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Strategies for ensuring effective surveillance in post‐transplant patients: practical organization and clinical evaluation
Author(s) -
Jurewicz W. Adam,
Miles Andrew
Publication year - 2004
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/j.1365-2753.2003.00408.x
Subject(s) - medicine , chronic allograft nephropathy , calcineurin , intensive care medicine , tacrolimus , transplantation , context (archaeology) , disease , nephropathy , kidney transplantation , surgery , diabetes mellitus , paleontology , biology , endocrinology
Results of renal transplantation have improved steadily over the years. This article reviews the current status of patient and graft survival and discusses major causes of mortality and renal allograft failure. Review of recent literature demonstrates that the traditional enemies of transplantation, acute rejection and opportunistic infections are no longer major problems facing transplantation. Chronic graft nephropathy and death with functioning graft due to cardiovascular disease are the main challenges in the current era. An impact of an early graft thrombosis, recurrent renal disease and post‐transplant malignancies are also reviewed. Chronic graft nephropathy is examined in a context of differences between two calcineurin inhibitors, cyclosporin microemulsion and tacrolimus. Strategies of post‐transplant surveillance are suggested.