Challenges in pediatric kidney transplantation : a practical guide / / edited by Katherine E. Twombley

• Record Nr.: UNINA9910488710503321
• Pubbl/distr/stampa: Cham, Switzerland : , : Springer, , [2021]; ©2021
• ISBN: 3-030-74783-2
• Descrizione fisica: 1 online resource (429 pages)
• Disciplina: 617.9540083
• Soggetti: Pediatric nephrology; Kidneys - Transplantation; Transplantation of organs, tissues, etc. in children; Trasplantament renal; Nefrologia pediàtrica; Trasplantament d'òrgans; Llibres electrònics
• Lingua di pubblicazione: Inglese
• Formato: Materiale a stampa
• Livello bibliografico: Monografia
• Note generali: Includes index.
• Nota di contenuto: Intro -- Contents -- Contributors -- Part I: Immunologic Challenges -- 1: Immunologic Challenges Pre-transplant -- Introduction -- What Is Human Leukocyte Antigen (HLA)? -- Pre-transplant -- How Does Sensitization Occur? -- Why Is HLA Compatibility Important? -- Epitope Mismatch -- How Are HLA Antibodies Detected and HLA Matching Performed? -- Antibody Detection -- Cell-Based Assays -- Solid-Phase Assays -- Is Median Fluorescent Intensity (MFI) Signal a Surrogate Measure of the Level of HLA Antibody? -- Peri-transplant -- The Virtual Crossmatch (vXM) in Transplantation -- Unexpected Crossmatch Scenarios -- Clinical Scenarios and Interpretation of Crossmatch Results in Kidney Transplantation -- Conclusion -- Questions and Answers with Explanation -- References -- 2: Challenges in Post-transplant Immunologic Monitoring -- Challenges in Post-transplant Immunologic Monitoring -- Conventional Monitoring Post-Transplant -- Serum Creatinine (Graft Function) -- Drug Monitoring and Variability -- Surveillance Monitoring of Donor-Specific Antibodies -- Non-HLA ; Antibodies -- Surveillance Biopsies (SBs) -- Innovative Biomarkers for Immunologic Monitoring Post-transplant -- Donor-Derived Cell-Free DNA (dd-cfDNA) -- Urinary Biomarkers -- Molecular Diagnostics -- The Future of Post-transplant Immune Monitoring -- Q&amp -- A -- Bibliography -- 3: Rejection Challenges: Diagnosis and Management -- A Brief History of Rejection -- An Evolving Paradigm of Rejection: From Discreet Episodic Events to a Fluctuating Continuum of Immune Alloreactivity -- Pathophysiology of Alloimmune Activation and Downstream Processes -- T Cell Development and Activation -- T Cell Migration and Mechanisms of Injury in T Cell-Mediated Rejection with the Allograft -- B Cell Development and Activation -- Alloantibodies and Antibody-Mediated Rejection -- Alloimmune Chronicity.; Detecting Rejection and Monitoring Its Course -- Clinical Monitoring and Biopsy Indication -- Surveillance Biopsies -- Follow-Up Biopsies -- Biomarkers for Rejection -- Gene Expression Signatures -- Chemokines -- Metabolomics -- Cell-Free DNA -- Predisposing Risk Factors for Rejection -- Recipient-Related Risks -- Donor-Recipient Interface -- Donor-Related Risks -- Silent Sensitization -- HLA Mismatch -- Post-transplant Factors -- Hyperacute Rejection -- Acute T Cell-Mediated Rejection (TCMR) -- Clinical and Histological Features -- Treatment of TCMR -- Corticosteroids -- Lymphocyte-Depleting Therapies -- Late Acute TCMR -- B Cell-Rich and Plasma Cell-Rich Acute Rejection -- B Cell-Rich Rejection -- Plasma Cell-Rich Acute Rejection -- Active Antibody-Mediated Rejection (AMR) -- Clinical and Histological Features -- Treatment of AMR -- Plasmapheresis and IVIG -- Rituximab -- Bortezomib -- Emerging Treatments -- Response to Treatment -- Chronic Active TCMR -- Clinical and Histological Features -- Management -- Chronic Active AMR -- Clinical and Histological Features -- Management -- Emerging Therapies -- Post Rejection Infection Prophylaxis -- Special Circumstances: Infection and Rejection -- AGPN and Rejection -- BK Virus and Rejection -- Case Studies -- References -- Part II: Infectious Challenges -- 4: Pretransplant Donor and Recipient Infectious Challenges -- Pretransplant Infectious Disease Evaluation -- Evaluation of the Pediatric Kidney Transplant Candidate -- HIV and Hepatitis Viruses -- Cytomegalovirus/Epstein-Barr Virus Serostatus of Donor and Recipient -- Cytomegalovirus -- Epstein-Barr Virus -- Mycobacterium tuberculosis -- Fungal Infections and Endemic Mycoses -- Parasitic Infections -- COVID-19 -- Urinary Tract Infections -- PHS Increased Risk Donors -- Window Period Duration and the Risk of Virus Transmission.; Outcomes of PHS Increased Risk Donors in Pediatric Kidney Transplantation -- Informed Consent -- Posttransplant Testing -- Immunizations -- Preparing the Dialysis Patient for Transplantation -- Vaccine Schedule: Current American Academy of Pediatrics Recommendations -- Summary of recommendations with end stage kidney disease, including transplant candidates [62-64] -- Hepatitis B -- Influenza Vaccine -- Pneumococcal Vaccine [68, 69] -- Special Situations [70, 71] -- Household/Live Donor Vaccination -- Live Vaccines -- Varicella Vaccine -- Measles-Mumps-Rubella Vaccine -- Recombinant and Inactivated ("Killed") Vaccines -- DTaP/Tdap/dT Vaccine -- Poliovirus Vaccine -- Haemophilus Influenzae Type B Vaccine -- Hepatitis A Vaccine -- Hepatitis B Vaccine -- Meningococcal Vaccine -- Human Papillomavirus -- Updating Immunizations for the Dialysis Patient Awaiting Transplant -- Questions -- References -- 5: Post-transplant Recipient Infectious Challenges -- Introduction -- Opportunistic Post-Kidney Transplant Infections (CMV, EBV, and BK ; Virus and PJP) -- Cytomegalovirus (CMV) -- Risk Factors -- Clinical Presentation -- Screening -- Prophylaxis and Preemptive Therapy -- Treatment -- BK Virus -- Risk Factors -- Clinical Presentation -- Screening -- Treatment -- Epstein-Barr Virus -- Risk Factors -- Clinical Presentation -- Screening -- Treatment -- Pneumocystis jirovecii pneumonia (PJP) -- Resurgent Viral Infection Outbreaks: Measles and Mumps -- Cancer Risks -- Cancer Incidence -- Cancer Risk Factors -- Immunosuppression Burden -- EBV Recipient-Donor Sero-Mismatch -- Time Since Transplant -- HLA Haplotypes -- Pre-transplant Malignancy -- Age -- Gender -- Race -- Donor Source -- Recombinant Growth Hormone (rGH) Use -- Cancer Prevention Strategies -- Cancer Treatment -- Cancer Outcomes -- Urinary Tract Infections (UTI) -- Prevalence -- Risk Factors.; Prevention -- Treatment -- Asymptomatic Bacteriuria -- Outcomes -- MOC Questions -- References -- Part III: Disease Challenges -- 6: Urological Considerations for Pediatric Renal Transplantation: CAKUT Challenges -- Urological Complications Post-transplant -- References -- 7: Rheumatologic Challenges -- Systemic Lupus Erythematosus -- Introduction -- Clinical Course of Renal Involvement and Outcomes -- Renal Transplantation in Lupus Nephritis -- Recurrence of Lupus Nephritis Post-transplantation -- Health Disparities in Systemic Lupus Erythematosus and Lupus Nephritis -- Conclusion -- IgA Vasculitis -- Introduction -- Clinical Course of Renal Involvement and Outcomes -- Renal Transplantation in IgAV Nephritis and Outcomes -- ANCA-Associated Vasculitis -- Introduction -- Clinical Course of Renal Involvement and Outcomes -- Renal Transplantation in Childhood AAV and Outcomes -- Conclusion -- References -- 8: Recurrent Disease Challenges in Pediatric Kidney Transplantation -- Introduction -- Atypical Hemolytic Uremic Syndrome (aHUS) -- Nature and Frequency of Primary Disease -- Considerations for Transplant Planning -- Risk Factors for Recurrence and Treatment of Recurrence -- Risk of Disease Recurrence in the Era of Eculizumab -- Additional Post-transplant Considerations -- C3 Glomerulopathy (C3G) -- Nature and Frequency of C3G -- Considerations for Transplant Planning -- Risk Factors for Recurrence and Treatment of C3G Recurrence -- IgA Nephropathy -- Nature and Frequency of IgA Nephropathy (IgAN) -- Risk Factors for Recurrence -- Considerations for Transplant Planning -- Treatment of IgAN Recurrence -- Impact of IgAN on Graft Function and Survival -- IgA Vasculitis (Henoch-Schonlein Purpura) -- Lupus Nephritis -- Nature and Frequency of Disease -- Risk for Disease Recurrence -- Considerations for Transplant Planning.; Impact of RLN on Graft Function and Survival -- Other Diseases -- Primary Hyperoxaluria Type 1 (Oxalosis) -- Membranous Nephropathy -- Conclusion -- References -- 9: Nephrotic Syndrome Challenges: An Old Recurring Problem -- APOL1 -- Mechanism of Renal Injury -- Second Hit Modifiers -- Clinical Implications -- Pre-transplant Nephrectomy -- Proteinuria -- WT1 Mutation -- Disease Recurrence -- Genetic Mutations -- Living vs Deceased Donation -- Clinical Features Predictive of DR -- Circulating Factor and DR -- Treatment of Disease Recurrence -- Plasmapheresis -- Immunoadsorption -- Rituximab -- Cyclosporine -- Lipid Apheresis -- Questions -- Bibliography -- 10: Challenges of Maintaining Adequate Health and Well-Being, Growth, Nutrition, and Development in Pediatric Transplant Recipients -- Vaccinations -- Pre-transplant -- Post-transplant -- Vaccines and Travel -- Nutritional Challenges -- Pre-transplant -- CKD 2-5 Pre-dialysis -- Hemodialysis -- Peritoneal Dialysis -- Nutritional Management in CKD and Dialysis -- Enteral Nutrition Support -- Post-transplant -- Appetite and Weight -- Transition from Enteral to Oral ; Feeding -- Medication Effects -- Nutritional Management Post-transplant -- Food Safety -- Growth Challenges -- Growth Hormone Physiology -- Growth and CKD -- Growth After Kidney Transplant -- Outcomes -- Growth Hormone Utilization -- Indications and Contraindications for Growth Hormone -- Work-Up, Treatment, and Monitoring -- Work-Up -- Treatment -- Monitoring -- Safety of Growth Hormone in Transplant Recipients -- Metabolic Bone Disease -- Pathophysiology of CKD-BMD -- Bone Mineral Monitoring -- Post-transplant Bone Metabolism -- PTH, FGF-23, and Hypophosphatemia -- Hypomagnesemia -- Vitamin D -- Immunosuppression -- Role of Sex Hormones -- Prevention Strategies -- Steroid Minimization -- Diet and Physical Activity -- Treatment.; Pharmacologic Therapies.