BookDuck Jong Han, editor.
Summary: This book presents state of the art knowledge on all aspects of kidney transplantation in recipients in whom desensitization strategies are necessary in order to overcome immunologic barriers such as anti-human leukocyte antigen (HLA) donor-specific antibody and ABO blood group incompatibility. Readers will find detailed, up-to-date information on the various immunomodulating therapies that may be employed in these circumstances and the outcomes that may be expected. Full guidance is provided on preoperative evaluation and management and post-transplantation care. In addition, the pathology of antibody-mediated rejection and acute cellular rejection in this context is discussed. For most patients with end-stage renal disease, kidney transplantation offers significant benefits compared with dialysis, but especially sensitization to HLAs remains a major clinical obstacle to success. Kidney Transplantation in Sensitized Patients will assist in achieving optimal results in individual patients. It will be an important resource for everyone involved in the care of kidney transplant recipients.
Contents:
Intro; Contents;
1: Introduction to Kidney Transplantation in sensitized patients; Definition of Sensitization; Donor-Specific Antibody (DSA); Non-HLA Antibody; Histocompatibility Testing and Virtual Crossmatching; Epitope; Prevalence of Sensitization in Kidney Transplantation; Causes of Sensitization; Approach to the Highly Sensitized Candidate; Allocation System; Acceptable Mismatch Program; Desensitization; Kidney Paired Exchange; Conclusion; References;
2: Preoperative Evaluation of Sensitized Patients; HLA Typing; Serologic Typing; Molecular Typing; HLA Antibody Testing Complement-Dependent Cytotoxicity CrossmatchTest Principle and Methods; Interpretation; Flow Cytometry Crossmatch; Principle; Methods; Interpretation; Solid Phase Immunoassay; Principle; Methods; Interpretation; Limitations; C1q SAB Assay; Principle; Methods; Interpretation; Limitations; Epitope Analysis; Correlation of Each Methodology; Cases of Sensitized Patients; A Case with Low-Level Anti-Class I and -Class II HLA Antibodies; A Case with High-Level Anti-Class II HLA Antibodies; A Case with CDC(+) and C1q(+) Anti-HLA Antibodies but with Stable Postoperative Course A Case with High-Level Anti-Class II HLA Antibodies with Postoperative DSA(-) ABMRReferences;
3: Preoperative Management (Desensitization); Overview of Desensitization Protocol; Plasmapheresis or Immunoadsorption for Desensitization; IVIG for Desensitization; Rituximab for Desensitization; Proteasome Inhibitors for Desensitization; Complement Inhibitors for Desensitization; Anti-IL-6 Receptor Blockers for Desensitization; IgG-Degrading Enzyme of Streptococcus pyogenes (IdeS) for Desensitization; References
4: Induction and Maintenance Immunosuppressants in Sensitized Renal Allograft RecipientsIntroduction; Induction Immunosuppressive Regimen; Antithymocyte Globulin; Rituximab; Bortezomib; Alemtuzumab; Maintenance Immunosuppression; Conclusion; References;
5: Postoperative Management; Monitoring and Prevention of Infectious Disease; Cytomegalovirus; BK Virus; Management of Hyperglycemia; Management of Hypertension; Management of Dyslipidemia; References;
6: Complication from Desensitization; Complication from Rituximab; Infection; AMC Case of Hepatitis in Anti-CD20; Rejection; Lung Disease Cardiac DiseaseOthers; Acute Thrombocytopenia; Complication from Bortezomib; GI Toxicity; Peripheral Neuropathy; Hematologic Toxicity; Compensatory Humoral Reaction; Others; Complication from IVIg; Thromboses; Hemolysis; Myocardial Infarction; Others; Complication from Eculizumab; Infection; Others; Complication from C1 Esterase Inhibitor (C1 INH); Infection; Others; Complication from IgG Endopeptidase (IdeS); Rebound Antibody Reaction; Immunogenicity of IdeS; Infection; Complication from Anti-IL-6R mAb (Tocilizumab: TCZ); Infection; Others; Complication from Plasmapheresis