My father of 75 is on his 23rd year of receiving his kidney transplant. His eGFR fluctuates from 12 -28, creatinine above 4. He has started dialysis 6 months ago. His nephrologist wants to stop the two immunosuppressants, completely. What could happen to the transplanted kidney if/when rejected by the body? Does it have to be surgically removed?

This is a difficult question to answer. There are many factors that have to be considered, such as the exact immunosuppressants that are to be stopped, your father’s underlying illness, the risks with continued immunosuppression in a dialysis patient, the likelihood that he would be considered for a second kidney transplant and the cause of the kidney failure in the transplant. In most cases, the transplanted kidney does not have to be surgically removed, unless acute rejection causes a break up of the kidney after the immunosuppression is stopped. This question is best answer by a nephrologist and preferably a transplant nephrologist that knows your father the best. This is often a very complex decision.

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