当前位置: 首页 > 期刊 > 《新英格兰医药杂志》 > 2005年第25期 > 正文
编号:11325626
Medical Management of Kidney Transplantation
http://www.100md.com 《新英格兰医药杂志》
     Transplantation has been a miracle of modern medicine. The success of transplantation of all solid organs began with the pioneers of kidney transplantation, who developed, tested, and refined innovative immunosuppressive treatment. In the early years, the American transplantation group consisted of a small number of transplantation surgeons who met annually at the Drake Hotel in Chicago. Over the past three decades, the American Transplant Congress has outgrown Chicago and many other sites for its meetings. The growth of the congress is entirely due to the success of transplantation. The burgeoning population of kidney recipients has resulted in the growth in the number of transplantation physicians caring for a group whose problems are largely medical.

    Medical Management of Kidney Transplantation is a timely, authoritative, multiauthored textbook that will serve the growing population of medical and allied health professionals, as well as those in the pharmaceutical industry who support transplantation. The care of the kidney-graft recipient parallels the care of other solid-organ recipients and has relevance to physicians caring for recipients of other organs.

    Other textbooks, regularly updated, have served a similar purpose. However, they include details on organ donation and surgical aspects of kidney transplantation as well as on medical and immunologic aspects. Weir's book, as the title suggests, focuses on medical issues that require considerable depth and breadth of discussion while retaining an awareness of surgical care and complications. This is the strength of the book. The editor's intention was to offer a timely review of the available medical literature and to provide insightful interpretations that would improve medical care. To all this, I would add the need to identify areas of uncertainty and to highlight areas where more research is required.

    How well has this intention been accomplished? As expected, there is considerable variation in style and depth from chapter to chapter. The University of Maryland, Baltimore, has one of the largest kidney-transplantation programs in the country, and Weir invited many of his colleagues to contribute to the book. Nonetheless, other North American experts contributed key chapters. The balance is heavily weighted toward clinical rather than basic science. Even the chapter on immune tolerance is geared toward the future of clinical practice. All the chapters are easy to read, well written, and well referenced. For the most part, the recommendations are generic, rather than proscriptive. Many chapters are excellent, notably those covering hematologic complications and liver disease. Several, such as those discussing urologic complications, pregnancy, pathology, imaging, and drug interactions, are remarkably succinct but comprehensive. A few chapters, in which the authors exercise their license to express opinion, border on single-mindedness. Nonetheless, these comments are both valuable and insightful, and although there are topics that overlap in several chapters, repetition is an issue only if one is reading the book cover to cover. Although some topics are treated lightly, such as therapeutic drug monitoring, assessment of the quality of organs from deceased donors, and allocation strategies, the book is comprehensive and has achieved its purpose.

    This excellent textbook is now the standard with which all other textbooks on kidney transplantation can be compared. Since transplantation medicine is an evolving art, the book will help all those on the path to improving the quality of life of patients undergoing kidney transplantation.

    Bryce A. Kiberd, M.D.

    Dalhousie University

    Halifax, NS B3H 3G9, Canada