Kidney Transplantation

This page follows the page about kidney dialysis.

As kidney dialysis (also known as 'renal dialysis') is costly and inconvenient for the patient, the possibility of a kidney transplant is appropriate for some patients diagnosed with kidney failure (or extemely poor kidney function).

Patients who have chronic renal failure - e.g. due to causes such as chronic pyelonephritis, diabetes mellitus, hypertension, polycystic kidneys, or connective tissue disorders, are maintained on dialysis until a suitable donor kidney becomes available.

Kidneys can be donated for transplant from either:

  • a cadaver (recently deceased donor), or
  • a living related donor.

In both cases necessary conditions are that there is:

  • ABO Blood Group compatibility, and
  • human leucocyte antigen (HLA) tissue-type compatibility.

Kidney Transplantation Procedure Diagram

Procedural Notes:

The donor kidney must be transplanted with 24-28 hours of removal from the donor.

It is transplanted into the pelvic area (as shown in the diagram on the left), and the renal blood vessels are anastomosed* to the illiac blood vessels. The donor ureter is implanted into the bladder.

The contents of the donor ureter can be sampled and the concentration of solutes tested to ascertain the success of the procedure very soon after it has been completed.

Possible Complications:

Complications arising from kidney transplants can include rejection of the new kidney (either immediately "acute rejection" or some time later), acute tubular necrosis, or infection.

After a kidney transplant patients are advised to take immunosuppressive medication indefinitely (i.e. lifelong).

Success of Kidney Transplants:

Graft survival is 80% one year after the procedure, and 60% 5 years after the procedure - according to 2001 UK statistics.

The relatively high overall success rate for kidney transplants can be attributed to the following:

  1. The vascular connections are relatively simple, as shown in the diagram above.
  2. It is possible to accept kidneys from live donors, which enables very close blood matching between donors and recipients.
  3. Partly due to (2.), above, there are fewer immuno-supression-related problems (in which the body's own immune system react against the new kidney) than might otherwise be the case.

Note: This topic is not strictly "Basic Anatomy & Physiology" but is simple information about a procedure. that might be of interest to students or included as part of course requirements.

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