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1

Coventry, Brendon J., ed. Cardio-Thoracic, Vascular, Renal and Transplant Surgery. London: Springer London, 2014. http://dx.doi.org/10.1007/978-1-4471-5418-1.

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2

Calne, S. The ultimate gift: The story of Britain's premier transplant surgeon. London: Headline Book Publishing, 1998.

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3

Jong-Tieben, Linda M. de. Human papillomavirus infection and skin cancer in renal transplant recipients. Leiden: University of Leiden, 1998.

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4

United Kingdom Transplant Support Service Authority. Renal transplant audit: United Kingdom and Republic of Ireland : 1981-1991. Bristol: UKTSSA, 1993.

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5

United Kingdom Transplant Support Service Authority. Renal transplant audit 1981-1991: United Kingdom and Republic of Ireland. Bristol: United Kingdom Transplant Support Service Authority, 1992.

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6

Caskey, Denise. A health promotion needs assessment of the renal transplant population in Northern Ireland. [s.l: The Author], 1994.

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7

Jurewicz, Wieslaw Adam. Indium-111 labelled autologous platelets in post-transplant monitoring of renal and pancreatic allografts in man. Birmingham: University of Birmingham, 1985.

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8

Spencer, Susan Elva. An investigation of the incidence and potential significance of antibodies to endothelial / monocyte antigensin renal transplant recipients. [s.l: The Author], 1990.

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9

Nessralla, Laurie-Ann. Incidence of rejection, morbidity, mortality and graft function in renal transplant recipients following cyclosporine to azathioprine switch. [New Haven: s.n.], 1990.

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10

Sherman, Michael Scott. Morbidity, mortality, and graft function in renal transplant recipients: A comparison of the effects of cyclosporine versus azathioprine. [New Haven: s.n.], 1986.

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11

Farrelly, Rita. An tioxidant enzymes in continuous ambulatory peritoneal dialysis (CAPD) patients and in renal transplant patients on azathioprine/prednisolone. [S.l: The Author], 1995.

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12

European Dialysis and Transplant Association - European Renal Association. Congress. Proceedings of the European Dialysis and Transplant Association - European Renal Association: Twenty-first congress held in Florence, Italy, 1984. Edited by Davison Alex M. 1940- and Guillou Pierre J. London: Pitman, 1985.

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13

European Dialysis and Transplant Nurses Association -European Renal Care Association. Congress. Proceedings ofthe European Dialysis and Transplant Nurses Association - European Renal Care Association: Fourteenth Congress held in Brussels, Belgium, 1985. Edited by Stevens Elizabeth 19--- and Monkhouse Patricia. London: Bailli'ere Tindall, 1985.

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14

Brian, Stiller, ed. Lifegifts: The real story of organ transplants. Toronto, Canada: Stoddart, 1990.

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15

Janet, Wild, ed. Everything you always wanted to know about dialysis and kidney transplants but were afraid to ask. 3rd ed. [Place of publication not identified]: Class Publishing, 2006.

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16

Janet, Wild, ed. Kidney failure explained: Everything you always wanted to know about dialysis and kidney transplants but were afraid to ask. 2nd ed. London: Class, 2002.

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17

Remuzzi, Giuseppe. Renal Transplant Tolerance. S Karger AG, 1992.

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18

Gruenewald, Simon, and Philip Vladica. Renal transplant imaging. Edited by Jeremy R. Chapman. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0282.

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The purpose of imaging of the transplant kidney is to assess integrity, anatomy, and function. Relatively or actually non-invasive technologies can be used to monitor for potential early post-transplant complications such as acute tubular necrosis, acute rejection, haematoma, pyelonephritis, abscess, urinoma, ureteral obstruction, vascular complications, and rarely graft torsion. The technologies also assist in the diagnosis and management of late complications such as those arising from immunosuppression, chronic rejection, lymphocoele, cyst, renal artery stenosis, urinary obstruction, and tumours. This chapter demonstrates the capacity of the various imaging modalities such as ultrasound, computed tomography, and magnetic resonance imaging, to assist in the clinical management of the renal transplant recipient.
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19

R, Castañeda-Zuñiga Wilfrido, ed. Radiologic diagnosis of renal transplant complications. Minneapolis: University of Minnesota Press, 1986.

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20

Smith, Ian. Kidney Transplant. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199764495.003.0029.

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Renal transplantation is the preferred treatment for pediatric patients who have end-stage renal disease. A successful transplant improves intellectual and behavioral development, quality of life, and survival, with the survival at 10 years being as high as 83% (Kim et al., 1991). We can optimize the chance of success by understanding the pathophysiology involved and applying this knowledge to guide our management of perioperative fluid balance, electrolyte anomalies, anemia, blood pressure control, and comorbidities. Also critical is an appreciation of the effects and consequences of the various immunosuppressive agents that are used. Close communication is required between the pediatrician, surgeon, and anesthesiologist.
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21

Gardiner, Matthew D., and Neil R. Borley. Transplant surgery. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199204755.003.0014.

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This chapter begins by discussing the basic principles of immunology and transplant rejection and immunosuppression, before focusing on the key areas of knowledge, namely organ donation, renal transplantation, and transplantation of other organs. The chapter concludes with relevant case-based discussions.
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22

Coventry, Brendon J. Cardio-Thoracic, Vascular, Renal and Transplant Surgery. Springer, 2016.

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23

Kumar, Deepali. Immunogenicity of pneumococcal vaccination in renal transplant recipients. 2004.

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24

United States. Health Care Financing Administration., ed. Medicare coverage of kidney dialysis and kidney transplant services. Baltimore, Md: U.S. Dept. of Health and Human Services, Health Care Financing Administration, 2000.

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25

Delayed acute rejection episodes in cyclosporine-treated renal transplant recipients. Annals of Surgery, 1985.

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26

M, Ferguson Ronald, and Sommer Bruce G, eds. The Clinical management of the renal transplant recipient with cyclosporine. Orlando: Grune & Stratton, 1986.

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27

Walele, Abdul Aziz. A study of coronary revascularization surgery in renal transplant candidates. 2004.

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28

Davenport, Dr Andrew. Renal diseases and emergencies. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199565979.003.00011.

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Chapter 11 discusses diseases and emergencies involving renal medicine, including investigation of the renal tract, acute kidney injury (AKI), haematuria and proteinuria, urinary tract infection (UTI), urinary tract obstruction, tumours of the renal tract, chronic kidney disease (CKD), and renal transplant patients.
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29

Winston, Jonathan, Etti Zeldis, John A. Grimaldi, and Esteban Martínez. HIV-Associated Nephropathy, End-Stage Renal Disease, Dialysis, and Kidney Transplant. Edited by Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding, and Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0044.

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Antiretroviral therapy has changed the phenotype of HIV-related kidney disease to a more chronic disease model. In addition to HIV-associated nephropathy (HIVAN), patients with HIV may experience kidney dysfunction related to other chronic illnesses, such as diabetes, hypertension, and hepatitis C. Patients with HIV should be monitored for the development of chronic kidney disease and the potential nephrotoxicity of antiretroviral therapy. For patients with HIV who progress to end-stage renal disease, the outcomes on dialysis and management of the dialysis procedure are similar to the outcomes of patients without HIV. Renal transplantation is a promising treatment option for HIV patients with end-stage renal disease, despite certain barriers inherent in the transplant evaluation process. Concomitant HIV and end-stage renal disease, with the stress of dialysis, can exacerbate psychiatric illness.
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30

Davidson and Guillou. Proceedings of the European Dialysis and Transplant Association: European Renal Association. Elsevier, 1986.

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31

Clayton, Philip, and Steven Chadban. Recurrent renal disease. Edited by Jeremy R. Chapman. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0289.

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Although kidney transplantation restores kidney function, it does not cure the cause of kidney failure when it is glomerulonephritis or a systemic disease. These can recur in the allograft, causing graft dysfunction and ultimately graft failure. This is a challenge in the pre-transplant phase, perioperatively, and in a patient with renal allograft dysfunction. This chapter discusses the prophylaxis, diagnosis, and management of recurrent renal disease, including disease-specific information on focal and segmental glomerulosclerosis, membranous nephropathy, membranoproliferative glomerulonephritis, immunoglobulin A nephropathy, lupus nephritis, haemolytic uraemic syndrome, oxalosis, Goodpasture disease, oxalosis, and vasculitis, amongst others.
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32

Davison, Alex M., and Pierre J. Guillou. Proceedings of the European Dialysis and Transplant Association - European Renal Association (Proceedings of the European Dialysis and Transplant Associat). Urban & Schwarzenberg, 1985.

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33

Sarwal, Minnie M., and Ron Shapiro. Paediatric renal transplantation. Edited by Jeremy R. Chapman. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0290.

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Approximately 1 in 65,000 children develops end-stage renal disease (ESRD) each year with almost 1200 children (aged 0–19 years) in the United States developing ESRD annually. Kidney transplantation is the primary method of treating ESRD in the paediatric population. The special issues in children and adolescents with ESRD include achieving normal growth and cognitive development. This chapter discusses the advances in surgical techniques, patient selection, transplant evaluation/preparing for transplantation, postoperative management (including fluid management in infants and small children), and the evolution of immunosuppressive drugs that have resulted in improved quality of life and a reduction in the mortality rate of children with chronic renal failure.
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34

D'Souza, Michelle. Development of a self-medication program for renal and heart transplant patients. 1991.

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35

1941-, Burdick James F., ed. Kidney transplant rejection: Diagnosis and treatment. 2nd ed. New York: Dekker, 1992.

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36

Elder, Grahame J. Metabolic bone disease after renal transplantation. Edited by Jeremy R. Chapman. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0288.

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Patients who undergo kidney transplantation have laboratory, bone, and soft tissue abnormalities that characterize chronic kidney disease mineral and bone disorder (CKD-MBD). After successful transplantation, abnormal values of parathyroid hormone, fibroblast growth factor 23, calcium, phosphate, vitamin D sterols, and sex hormones generally improve, but abnormalities often persist. Cardiovascular risk remains high and is influenced by prevalent vascular calcification, and fracture risk increases due to a combination of abnormal bone ‘quality’, compounded by immunosuppressive drugs and reductions in bone mineral density. Patients with well managed CKD-MBD before transplantation generally have a smoother post-transplant course, and it is useful to assess patients soon after transplantation for risk factors relevant to the general population and to patients with CKD. Targeted laboratory assessment, bone densitometry, and X-ray of the spine are useful for guiding therapy to minimize post-transplant effects of CKD-MBD. To reduce fracture risk, general measures include glucocorticoid dose minimization, attaining adequate 25(OH)D levels, and maintaining calcium and phosphate values in the normal range. Calcitriol or its analogues and antiresorptive agents such as bisphosphonates may protect bone from glucocorticoid effects and ongoing hyperparathyroidism, but the efficacy of these therapies to reduce fractures is unproven. Alternate therapies with fewer data include denosumab, strontium ranelate, teriparatide, oestrogen or testosterone hormone replacement therapy, tibolone, selective oestrogen receptor modulators, and cinacalcet. Parathyroidectomy may be necessary, but is generally avoided within the first post-transplant year. A schema is presented in this chapter that aims to minimize harm when allocating therapy.
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37

Hundert, Joshua S., Rashmi Verma, Ritika Suri, Anika T. Singh, and Ajay Singh. Neurological Manifestations of Renal Disease. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0191.

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In the United Syates, chronic kidney disease (CKD) affects approximately 5% to 10% of the general population. It is estimated that about 20 million Americans have some degree of CKD. Central nervous system (CNS) abnormalities are common in patients with CKD, especially in those individuals with end stage renal disease (ESRD) who require renal replacement therapy, such as dialysis or transplant. Neurological symptoms in patients with CKD may range from mild altered sensorium and cognitive dysfunction to tremors and coma. By the time patients require renal replacement therapy, some patients may have uremia, a clinical syndrome with protean manifestations.
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38

Knight, Simon R., and Rutger J. Ploeg. Immediate post-transplant care and surgical complications. Edited by Jeremy R. Chapman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0280_update_001.

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Care of the post-transplant kidney patient is complex and requires multidisciplinary team working. Careful attention is paid to haemodynamics, fluid balance, microbiology, drug prescription, and patient instruction. Delays in, or reduction of, graft function should be investigated and treated immediately to ensure long-term graft survival. Because complications do occur, they must be recognized early and dealt with promptly. The nature of the transplant operation and the need for immunosuppression mean that the complications differ from those of ordinary general surgical patients, and so require specialist medical, microbiological, or radiological input with a narrower time window for correction. This chapter covers the immediate postoperative care of the renal transplant recipient both as an inpatient and the early period as an outpatient, highlighting the potential complications and their management.
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39

Dropsy, Dialysis, Transplant: A Short History of Failing Kidneys (Johns Hopkins Biographies of Disease). The Johns Hopkins University Press, 2007.

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40

Cui, Zhao, Neil Turner, and Ming-hui Zhao. Alport post-transplant antiglomerular basement membrane disease. Edited by Neil Turner. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0075.

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Alport antiglomerular basement membrane (anti-GBM) disease is a rare example of disease caused by allo-sensitization after renal transplantation, first described in 1992. Because the recipient lacks a specific glomerular basement membrane (GBM) protein, they can become sensitized to the normal molecule present in the GBM of the donor kidney. The disease is restricted to the allograft. Interestingly severe disease arises from this only arises rarely, certainly less than 1 in 20, probably closer to 1 in 50. It characteristically causes late graft loss in a first transplant with accelerated tempo in later allografts, and in its most extreme form recurs within days. However, inexplicably some subsequent transplants do not provoke aggressive recurrence. Treatment of the most aggressive disease is difficult and in most cases has been ultimately unsuccessful. Lower levels of immune response, marked by linear binding of immunoglobulin-G to GBM without glomerular disease, are not uncommon in Alport patients after transplantation and should not lead to altered treatment. Immunoassays for anti-GBM antibodies can be misleading as in most cases the target of antibodies is the α‎‎‎5 chain of type IV collagen, rather than the α‎‎‎3 chain which is the target in spontaneous anti-GBM disease. Overall the outcome of transplantation in Alport syndrome is better than average. This complication is more likely in patients with partial or total gene deletion rather than point mutations, but no other predictive features have been identified.
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41

Naicker, Saraladevi, and Graham Paget. HIV and renal disease. Edited by Vivekanand Jha. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0187_update_001.

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The human immunodeficiency virus (HIV) infection epidemic has particularly affected the poorest regions of the world. HIV can directly or indirectly affect different aspects of renal function, and results in a variable expression of kidney disease.Acute kidney injury (AKI) occurs in approximately 20% of hospitalized patients. The prevalence of chronic kidney disease (CKD) amongst HIV-infected patients is reported at 3.5–38% in different regions of the world. The complex interplay between the pheno- and/or genotypic variants of the virus, the genetic make-up of the host, and environmental factors determine the clinical manifestations of renal disease. The association of APOL1 gene variants G1 and G2 with the risk of focal segmental glomerulosclerosis explains the high frequency of HIV-associated nephropathy (HIVAN) in populations of black ethnicity.Anti-retroviral therapy (ART) is effective in preventing progression of HIVAN. Some of the drugs used in ART regimens are potentially nephrotoxic and require dose adjustment or even avoidance in CKD. Progression to end-stage renal disease (ESRD) in HIVAN has been reported to correlate with the extent of chronic damage quantified by renal biopsy.HIV-infected patients requiring dialysis, who are stable on ART, are achieving survival rates comparable to those of non-HIV dialysis populations. Similarly, HIV infection does not seem to adversely affect patient and graft survival rates after kidney transplantation, and there has been no increase in the prevalence of opportunistic infections in transplant recipients on effective ART.
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42

Solez, Kim, James F. Burdick, and Lorraine C. Racusen. Kidney Transplant Rejection: Diagnosis and Treatment (Kidney Disease, Vol. 9). 2nd ed. Marcel Dekker Inc, 1991.

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43

Ronald M., M.D. Ferguson. Clinical Management of the Renal Transplant Recipient With Cyclosporine: A Transplantation Proceedings Reprint of Supplement 1, Vol Xviii, April 198. Grune & Stratton, 1986.

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44

Rowe, Meredeth Anne. THE IMPACT OF INTERNAL AND EXTERNAL RESOURCES ON FUNCTIONAL OUTCOME IN CHRONIC ILLNESS (RENAL DISEASE, HEMODIALYSIS, PERITONEAL DIALYSIS, TRANSPLANT, STRESS). 1994.

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45

Erickson, Stephen B., Hatem Amer, and Timothy S. Larson. Urolithiasis, Kidney Transplantation, and Pregnancy and Kidney Disease. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199755691.003.0475.

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It was previously assumed that all kidney stones crystallized as urine passed through the renal tubules and were retained by means of crystal-tubular cell interactions. Recently uroscopy with papillary biopsies has shown 2 different pathways for stone formation, both mediated by calcium phosphate crystals. Kidney transplant has become the preferred treatment for patients with end-stage renal disease. Those benefiting from transplant included patients who would be deemed "high risk," such as those with diabetes mellitus and those older than 70 years. Anatomical changes associated with pregnancy are renal enlargement and dilatation of the calyces, renal pelvis, and ureters. Physiologic changes include a 30% to 50% increase in glomerular filtration rate and renal blood flow; a mean decrease of 0.5 mg/dL in the creatinine level and a mean decrease of 18 mg/dL in the serum urea nitrogen level; intermittent glycosuria independent of plasma glucose; proteinuria; aminoaciduria; increased uric acid excretion; increased total body water, with osmostat resetting; 50% increase in plasma volume and cardiac output; and increased ureteral peristalsis.
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46

McQuarrie, Emily P., Hallvard Holdaas, Bengt Fellström, and Alan G. Jardine. Cardiovascular disease. Edited by Jeremy R. Chapman. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0285.

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Premature cardiovascular disease is much more common in renal transplant recipients than the general population, although less common than in patients relying on maintenance haemodialysis. Cardiovascular disease in renal transplant recipients differs from the traditional atherosclerotic model. Although ordinary risk factors such as age, gender, diabetes, hypertension, and smoking still apply, others such as left ventricular hypertrophy and uraemic cardiomyopathy are relevant. Transplantation also adds specific risks such as immunosuppressive therapies and acute rejection. Understanding and managing the cardiovascular risk in this population is limited by a lack of large-scale randomized trials. The approach to managing the cardiovascular risk profile of these patients should be multifactorial and start even before transplantation.
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47

Prout, Jeremy, Tanya Jones, and Daniel Martin. Anaesthesia for general surgery (including transplantation). Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199609956.003.0013.

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This chapter focuses on aspects of anaesthesia for complex, major surgery such as hepatic resection and oesophagectomy. The theories and practice of enhanced recovery after surgery and perioperative optimisation with goal directed therapy are included here. The systemic impact of malignancy and its treatment modalities are also discussed. The practical and ethical aspects of organ transplantation are discussed. Anaesthesia for renal and hepatic transplant is described, as well as considerations for anaesthetising the transplant recipient for non-transplant surgery. Recognition of transurethral resection syndrome in urological surgery is potentially life-saving; causes, management and avoidance are discussed. The NICE criteria for performing bariatric surgery, types of surgery, and conduct of anaesthesia for this challenging patient group is also covered.
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48

Teoh, Eugene, and Michael J. Weston. Computed tomography. Edited by Christopher G. Winearls. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0014.

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Computed tomography (CT) has increased in use exponentially for the assessment of patients with renal tract pathology. This has been promoted by the availability of multidetector thin-slice CT so that intravenous urography has been superseded by CT urography. The latter may be considered as a ‘one-stop’ imaging investigation for haematuria, with increased detection of both urinary tract cancers and urolithiasis. Multiplanar reformats are made possible with the use of thin slices, allowing clear delineation of other pathologies such as urinary tract injury. In the transplant recipient, protocols have been developed for the assessment of more immediate complications such as thrombotic and stenotic disease. During follow-up, CT continues to inform the management of post-transplant lymphoproliferative disorder and other immunosuppressant-related complications. Unenhanced CT of the urinary tract has established its role in assessment of patients with renal colic, with the ability to detect pathology outside of the urinary tract. Renal CT has been developed for the characterization of renal masses, accompanied by the now well-established Bosniak renal cyst classification system. As the usefulness of CT increases, clear awareness of safety issues has to be maintained. These include the administration of intravenous iodinated contrast medium in higher-risk patient groups, particularly those with renal impairment. The radiation burden that comes with CT poses an added risk to the patient that should not be ignored. This necessitates clear referral guidelines for its use, which should be applied in careful balance with the global assessment of the patient.
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49

E, De Broe M., and European Dialysis and Transplant Association - European Renal Association. Congress, eds. Aluminum and iron overload in haemodialysis: An international workshop held during the XXVth Congress of the European Dialysis and Transplant Association/European Renal Association. Toronto: Hogrefe & Huber Publishers, 1989.

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50

Daly, Ivonne M., and Ali Al-Khafaji. Intensive care management in hepatic and other abdominal organ transplantation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0371.

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Care of the transplant patient post-operatively requires a multidisciplinary approach. The goal of the intensivist is to create an ideal environment for the allograft to recover from its ischaemic insult and return to normal function. An understanding of the recipient’s pretransplant physiology is essential, as the pathological states associated with organ failure may persist for weeks to months after transplant. In particular, cardiac and renal disease may impact care in the immediate post-transplant period. An understanding of immune suppressive strategies will enable the intensivist to mitigate nephrotoxic side effects of these medications and anticipate specific vulnerabilities to infection. Attention to all the details of good critical care will give the allograft and the recipient the best chance for long-term survival. The intensivist must be able anticipate problems related to surgery and early signs of allograft recovery and dysfunction. Common post-operative complications are described in this chapter.
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