Related Experiment Video
Updated: Dec 26, 2025
07:13
Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
Published on: April 12, 2021
4.8K
Dialysis after graft loss: a Swiss experience
Marco Bonani1, Rita Achermann2, Harald Seeger1
1Division of Nephrology, University Hospital Zürich, Zürich, Switzerland.
Summary
Patients returning to dialysis after kidney transplant graft loss face high mortality. Early graft loss significantly increases the risk of death and the need for nephrectomy and re-transplantation.
Area of Science:
- Nephrology
- Transplantation immunology
- Clinical outcomes research
Background:
- Graft loss following renal transplantation is associated with significant patient morbidity and mortality.
- Understanding outcomes for patients returning to dialysis after graft failure is critical for improving care.
Purpose of the Study:
- To describe current practices and outcomes for patients experiencing graft loss in Switzerland.
- To compare outcomes between early (within 1 year) and late graft loss.
Main Methods:
- Analysis of data from the Swiss Transplant Cohort Study (May 2008 - Dec 2014).
- Inclusion of patients with renal allografts who experienced graft loss, excluding primary non-function.
- Categorization into early (<1 year) and late (>1 year) graft loss groups.
Main Results:
- 77/1502 patients lost their graft; 40 experienced early graft loss.
- 11 patients died within 30 days of allograft loss; 3-year patient survival was 74%.
- Patients initiating hemodialysis with definitive vascular access had lower mortality (HR=0.28) compared to those with catheters. Early graft loss correlated with higher rates of nephrectomy and re-transplantation.
Conclusions:
- Graft loss necessitates high rates of allograft nephrectomy and re-transplantation, with substantial early mortality.
- Definitive vascular access for hemodialysis is associated with improved survival post-graft loss.
- The interplay between immunosuppression reduction, nephrectomy, and re-transplantation outcomes requires further investigation.
Related Concept Videos
01:25Hemodialysis I: Introduction
1.0K
Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
1.0K
01:26Kidney Transplant II: Surgical Procedure
237
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
237
01:28Kidney Transplant I: Introduction
266
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
266
01:24Hemodialysis II: Procedure and Complications
474
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
474
01:16Kidney Transplant III: Nursing Management
263
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
263
01:27Dialysis
1.1K
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
1.1K