Kidney transplantation is the optimal therapy for patients with end stage renal disease (ESRD). ESRD patients who undergo kidney transplantation enjoy a healthier and longer life than those who remain on dialysis. It is even better to receive kidney transplantation without ever going on dialysis (Preemptive transplant). Furthermore, for those who start dialysis, the sooner they get kidney transplant the longer and healthier they live.
Kidneys used for transplant can come from a living donor that may (living-related donor) or may not (living-unrelated donor) relate to the recipient. Another type of donor are those who die and their families agree to donate their organ(s) (deceased donor). Living donors are better than deceased donors, since deceased donor organs suffer from various types of injuries during the illness causing the death, in addition to the damage caused by lack of blood perfusion during removal and storage.
The donor has to have the same blood group, although, many centers are using donors with different blood group (ABO incompatible transplant) as long as the recipient has relatively low levels of antibody titers against that different blood group. In addition, the recipient may have to go through additional therapies, such as plasmapheresis, and more immunosuppressive treatment.
Another requirement for the transplant to proceed is for the recipient to be free from antibodies that can attack the donor's kidney (Anti-HLA antibodies). Again, many centers are doing transplant despite the presence of these antibodies, especially, when their titers are relatively low. Similar to the ABO incompatible transplants, the recipient may have to undergo plasmapheresis in addition to additional immunosuppressive therapies.
Donors usually go through extensive medical evaluation to make sure they are healthy, free of infectious pathogens and can go through the donation surgery with minimal risk. Similarly, recipients has to go through medical evaluation to make sure they can tolerate the transplant surgery with an acceptable risk of complications.
Kidney transplant recipients receive very regular and close follow up after transplant, especially early on, since the risk of rejection is the highest during the first few months.
Taking transplant medications and regular medical follow up is of utmost importance for the transplant success and longevity.
The medical information presented in this website is of general nature and intended for educational purposes only. This information should not be used as a basis for making or altering medical decisions or therapies. Medical and therapeutic decisions should be made or altered only by the physician who is evaluating and treating a particular patient. Medicine is an ever-changing and -evolving field. Although, the author of this site has made every effort to present an accurate and up-to-date information, however, he is not responsible by any means for any unintended mistakes or misuse of the information presented.