation: Outcome Based Approach

BOOK TITLE: Kidney & Pancreas Transplantation

Author
1. Bhaskaran Madhu
2. Ali Nicole
3. Basu Amit
4. Siskind Eric J
5. Sagar Ankita
6. Smith Patrick R
7. Agorastos Stergiani
8. Rajendran Prejith P
9. Ramadas Poornima
10. Krishnan Prathik
11. Amodu Leo
12. Cagliani Joaquin
13. Radtke Arnold
14. Sgourakis George
15. Mendez Jr Marcelo
ISBN
9789351523390
DOI
10.5005/jp/books/12547_4
Edition
1/e
Publishing Year
2015
Pages
6
Author Affiliations
1. North Shore-LIJ Health System; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York, USA
2. North Shore-LIJ Health System, Hempstead, New York, USA
3. North Shore-LIJ Health System, Hempstead, New York, USA
4. North Shore-LIJ Health System, Hempstead, New York, USA
5. North Shore-LIJ Health System, Hempstead, New York, USA
6. Center for Learning and Innovation, North Shore-LIJ Health System, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York, USA
7. Feinstein Institute for Medical Research, North Shore-LIJ Health System, Hempstead, New York, USA
8. North Shore-LIJ Health System, Hempstead, New York, USA
9. North Shore-LIJ Health System, Hempstead, New York, USA
10. North Shore-LIJ Health System, Hempstead, New York, USA
11. North Shore-LIJ Health System, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York, USA
12. North Shore-LIJ Health System, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York, USA
13. University of Muenster, Muenster, Germany
14. Korgialenion-Benakion, Red Cross Hospital, Athens, Greece
15. Mount Sinai Beth Israel Hospital, New York, New York, USA
Chapter keywords
end-stage renal disease, ESRD, risk evaluation, cancer screening, compliance screening, cardiovascular event, coagulopathy, perioperative mortality

Abstract

This chapter discusses about the kidney transplant recipient evaluation based on transplantation outcomes. Factors affecting perioperative outcome as well as long-term post-transplant outcome are to be addressed to ensure a smooth perioperative and optimal post-transplant course for the recipient. Factors affecting perioperative mortality include life-threatening cardiovascular event, coagulopathy causing bleeding, severe pre-existing lung disease, fatal gastrointestinal bleeding, and postoperative infection causing sepsis. Factors affecting prolonged hospital stay include nonfatal acute coronary event, postoperative pneumonia causing respiratory failure, postoperative bleeding-operative site or gastrointestinal requiring transfusion, or mechanical complications related to surgery. Categories comprehensively address the outcome based approach to recipient evaluation include cardiovascular risk evaluation, cancer screening, compliance screening, infectious diseases, imaging, nutritional evaluation, financial evaluation, and social work evaluation. Pre- end-stage renal disease, ESRD patients pose a special risk of contrast nephropathy pushing them into dialysis and risk versus benefit consideration often requires a detailed discussion with the primary nephrologist, cardiologist and the informed patient.

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