UNDERSTANDING THE COMPLEXITIES OF KIDNEY TRANSPLANTATION Edited by Jorge Ortiz and Jason André Contents Preface IX Part 1 Pretransplant Considerations 1 Chapter 1 The History of Kidney Transplantation: Past, Present and Future (with Special References to the Belgian History) 3 Squifflet Jean-Paul Chapter 2 Ethical Controversies in Organ Transplantation 41 Ehtuish Ehtuish Chapter 3 Preemptive Kidney Transplantation 77 Burak Sayin Chapter 4 Proactive Management Approach in Prevention of Kidney Transplantation 81 Levent B. Kıdak Chapter 5 Transplantation in Diabetics with End-Stage Renal Disease 107 Elijah Ablorsu Chapter 6 Cardiovascular Diseases in Kidney Transplantation 143 Roberto Marcén and Sara Jiménez Chapter 7 Obesity and Kidney Transplantation 169 Alex Chang, Susan Hou and Holly Kramer Chapter 8 The Impact of Donor Type and Quality on Renal Transplant Outcomes 189 Hung Do Nguyen, Kenneth Yong, Rebecca Croke and Wai H Lim Chapter 9 Donor Quality Scoring Systems and Early Renal Function Measurements in Kidney Transplantation 215 Quirino Lai, Francesco Nudo, Vincenzo Morabito, Giovanni Battista Levi Sandri, Fabio Melandro, Lucia Parlati, Nicola Guglielmo, Marco Di Laudo, Manuela Garofalo, Luca Poli, Renzo Pretagostini and Pasquale B Berloco Chapter 10 Donor Characteristics in 1,000 Consecutive Simultaneous Pancreas-Kidney Transplants 237 Hans W. Sollinger, Jon S. Odorico, Glen E. Leverson, Barbara J. Voss and Anthony M. D’Alessandro Chapter 11 Perioperative and Long-Term Safety of Living Kidney Donors 243 Masahiko Okamoto Chapter 12 Perioperative Hydration Policy 259 Mahmoud M. Othman Chapter 13 Anaesthesia for Kidney Transplantation 271 Yasser Haggag and Imran Ahmad Chapter 14 Augmentation Cystoplasty: in Pretransplant Recepients 279 Ashraf Abou-Elela Part 2 Special Considerations 331 Chapter 15 ABO-incompatible Kidney Transplantation 333 Mina Hur, Hee-Won Moon and Seog-Woon Kwon Chapter 16 Combined Liver and Kidney Transplantation 349 Cláudia Fagundes and Mónica Guevara Chapter 17 Transplantation for the Complex Patient with Hepatitis C and End Stage Renal Disease: A Review 359 Jorge Ortiz, Jason Andre, Kamran Khanmoradi and Victor Araya Chapter 18 Combined Kidney-Islet Transplantation 371 Giuseppe Cavallari, Flavia Neri and Bruno Nardo Chapter 19 Kidney-Pancreas Transplantation 387 Farzad Kakaei and Saman Nikeghbalian Chapter 20 Clinical Pharmacokinetics of Triple Immunosuppression Scheme in Kidney Transplant (Tacrolimus, Mycophenolate Mofetil and Corticosteroids) 407 Robles Piedras Ana Luisa and Monroy Funes Manuel Alejandro Chapter 21 Desensitization and Induction Immunosuppressive Therapy in Highly HLA-Sensitized Patients Receiving Cadaveric Renal Allograft) 439 Juana Margarita Rufino Hernández, José Manuel González-Posada Delgado and Domingo Hernández Marrero Part 3 Surgical Approaches and Complications 459 Chapter 22 The Transplantation Operation and Its Surgical Complications 461 Junjie Zhao, Zhenli Gao and Ke Wang Chapter 23 Novel Renal Transplant-Related Surgical Approaches in the 21st Century 487 Shih-Chieh Jeff Chueh and Bashir R. Sankari Chapter 24 Minimally Invasive Renal Transplantation 509 Ole Øyen Chapter 25 Surgical Complications of Renal Transplantation 527 Marcelo Ferreira Cassini, Murilo Ferreira de Andrade and Silvio Tucci Junior Chapter 26 Vascular Complications in Kidney Transplantation 547 Alexandros Giakoustidis, Nikolaos Antoniadis and Dimitrios Giakoustidis Preface Kidney failure is a major financial burden throughout the world. Renal failure and dialysis in particular are associated with an increased mortality risk and high medical costs. According to an article published in USA Today in 2009, dialysis cost the US $8.6 billion in 2007 and in 2006 20.1% of dialysis patients died. The only alternative that is available to dialysis at this time is kidney transplantation, a way to give patients with renal failure a new beginning. Kidney transplantation is a complex field that incorporates several different specialties to manage the transplant patient. Because patients with kidney failure frequently have other significant comorbidities, the workup for a potential transplant recipient can be quite involved. A potential transplant recipient often has significant exposure to blood borne infections like hepatitis, HIV, and many other potential pathogens. Patients often have severe hypertension or poorly controlled diabetes that has lead to their renal failure and yet others still have a history of heart problems. This book was created because of the importance of kidney transplantation. This particular volume focuses on the complexities of the transplant patient. In particular, there is a focus on the comorbidities and special considerations for a transplant patient and how they affect kidney transplant outcomes. In this book you will also find a brief history on the field of kidney transplantation as well as the ethical considerations in the field of transplantation. Next, the reader will find a section dedicated to special potential transplant recipients who require specialized considerations when contemplating transplantation. There is a discussion on the actual transplant procedure and potential for newer and innovative methods to completing a kidney transplantation. Contributors to this book are from all over the world and are experts in their individual fields. They were all individually approached to add a chapter to this book and with their efforts this book was formed. Understanding the Complexities of Kidney Transplantation gives the reader an excellent foundation to build upon to truly understand kidney transplantation. Dr. Jorge Ortiz and Dr. Jason André Albert Einstein Medical Center Philadelphia, PA