Editor: "Massimiliano Veroux"

Kidney Transplantation: Challenging the Future

Personal Book: US $129 Special Offer (PDF + Printed Copy): US $219
Printed Copy: US $155
Library Book: US $516
ISBN: 978-1-60805-424-4
eISBN: 978-1-60805-144-1 (Online)
DOI: 10.2174/97816080514411120101

Introduction

Kidney transplantation is worldwide considered the best replacement therapy in patients with end-stage renal disease. However, although impressive improvements in surgical techniques and in the management of immunosuppression, long-term results have not significantly changed over the last decades. The purpose of this book is not to be a comprehensive review on kidney transplantation, but it would overview the recent acquisitions in the field of kidney transplantation, by offering to clinicians the future directions and the possible fields of research to improve the long term outcome. The book is divided into 27 chapters. The first part of the book is devoted to the basic principles of immunity and organ transplantation and the clinical evaluation of potential recipient. Moreover, in this section are discussed the most recent strategies to increase the donor pool trying to offer a kidney transplantation to a growing number of patients. The second part of the book is devoted to the immunosuppression. In these two chapters, the authors present an overview on the immunosuppressive management of kidney transplant recipients, with particular emphasis on the minimization of immunosuppression. The third part of the book is devoted to the complications of immunosuppression and to the psychological aspects of transplantation. This section is particularly detailed, and offers a complete point of view on the consequences and benefits of kidney transplantation. Last section is devoted to the future. The clinical tolerance and xenotransplantation are not still the present, but the authors illustrate the fields of application of these fundamental aspects of organ transplantation. The authors and editors have tried to select an appropriate mix of citations, but it has not been possible to cite all the relevant articles. Apologies are due to those authors whose works we have failed to cite. Our goal was to provide the most recent acquisitions in a practical manner. We hope that we have succeeded. Special thanks to all the authors for their excellent and enthusiastic collaboration and special thanks to our patients to whom are dedicated all our efforts.

Indexed in: Book Citation Index, Science Edition, Web of Science, Scopus, EBSCO.

Foreword

During the last 30 years the progress in transplantation has been impressive. Advances in surgery and medicine and the development of new immunosuppressive drugs have allowed that thousands of patients could be transplanted successfully.

Over 1 million people worldwide have received an organ and some of them have already survived more than 25 years.

However the shortage of organ donors remains the major obstacle preventing the full development of transplant services and imposes a severe limit to the number of patients who benefit from this form of therapy. The shortage of organs increases the gap between the number of available organs and the patients on waiting lists; that’s the reason why, patients who respond to a specific profile have more chances to be recorded on waiting list.

As such, multidirectional efforts are required to expand donor pool. Nowadays one more therapeutic option is represented by transplantation of organs from living donors; living donation is demonstrated to be associated with superior results for the recipient, and relatively benign long-term outcomes for donors.

It is important to remember that organ donation, both from living and dead donor, is an expression of self-giving to another person, the recipient, characterizing every voluntary transplantation primarily as an interpersonal action. The act of organ donation can be seen as offering a gift; the reason is that the giver wants to benefit the recipient, acting freely, and nothing being expected in return for the donation.

“Challenging the future” is a “must” for every worker in transplant field and for every citizen: research on immunology, improvement on surgical techniques, enhancement on procurement and allocation of organs, spread communication to create a culture of donation represent the main way to imagine a future where more people can be transplanted and can rely on a better quality of life.

Dr. Alessandro Nanni Costa
Director
Italian National Transplant Centre
Rome
Italy


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