62 colvin rb eye of the needle am j transplant

62. Colvin RB. Eye of the needle. Am J Transplant 2007;7:267.
63. Karpinski J, Lajoie G, Cattran D, Fenton S, Zaltzman J, Cardella C, Cole E. Outcome of
kidney transplantation from high-risk donors is determined by both structure and function.
Transplantation 1999;67:1162.
64. Nankivell BJ, Borrows RJ, Fung CL, O’Connell PJ, Allen RD, Chapman JR. Natural history,
risk factors, and impact of subclinical rejection in kidney transplantation. Transplantation
2004;78:242.
65. Kee TY, Chapman JR, O’Connell PJ, Fung CL, Allen RD, Kable K, Vitalone MJ, Nankivell
BJ. Treatment of subclinical rejection diagnosed by protocol biopsy of kidney transplants.
Transplantation 2006;82:36.
66. Cosio FG, Grande JP, Wadei H, Larson TS, Griffin MD, Stegall MD. Predicting subse-
quent decline in kidney allograft function from early surveillance biopsies. Am J Transplant
2005;5:2464.
67. Haas M, Montgomery RA, Segev DL, Rahman MH, Racusen LC, Bagnasco SM, Simpkins
CE, Warren DS, Lepley D, Zachary AA, Kraus ES. Subclinical acute antibody-mediated
rejection in positive crossmatch renal allografts. Am J Transplant 2007;7:576.
68. Hoffmann SC, Hale DA, Kleiner DE, Mannon RB, Kampen RL, Jacobson LM, Cendales LC,
Swanson SJ, Becker BN, Kirk AD. Functionally significant renal allograft rejection is defined
by transcriptional criteria. Am J Transplant 2005;5:573.
J.R. Torrealba and M.D. Samaniego

Chapter 13
Evaluation of the Kidney Transplant Candidate
and Follow-Up of the Listed Patient
Roy D. Bloom and Alden M. Doyle
The Pre-transplant Evaluation and Follow-Up of the Listed
Patient
The most fundamental aspect of the entire transplant course is the pre-transplant
evaluation of the potential kidney recipient. The pre-transplant evaluation is the
initial step that triggers a sequence of events and actions, resulting in the wait-
listing and eventual transplantation of patients, with the primary outcome goals of
enhancing quality of life and/or prolonging life expectancy. In this chapter, we shall
provide an overview of the process involved in getting transplant candidates through
their evaluation onto the waiting list and their subsequent transplant center-relevant
management until they are transplanted.
Introduction
The purpose of the transplant evaluation is to identify, educate, and prepare suitable
candidates for transplantation. It is increasingly important for physicians who care
for patients with kidney disease to be familiar with the evaluation process so that
they can help their patients make the best informed medical decisions. For exam-
ple, awareness of the minimum criteria for listing and transplantation should trigger
opportune discussions between nephrologists and their patients, followed by refer-
ral for a transplant evaluation in a time frame that anticipates listing for a kidney as
soon as the patient is eligible. This is particularly true as the average waiting times
for deceased donor kidneys have continued to grow, reflective of the burgeoning
disparity between organ demand and supply. Long wait times for these organs have,
in turn, driven the development of new strategies to increase the supply of suitable
organs and better match these organs with potential recipients. The pre-transplant
R.D. Bloom (
B
)
Kidney Transplant Program, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
e-mail: [email protected]
191 D.B. McKay, S.M. Steinberg (eds.), Kidney Transplantation: A Guide to the Care
of Kidney Transplant Recipients , DOI 10.1007/978-1-4419-1690-7_13,