Medical Complications of Kidney Transplantation PDF
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Today kidney transplantation is considered to be the treatment of choice for most patients with end stage renal disease. Yet, in spite of the tremenous advances in immunosuppressive and supportive therapies, the task of transplant clinicians remains very difficult as the morbidity related to kidney transplantation may encompass almost all branches of internal medicine. On the other hand, the recent introduction of newer immunosuppressive drugs and supportive treatments as well as the discovery of new complications that may affect the transplant recipients has considerably modified the results and the clinical scenario of kidney transplantation in the last few years. This book is designed to acquaint the clinicians with the most frequent problems that may occur after renal transplantation. The typology of the kidney donor and the transplant recipient, which has considerably changed in the recent period, is covered in the first two chapters of the book. Five chapters are focused on the kidney allograft complications and include delayed graft function, acute rejection, chronic allograft nephropathy, recurrent primary diseases and de novo renal diseases. A special chapter is devoted to the toxicity of the currently available immunosuppressive drugs. Three large chapters deal with the most worrying extra-renal complications that may affect the kidney transplant recipient, namely infection, cardiovascular disease and malignancy. The remaining chapters describe the many disorders that may affect the different organs and systems, so impairing the quality of life expectancy of a renal transplant recipient. It is my hope that the compilation of this material into one volume may be useful to clinicians who are treating renal transplant patients in their daily practice. Appropriate illustrative material and tables have been generously provided. Someone may criticize the fact that this monograph has been written by a single author. This should not be interpreted as a sin of presumption but as an attempt to avoiding discrepancies or conflicting views among different co-authors in a complicated area as renal transplantation is. I have to acknowledge that the preparation of this monograph would have been impossible without the collaboration of the many doctors, nurses, and patients who lived with me a long fight against renal disease. I wish to deeply thank all of them. A special thought to Antonio Tarantino a skilful clinician who spent most of his professional life in the care of renal transplant patients, and to my other colleagues involved in kidney transplantation Giuseppe Montagnino, Adriana Aroldi, Maria Rosaria Campise, Patrizia Passerini. My gratitude goes to Antonio Vegeto, Luisa Berardinelli and their surgical team for their excellent collaboration. Particular thanks to Giovanni Banfi, a great expert of clinical nephrology and renal histology, who provided most of the figures of the book.