Transplantation Reviews最新文献

{"title":"The British Transplantation Society guidelines on ethics, law and consent in relation to deceased donors after circulatory death","authors":"Greg Moorlock ,&nbsp;Ellie Asgari ,&nbsp;Chris Callaghan ,&nbsp;Heather Draper ,&nbsp;Peter Dupont ,&nbsp;Patty Gilbert ,&nbsp;David Nasralla ,&nbsp;Peter Veitch ,&nbsp;Chris Watson ,&nbsp;Stephen O'Neill","doi":"10.1016/j.trre.2023.100803","DOIUrl":"10.1016/j.trre.2023.100803","url":null,"abstract":"<div><p>The British Transplantation Society (BTS) ‘Guideline on transplantation from deceased donors after circulatory death’ has recently been updated and this manuscript summarises the relevant recommendations from chapters specifically related to law, ethics, donor consent and informing the recipient.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 1","pages":"Article 100803"},"PeriodicalIF":4.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X23000575/pdfft?md5=e5777b0b6f91874ca342be5ac81ddeb4&pid=1-s2.0-S0955470X23000575-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71430762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary and esophageal function in lung transplantation: Fundamental principles and clinical application","authors":"Andrés R. Latorre-Rodríguez ,&nbsp;Deepika Razia ,&nbsp;Ashraf Omar ,&nbsp;Ross M. Bremner ,&nbsp;Sumeet K. Mittal","doi":"10.1016/j.trre.2023.100796","DOIUrl":"10.1016/j.trre.2023.100796","url":null,"abstract":"<div><p><span><span>The lungs and esophagus have a close anatomical and physiological relationship. Over the years, reflux-induced pulmonary injury has gained wider recognition, but the full effects of pulmonary disease on </span>esophageal function<span> are still unknown. Intrathoracic pressure dynamics potentially affect esophageal function, especially in patients with end-stage lung disease, both obstructive and restrictive. </span></span>Lung transplantation<span><span><span><span> is the only viable option for patients with end-stage pulmonary disease and has provided us with a unique opportunity to study these effects as transplantation restores the intrathoracic environment. Esophageal and foregut functional testing before and after transplantation provide insights into the </span>pathophysiology of the foregut-pulmonary axis, such as how underlying pulmonary disease and intrathoracic pressure changes affect esophageal physiology. This review summarizes the available literature and shares the research experience of a lung transplant center, covering topics such as pre- and posttransplant foregut function, </span>esophageal motility in lung transplant recipients, immune-mediated mechanisms of </span>graft rejection<span><span> associated with gastroesophageal reflux, and the role of </span>antireflux surgery in this population.</span></span></p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 1","pages":"Article 100796"},"PeriodicalIF":4.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41242865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progress in preservation of intestinal grafts by oxygenated hypothermic machine perfusion","authors":"Shuang Yang ,&nbsp;Wen Hou ,&nbsp;Lei Liu","doi":"10.1016/j.trre.2023.100802","DOIUrl":"10.1016/j.trre.2023.100802","url":null,"abstract":"<div><p>Intestine transplantation (IT) is a critical treatment strategy for irreversible intestinal failure. Among all abdominal solid organ transplants, the intestine was the most vulnerable to ischemia and reperfusion injury (IRI). The static cold storage (SCS) technique is currently the most commonly used graft preservation method, but its hypoxia condition causes metabolic disorders, resulting in the occurrence of IRI, limiting its application in marginal organs. It is especially important to improve preservation techniques in order to minimize damage to marginal donor organs, which draws more attention to machine perfusion (MP). There has been much debate about whether it is necessary to increase oxygen in these conditions to support low levels of metabolism since the use of machine perfusion to preserve organs. There is evidence that oxygenation helps to restore intracellular ATP levels in the intestine after thermal or cold ischemia damage. The goal of this review is to provide an overview of the role of oxygen in maintaining environmental stability in the gut under hypoxic conditions, as well as to investigate the possibilities and mechanisms of oxygen delivery during preservation in intestine transplantation studies and clinical models.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 1","pages":"Article 100802"},"PeriodicalIF":4.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X23000563/pdfft?md5=33beba80b0cef6199ae6749a374b64c6&pid=1-s2.0-S0955470X23000563-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61567122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunosuppression for older liver transplant recipients","authors":"Paolo De Simone ,&nbsp;Sara Battistella ,&nbsp;Quirino Lai ,&nbsp;Juri Ducci ,&nbsp;Francesca D'Arcangelo ,&nbsp;Piero Marchetti ,&nbsp;Francesco Paolo Russo ,&nbsp;Patrizia Burra","doi":"10.1016/j.trre.2023.100817","DOIUrl":"10.1016/j.trre.2023.100817","url":null,"abstract":"<div><p><span><span><span>Older liver transplant<span> recipients have a lower risk of acute rejection than younger patients (9% for patients aged ≥65 years versus 23% for those aged 18–34 years) and are more vulnerable to immunosuppression-related complications. The number of liver transplant recipients ≥65 years has risen to 22% in Europe and the US, but limited information is available on the optimal </span></span>immunosuppressive regimen for these patients. In this review, we discuss the appropriate management of immunosuppressive agents in older adults to minimize adverse events while avoiding acute rejection. The way the body processes </span>drugs<span><span><span> greatly depends on age. In the case of calcineurin inhibitor drugs, aging reduces hepatic metabolism, leading to changes in their </span>pharmacokinetics. Corticosteroids also show decreased clearance as the patient ages. In severe cases of </span>hypoalbuminemia, dose adjustment of </span></span>mycophenolate<span><span><span> acid derivatives may be necessary. However, the pharmacokinetic profiles of the mammalian target of rapamycin inhibitors, </span>basiliximab, and rabbit anti-thymocyte globulin remain unaffected by age. Furthermore, age-related </span>frailty<span> may impact drug metabolism and require tailored interventions and closer follow-up. Although there is limited research, elderly liver transplant recipients require less immunosuppression with double or triple-agent regimens, lower exposure to calcineurin inhibitors, and a shorter course of corticosteroids. The usage of mammalian target of rapamycin inhibitors in older transplant populations has not been specifically investigated, and thus their usage should align with indications for younger patient groups.</span></span></p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 1","pages":"Article 100817"},"PeriodicalIF":4.0,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138744608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The applications of ECMO in liver transplant recipients","authors":"Yue Qiu ,&nbsp;Ibtesam Hilmi","doi":"10.1016/j.trre.2023.100816","DOIUrl":"10.1016/j.trre.2023.100816","url":null,"abstract":"<div><p>Extracorporeal membrane oxygenation (ECMO) has emerged as a vital instrument for sustaining respiratory and cardiac functions when traditional methods have failed. Its function in managing acute pulmonary and cardiac challenges during liver transplantation (LT) has expanded significantly. While ECMO was initially viewed as a rescue strategy for acute intraoperative or posttransplant complications, its application now also encompasses the pretransplant stage of LT. Our review aims to thoroughly summarize both research and specific cases where ECMO has been utilized across pre- and perioperative phases in liver transplant recipients. By assessing the published literature, we discuss specific indications, the types of ECMO employed, their outcomes, and the unique challenges of applying ECMO during LT. In particular, the pretransplant use of ECMO is increasing, and its prudent introduction prior to LT, supported by meticulous planning, has the potential to optimize patient outcomes. It is challenging to manage liver transplant patients on ECMO. More research and experience are needed to refine the techniques and improve patient outcomes. Furthermore, decision-making must be tailored to each patient's unique circumstances, and a clear, practical, and well-defined plan for subsequent steps is essential.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 1","pages":"Article 100816"},"PeriodicalIF":4.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X23000708/pdfft?md5=7d6a58f5af17c54b55c782e65050cf2a&pid=1-s2.0-S0955470X23000708-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138630847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between tacrolimus exposure and tremor, headache and insomnia in adult kidney transplant recipients: A systematic review","authors":"Catherine P. King ,&nbsp;Amelia R. Cossart ,&nbsp;Nicole M. Isbel ,&nbsp;Scott B. Campbell ,&nbsp;Christine E. Staatz","doi":"10.1016/j.trre.2023.100815","DOIUrl":"10.1016/j.trre.2023.100815","url":null,"abstract":"<div><h3>Purpose</h3><p>Tremor, headache and insomnia have been linked to the immunosuppressant, tacrolimus. The aim of this systematic review was to determine if there is a correlation between tacrolimus exposure and new-onset tremor, headache and insomnia experienced by adult kidney transplant recipients.</p></div><div><h3>Methods</h3><p>PubMed, Embase, Cochrane Library and CINAHL databases were searched up to 11 April 2023 for published studies which reported on tacrolimus exposure in adult kidney transplant recipients, alongside information on treatment-emergent neurologic manifestations, including tremor, headache and insomnia. Review articles, case studies, conference abstracts and articles not published in English in peer-reviewed journals were excluded. The Physiotherapy Evidence Database and Newcastle-Ottawa Quality Assessment Scales were used to assess risk of bias. Extracted data was analysed via a narrative synthesis.</p></div><div><h3>Results</h3><p>Eighteen studies involving 4030 patients in total were included in the final analysis. These comprised five randomised control trials and thirteen observational studies. Studies failed to find significant association between tacrolimus trough concentrations in whole blood and the incidence of neurologic side effects such as tremor, headache and insomnia; however, in one study the incidence of toxicity requiring a dose reduction increased with increasing, supratherapeutic targeted levels. Females, especially Black females, and older age were positively associated with the prevalence of neurologic adverse effects. Results were conflicting regarding whether extended-release formulations were associated with fewer neurologic complications than immediate-release formulations.</p></div><div><h3>Conclusion</h3><p>The varied study designs and criteria for reporting tremor, headache and insomnia impacted on the quality of the data for exploring the relationship between tacrolimus exposure and the onset of neurologic manifestations experienced after kidney transplantation. Studies that examine defined neurologic complications as the primary outcome, and that consider novel markers of tacrolimus exposure while assessing the potential contribution of multiple covariate factors, are required.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 1","pages":"Article 100815"},"PeriodicalIF":4.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X23000691/pdfft?md5=fbe925638ee6638f7d56cc782a925b43&pid=1-s2.0-S0955470X23000691-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138563387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in kidney transplantation accessibility among immigrant populations in Europe: A systematic review and meta-analysis","authors":"Pieter A.H. van Overdijk ,&nbsp;Alessandra A. Grossi ,&nbsp;Céline H. van Delft ,&nbsp;Nichon E. Jansen ,&nbsp;Martijn W.F. van den Hoogen ,&nbsp;David Paredes-Zapata","doi":"10.1016/j.trre.2023.100814","DOIUrl":"10.1016/j.trre.2023.100814","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Disparities in access to healthcare for patients with an immigration background are well-known. The aim of this study was to determine whether disparities among immigrant populations translate into a relative difference in the number of kidney transplants (KT) performed in documented immigrant patients (first and second generation) relative to native-born patients in Europe.</p></div><div><h3>Methods</h3><p>A literature search was performed in PubMed from inception to 11-10-2022. Studies were eligible if: (1) written in English, (2) included immigrant and native-born KT patients, (3) performed in countries registered as Council of Europe members, (4) focused on documented first- and second-generation immigrant populations [1]. Systematic reviews, literature reviews, and case reports or articles about emigration, non-KT, and undocumented immigrants were excluded. The outcome measurement was a relative percentage of KTs to the total population per 100.000 residents. By dividing the immigrant percentages by the native-born resident percentages, the odds ratio (OR) was calculated in a meta-analysis. The risk of bias was assessed; articles with high risk of bias were excluded in a second meta-analysis.</p></div><div><h3>Results</h3><p>Out of 109 articles, 5 were included (<em>n</em> = 24,614). One Italian study (<em>n</em> = 24,174) had a ratio below 1, being 0.910 (95%CI 0.877–0.945). The other four articles (<em>n</em> = 196, <em>n</em> = 283, <em>n</em> = 77, <em>n</em> = 119) had ratios above 1: 1.36 (95%CI 0.980–1.87), 2.04 (95%CI 1.56–2.68), 2.23 (95%CI 1.53–3.25) and 2.64 (95%CI 1.68–4.15). After performing a meta-analysis, the OR did not show a significant difference: 1.68 (95%CI 1.03–2.75). After bias correction, this remained unchanged: 1.78 (95%CI 0.961–3.31).</p></div><div><h3>Conclusions</h3><p>In our meta-analysis we did not find a significant difference in the relative number of KTs performed in immigrant versus native-born populations in Europe. However, a lesser likelihood for immigrants to receive a pre-emptive kidney transplantation was found. Large heterogeneity between studies (e.g. different sample size, patient origins, study duration, adult vs children patients) was a shortcoming to our analysis. Nevertheless, our article is the first review in this understudied topic. As important questions (e.g. on ethnicity, living donor rate) remain, future studies are needed to address them.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 1","pages":"Article 100814"},"PeriodicalIF":4.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X2300068X/pdfft?md5=480447307e98f7b28aa184e54aa1c365&pid=1-s2.0-S0955470X2300068X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138515738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Graft retrieval incisions in minimally invasive donor nephrectomy: Systematic review and network meta-analysis","authors":"Khi Yung Fong ,&nbsp;Joshua Chek Hao Foo ,&nbsp;Yiong Huak Chan ,&nbsp;Edwin Jonathan Aslim ,&nbsp;Lay Guat Ng ,&nbsp;Valerie Huei Li Gan ,&nbsp;Ee Jean Lim","doi":"10.1016/j.trre.2023.100813","DOIUrl":"10.1016/j.trre.2023.100813","url":null,"abstract":"<div><h3>Background</h3><p>Various incisions<span> are employed for graft extraction during minimally invasive donor nephrectomy, but an overarching synthesis of associated short-term donor outcomes is lacking.</span></p></div><div><h3>Methods</h3><p><span>An electronic literature search was conducted on PubMed, EMBASE and Scopus for studies comparing ≥2 graft extraction incisions in laparoscopic or robotic donor nephrectomy with ≥10 patients per arm. Eligible study designs included randomized trials, case-control, and cohort studies. Primary outcomes were donor length of stay (LOS); in-hospital </span>analgesic<span> requirement; and postoperative complications<span>. Secondary outcomes were warm ischemia time (WIT), total operation time (TOT), and estimated blood loss (EBL). Random-effects Frequentist network meta-analyses were conducted for all outcomes.</span></span></p></div><div><h3>Results</h3><p>Twenty-nine studies (4702 patients) were shortlisted. Six incisions were analyzed: iliac, Pfannenstiel, midline hand-assisted laparoscopic (HAL), midline umbilical, flank and transvaginal natural orifice transluminal endoscopic surgery<span> (NOTES). The flank incision had significantly longer LOS than all other incisions. LOS was significantly longer in Pfannenstiel than iliac incision (mean difference [MD] = 0.29, 95%CI = 0.002–0.58 days). Midline HAL had significantly shorter TOT than most other incisions. Midline umbilical incisions had significantly higher WIT than midline HAL and Pfannenstiel incisions. Midline HAL had shorter WIT than transvaginal NOTES (MD = 0.80, 95%CI = 0.05–1.56 min). No major differences were seen in analgesia requirement, postoperative complications and EBL.</span></p></div><div><h3>Conclusion</h3><p>Six different incisions for graft retrieval are broadly comparable across most short-term outcomes although long-term outcomes remain to be elucidated. Iliac and Pfannenstiel incisions yielded similar outcomes besides marginally lower LOS for the former. Midline incision for HAL may be associated with shorter TOT, and transvaginal NOTES is an effective technique for selected female donors.</p><p><strong>Trial registration</strong>: PROSPERO CRD42023445407</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 1","pages":"Article 100813"},"PeriodicalIF":4.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135764153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-tuberculous mycobacteria disease pre-lung transplantation: A systematic review of the treatment regimens and duration pre- and post-transplant.","authors":"Johanna P. van Gemert ,&nbsp;Sofanne J. Ravensbergen ,&nbsp;Erik A.M. Verschuuren ,&nbsp;Huib A.M. Kerstjens ,&nbsp;Brigitte W.M. Willemse ,&nbsp;Jakko van Ingen ,&nbsp;Wouter Hoefsloot ,&nbsp;Tji Gan ,&nbsp;Onno W. Akkerman","doi":"10.1016/j.trre.2023.100800","DOIUrl":"10.1016/j.trre.2023.100800","url":null,"abstract":"<div><h3>Background</h3><p>There is lack of consensus on non-tuberculous mycobacteria pulmonary disease (NTM-PD) treatment regimen and duration in patient listed for lung transplantation (LTx). We conducted a systematic review on treatment regimen and duration pre- and directly post-LTx, for patients with known NTM-PD pre-LTx. Additionally, we searched for risk factors for NTM disease development post-LTx and for mortality.</p></div><div><h3>Methods</h3><p>Literature was reviewed on PubMed, Embase and the Cochrane Library, for articles published from inception to January 2022. Individual patient data were sought.</p></div><div><h3>Results</h3><p>Sixteen studies were included reporting 92 patients. Most frequent used agents were aminoglycosides and macrolides for <em>Mycobacterium abscessus</em> (<em>M. abscessus</em>) and macrolides and tuberculostatic agents for <em>Mycobacterium avium</em> complex (<em>M. avium</em> complex). The median treatment duration pre-LTx was 10 months (IQR 6–17) and 2 months (IQR 2–8) directly post-LTx. Longer treatment duration pre-LTx was observed in children and in patients with <em>M. abscessus</em>. 46% of the patients with NTM-PD pre-LTx developed NTM disease post-LTx, related mortality rate was 10%. Longer treatment duration pre-LTx (<em>p</em> &lt; 0.001) and sputum non-conversion pre-LTx (<em>p</em> = 0.003) were significantly associated with development of NTM-disease post-LTx. Longer treatment duration pre-LTx (<em>p</em> = 0.004), younger age (<em>p</em> &lt; 0.001) and sputum non-conversion (<em>p</em> = 0.044) were risk factors for NTM related death.</p></div><div><h3>Conclusions</h3><p>The median treatment duration pre-LTx was 10 months (IQR 6–17) and 2 months (IQR 2–8) directly post-LTx. Patients with longer treatment duration for NTM-PD pre-LTx and with sputum non-conversion are at risk for NTM disease post-LTx and for NTM-related death. Children were particularly at risk for NTM related death.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 4","pages":"Article 100800"},"PeriodicalIF":4.0,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of an aneurysmal arteriovenous fistula in kidney transplant recipients","authors":"Michael Corr ,&nbsp;Kateřina Lawrie ,&nbsp;Peter Baláž ,&nbsp;Stephen O'Neill","doi":"10.1016/j.trre.2023.100799","DOIUrl":"10.1016/j.trre.2023.100799","url":null,"abstract":"<div><p>Aneurysms remain the most common complication of an arteriovenous fistula created for dialysis access. The management of an aneurysmal arteriovenous fistula (AAVF) in kidney transplant recipients remains contentious with a lack of clear clinical guidelines. Recipients of a functioning graft do not require the fistula for dialysis access, however risk of graft failure and needing the access at a future date must be considered. In this review we outline the current evidence in the assessment and management of a transplant recipient with an AAVF. We will describe our recommended five-step approach to assessing an AAVF in transplant patients; 1.) Define AAVF 2.) Risk assess AAVF 3.) Assess transplant graft function and future graft failure risk 4.) Consider future renal replacement therapy options 5.) Vascular mapping to assess future vascular access options. Then we will describe the current therapeutic options and when they would most appropriately be employed.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 4","pages":"Article 100799"},"PeriodicalIF":4.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41161596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}