"Kidney transplant or renal transplant is the organ transplant of a kidney into a patient with end-stage kidney disease (ESRD)."
This topic covers the surgical procedure of transplanting a new kidney into a person whose kidneys have failed.
Anatomy and Physiology of the Kidney: Understanding the structure and function of the kidney is important in the management of kidney transplantation.
Types of Kidney Transplantation: Understanding the different types of kidney transplantation, including deceased donor, living donor, and paired exchange transplantation, is important in deciding the best transplant option for each patient.
Indications and Contraindications for Kidney Transplantation: Knowing the criteria for selecting patients for kidney transplantation and contraindications to transplantation is important in selecting appropriate candidates for transplant.
Pre-transplant Evaluation: Understanding the pre-transplant evaluation process is important in determining the suitability of a patient for transplantation and in identifying potential complications.
Organ Allocation: Understanding the organ allocation system in kidney transplantation is important in ensuring fair and equitable distribution of organs to patients in need.
Immunosuppression: Understanding the mechanisms and principles of immunosuppressive therapy is important in minimizing rejection and optimizing transplant outcomes.
Surgical Techniques: Understanding the surgical techniques involved in kidney transplantation is important in ensuring successful organ placement and minimizing complications.
Post-transplant Management: Understanding the post-transplant management of patients, including immunosuppressive therapy, monitoring for complications, and management of infections, is important in optimizing long-term graft survival.
Graft and Patient Survival: Understanding the factors that influence graft and patient survival after kidney transplantation is important in predicting outcomes and improving care.
Complications: Understanding the potential complications of kidney transplantation, including graft rejection, infection, and cardiovascular disease, is important in preventing and managing these complications.
Emerging Technologies: Understanding emerging technologies and therapies in kidney transplantation, such as precision medicine and regenerative medicine, is important in improving outcomes for patients with kidney disease.
Living donor kidney transplantation: This type of transplantation involves a healthy person donating one of their kidneys to a recipient who needs it. The living donor can be a family member, friend, or even a stranger who is a good match for the recipient. Living donor kidney transplants have higher success rates and shorter waiting times than deceased donor kidney transplants.
Deceased donor kidney transplantation: This type of transplantation involves a kidney being removed from an individual who has recently passed away and then transplanted into a recipient who needs it. Deceased donor kidneys can come from people who have voluntarily chosen to donate their organs, or from people who are declared brain-dead and whose families consent to donation.
Paired kidney exchange transplantation: This type of transplantation is used when a living donor is willing to donate a kidney to a loved one who needs it, but they are not a good match. In this case, the donor and recipient pair are matched with another pair in a similar situation. The donor in each pair donates their kidney to the recipient in the other pair, allowing both recipients to receive a compatible kidney.
ABO-incompatible kidney transplantation: This type of transplantation involves transplanting a kidney even if the donor and recipient have different blood types. The recipient must undergo a pre-transplant treatment to reduce their antibodies and help prevent rejection of the donated kidney.
HLA-incompatible kidney transplantation: This type of transplantation involves transplanting a kidney even if the donor and recipient have different human leukocyte antigen (HLA) profiles. The recipient must undergo a pre-transplant treatment to help prevent the immune system from rejecting the donated kidney.
Simultaneous kidney-pancreas transplantation: This type of transplantation is used for people with both kidney failure and Type 1 diabetes. The recipient receives both a kidney and a pancreas from a deceased donor in a single surgery.
En-bloc kidney transplantation: This type of transplantation involves transplanting an intact kidney from a deceased donor, including the ureter and blood vessels. It is sometimes used when a child needs a kidney transplant, as the smaller size of an adult kidney can make the surgery difficult.
"Kidney transplant is typically classified as deceased-donor or living-donor transplantation depending on the source of the donor organ."
"Living-donor kidney transplants are further characterized as genetically related (living-related) or non-related (living-unrelated) transplants."
"Before receiving a kidney transplant, a person with ESRD must undergo a thorough medical evaluation to make sure that they are healthy enough to undergo transplant surgery."
"If they are deemed a good candidate, they can be placed on a waiting list to receive a kidney from a deceased donor."
"In the United States, the average waiting time is three to five years."
"During transplant surgery, the new kidney is usually placed in the lower abdomen (belly)."
"The person's two native kidneys are not usually taken out unless there is a medical reason to do so."
"People with ESRD who receive a kidney transplant generally live longer than people with ESRD who are on dialysis."
"Kidney transplant recipients must remain on immunosuppressants (medications to suppress the immune system) for as long as the new kidney is working to prevent their body from rejecting it."
"This long-term immunosuppression puts them at higher risk for infections and cancer."
"Kidney transplant rejection can be classified as cellular rejection or antibody-mediated rejection."
"Antibody-mediated rejection can be classified as hyperacute, acute, or chronic, depending on how long after the transplant it occurs."
"If rejection is suspected, a kidney biopsy should be obtained."
"It is important to regularly monitor the new kidney's function by measuring serum creatinine and other labs; this should be done at least every three months."
"In 2018, an estimated 95,479 kidney transplants were performed worldwide."
"36% of kidney transplants came from living donors."
"The first successful kidney transplant was performed in 1954 by a team including Joseph Murray, the recipient’s surgeon, and Hartwell Harrison, surgeon for the donor."
"Murray was awarded a Nobel Prize in Physiology or Medicine in 1990 for this and other work."
"This long-term immunosuppression puts them at higher risk for infections and cancer."