Prevention and management of kidney graft failure

Wednesday 25 October 2023, 12:30 pm
PhD student
K.L.W. Bunthof drs.
prof. dr. L.B. Hilbrands
dr. M.C. Baas

Immunosuppressive drugs are needed to prevent acute rejection after kidney transplantation. Tacrolimus is an important drugs. The first part of this thesis includes the optimization of tacrolimus treatment. The tacrolimus intrapatient variability study shows no difference in the variability in trough levels between preparations with immediate (twice daily) or modified release (once daily).

The second part of the thesis is about kidney graft failure. Mostly the failed kidney graft will be left in situ. However in some cases a graft intolerance syndrome (GIS) will occur with the need for an urgent graft nephrectomy. Urgent graft nephrectomy is risky with severe complications in 15%. GIS can be reasonably predicted with a model in which young age, short graft survival and acute rejection are predictors. In case of high risk active surveillance or even pre-emptive graft nephrectomy can be considered. Lastly, routinely histopathological examination of removed kidney grafts is not useful.

Kim Bunthof (1984) graduated in 2010 (cum laude) and started her residency in internal medicine in that same year. In 2015 she started with her PdD about kidney graft failure at the department of Nephrology. Since 2019 she is nephrologist and in 2021 she started working in the Bravis Hospital in Roosendaal.