Renal transplantation.

Abstract

Kidney transplantation is the optimal treatment for end stage renal disease. However, there are risks both from early complications directly related to the surgical procedure, and from longer-term complications resulting from the effects of immunosuppression. This chapter describes the transplant process from the evaluation of patients with renal failure for suitability for transplantation, through the surgical procedure itself, the early and late management of recipients, and the management of the complications that can arise, including acute and chronic graft dysfunction, infection, malignancy, and cardiovascular disease. It also covers the short- and long-term outcomes of kidney transplantation. Since live kidney donors have become an increasingly important source of kidneys for renal transplantation, it also describes the work-up process for potential live donors and the long-term outcomes following donation. Finally, combined kidney/pancreas transplantation is included separately and includes a discussion around the selection and evaluation recipients, the surgical procedure, short- and long-term complications, and the outcomes.