Kidney Week 2025 Early Program - Care of Kidney Transplant Candidates and Recipients-Moderated Discussion

Video Transcription

Video Summary

The discussion focuses on managing delayed graft function (DGF) after kidney transplant, especially the transition back to outpatient dialysis units. Speakers stress the need for a “warm handoff” with clear responsibility: transplant nephrologist-to-nephrologist communication (not just calling the dialysis unit), plus nurse-to-nurse coordination, to avoid patients “slipping through the cracks.” Many centers effectively manage dialysis orders themselves during this short, high-risk period (often 2–3 weeks), using close clinic follow-up, urine output/weight logs, and guidance on permissive fluid overload (e.g., 3–5 kg above dry weight). Challenges include out-of-state patients, provider turnover, and peritoneal dialysis managed remotely.<br /><br />Other Q&A topics include: preventing early antibody-mediated rejection by adding single-antigen DSA testing and adjusting crossmatch thresholds; when to use procurement biopsies (limited predictive value, high variability, best interpreted with donor “story” and perfusion parameters); and evolving use of belatacept—selectively for prolonged DGF, CNI toxicity, vasculopathy, side effects, or adherence, balancing a modestly higher rejection risk.

Asset Subtitle

Rajendra S. Baliga, Roy D. Bloom, Harini A. Chakkera, Gaurav Gupta, Vineeta Kumar, Karin A. True, Alexander C. Wiseman

Meta Tag

Module TRX

Speaker FACULTY FACULTY

Keywords

delayed graft function (DGF) management

outpatient dialysis transition and warm handoff

transplant nephrologist communication and care coordination

donor-specific antibody (DSA) testing and antibody-mediated rejection prevention

procurement kidney biopsy interpretation and limitations

belatacept use in kidney transplantation