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Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
Published on: April 12, 2021
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Evolving indications and management patterns in heart - kidney transplantation
Frederick M Lang1, Veli K Topkara2
1Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Current Opinion in Nephrology and Hypertension
|November 5, 2024
Summary
Dual heart-kidney transplantation (HKT) offers a vital strategy for patients with advanced heart and kidney failure. New United Network for Organ Sharing (UNOS) policies standardize indications, improving outcomes for simultaneous heart-kidney transplantation (SHKT) and kidney-after-heart transplantation (KAHT).
Area of Science:
- Cardiology
- Nephrology
- Transplantation Medicine
Background:
- Dual heart-kidney transplantation (HKT) addresses end-stage heart failure with concurrent renal impairment.
- Increasing utilization necessitates formalized indications and outcome analysis.
Purpose of the Study:
- Review the evolution of HKT indications.
- Analyze outcomes of simultaneous heart-kidney transplantation (SHKT) and kidney-after-heart transplantation (KAHT).
- Discuss pre- and post-transplant management and future research directions.
Main Methods:
- Retrospective outcome studies informed United Network for Organ Sharing (UNOS) policy development.
- Analysis of patient populations undergoing SHKT and KAHT.
- Review of novel management strategies and emerging technologies.
Main Results:
- Simultaneous heart-kidney transplantation (SHKT) shows superiority over single-organ heart transplantation (HT) in select patients with severe renal impairment.
- Kidney-after-heart transplantation (KAHT) serves as a crucial option for HT recipients with deteriorating renal function.
- Pretransplant device trials and calcineurin inhibitor-sparing regimens improve outcomes.
Conclusions:
- Recent advancements refine selection and management for dual HKT recipients.
- New UNOS policies provide essential standardization for HKT.
- Dual HKT represents a significant therapeutic advancement for complex patient cases.
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