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Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

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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...
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Kidney Transplant II: Surgical Procedure01:26

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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...
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Kidney Transplant III: Nursing Management01:16

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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...
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Tissue Transplantation01:24

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Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
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The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Mouse Kidney Transplantation: Models of Allograft Rejection
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Immune Checkpoint Inhibitors and Allograft Rejection Risk: Emerging Evidence Regarding Their Use in Kidney Transplant

Muhammad Ali Khan1, Munir Mehmood2, Hind El Azzazi3

  • 1Division of Nephrology and Hypertension, Mayo Clinic Arizona, 5777 E. Mayo Blvd, Phoenix, AZ 85054, USA.

Journal of Clinical Medicine
|July 29, 2025
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Summary

Immune checkpoint inhibitors (ICIs) show promise in cancer therapy but can increase kidney transplant rejection risk. This review examines ICI outcomes in kidney transplant recipients for cancer treatment.

Keywords:
CTLA-4 antigengraft rejectionimmune checkpoint inhibitorskidney transplantationpost-transplant malignancyprogrammed cell death 1 ligand 1 proteinprogrammed cell death 1 receptor

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Area of Science:

  • Oncology
  • Nephrology
  • Immunology

Background:

  • Immune checkpoint inhibitors (ICIs) are increasingly used for cancer treatment due to efficacy and favorable toxicity.
  • ICIs enhance anti-tumor T-cell activity by blocking inhibitory signals.
  • ICI use is associated with adverse renal events in native and transplanted kidneys.

Purpose of the Study:

  • To review the literature on outcomes in kidney transplant recipients receiving ICIs for oncologic indications.
  • To assess the risk of kidney allograft rejection and graft loss associated with ICI use.

Main Methods:

  • Literature review of studies examining kidney transplant recipients treated with ICIs.
  • Analysis of reported oncologic outcomes and renal outcomes, including allograft rejection and graft survival.

Main Results:

  • ICI use in cancer patients with kidney transplants is linked to a significant risk of allograft rejection.
  • Reported rates of kidney allograft rejection in this population approach 40%.
  • Increased risk of graft loss is a concern in kidney transplant recipients receiving ICIs.

Conclusions:

  • Kidney transplant recipients receiving ICIs for cancer face a substantial risk of allograft rejection and potential graft loss.
  • Careful monitoring and risk-benefit assessment are crucial when considering ICIs in this patient group.
  • Further research is needed to optimize ICI use and mitigate renal risks in kidney transplant recipients.