VIDEO: Distress, anxiety need to be addressed when patients face a failed transplant
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Key takeaways:
- Transplant physicians should have a care plan in place when helping patients transition after a failed transplant.
- Patients may experience emotional distress and anxiety when returning to dialysis.
SAN DIEGO — Transplant physicians should have a patient care plan in place when helping patients deal with the distress and anxiety after a failed transplant, a presenter said here.
“Number one, the focus among other things is their mental health,” Anjay Rastogi, MD, PhD, clinical chief of nephrology at UCLA Health and medical director of the Core Kidney Program, said in a presentation at the Annual Dialysis Conference. “These are patients who had the hope, got the transplant and now it has failed, and they are getting back to dialysis. So mental health is very important. These patients will have a high level of anxiety and depression that should be addressed.”
Clinicians should also have a clear understanding as to why the transplanted kidney failed. “Was it a recurrence of the primary disease or was it noncompliance or nonadherence” to the immunosuppressive drugs that patients take to limit the risk of allograft failure, Rastogi said.
For patients facing a failing kidney, Rastogi suggested efforts should be made to get a preemptive transplant to help keep the patient off dialysis. “There is nothing different between [these patients] and patients who have [chronic kidney disease] CKD in stages 4 or 5 and looking for a living kidney donor and getting them a kidney transplant,” Rastogi said.
Lastly, clinicians should evaluate patients for infections, malignancy and cardiovascular and metabolic risk factors that come from immunosuppressive drug regimens before making the transition to dialysis, Rastogi said.
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Rastogi A. Dialysis after failed transplants. Presented at: Annual Dialysis Conference; March 8-10, 2024; San Diego.
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