kdigo.org). Specifically, for the HCV-infected potential kidney transplant recipient; HCV RNA positive infected patients being considered as candidates for kidney transplantation should undergo specialist hepatology assessment. If suitable treatment with anti-viral medication should be undertaken Angiogenesis inhibitor prior to transplantation (ungraded). HCV infected patients with cirrhosis and compensated liver disease may be considered for transplantation in some investigational
circumstances (ungraded). HCV infected patients with cirrhosis and decompensated liver disease may be candidates for combined liver/kidney transplantation (ungraded). Concerns regarding infectious complications exacerbated by immunosuppression after transplantation have led to the widespread screening of all potential renal transplant candidates for evidence of active infection. Often, however, these infections can be adequately managed to allow successful transplantation.[1-3] This guideline was designed to focus on chronic viral infections (HIV, HBV and HCV) which are increasingly recognized amongst potential transplant recipients and may be modified to safely allow transplantation. This guideline reviews selleck products the optimal approach to HIV, HBV and HCV amongst those patients being considered for listing as candidates for renal transplantation. It is focused on
these chronic viral infections, in particular, because each has relevant therapeutic interventions which may be undertaken to potentially reduce morbidity and mortality after renal transplantation. It is designed specifically to ensure that all patients with these conditions are considered for renal transplantation, which can improve their clinical outcomes compared with remaining on long-term dialysis. There is increasing clinical experience and an emerging body of evidence to suggest that potential renal transplant recipients with chronic viral infections (HIV, HBV and HCV) are candidates for transplantation Ergoloid and in many circumstances will have outcomes equivalent to
the non-infected population. These excellent outcomes require careful selection of these patients prior to transplantation. This will allow for the optimization of outcomes and a full assessment of the risks and benefits for each patient prior to proceeding with long-term immunosuppression in the setting of a chronic infection. Because of the nature of this area no randomized controlled trials exist. Additionally, the assessment of the evidence and how it applies to each potential transplant candidate requires knowledge of the up to date developments in the field, with the rapid emergence of new treatments and approaches to management. Newer antivirals, specialized management in the pre- and post-transplant period and other developments mean that this is an emerging and evolving field.