RENAL TRANSPLANTATION AN OVERVIEW

Posted by e-Medical PPT
Patients Selection For Kidney Transplanatation
All patients with end stage renal disease (ESRD) are condidates for KT unless
Systemic malignancy   
Chronic infection.
Severe cardiovascular disease.
Neuropsychiatric disorder
Extremes of age (relative)

Patient Survival After Kidney Transplantation VS haemodialysis
Annual mortality rates for patients under dialysis range from 21%-25%, but <8% with cadaveric and <4% with living-related transplant recipients.
Healthier patients generally are selected for transplantation.
The benefit of transplantation is most notable in young people and in those with diabetes mellitus.

Principles Involved In evaluating A Prospective Living Kidney Donor
Whether there is a medical condition that will put donor at increased risk for complications for general anesthesia or surgery.
Whether the removal of one kidney will increase the donor’s risk for developing renal insufficiency.

CONTRAINDICATIONS TO RENAL TRANSPLANTATION
ABO incompatibility.
Cystoxic antibodies against HLA antigens of donor.
Recent or metastatic malignancy.
Active infection.
AIDS.
Severe extrarenal disease (cardiac, pulmonary, hepatic).
Active vasculitis or glomeulonephritis.
Uncorrectable lower urinary tract disease.
Noncompliance.
Psychiatric illness including alcoholism and drug addiction.
Morbid obesity.
Age > 70 years.
Primary oxalosis.
Persistent coagulation disorder.

Does Donation Of A kidney Pose A long-term Risk For The Donor?
Following nephrectomy, compensatory hypertrophy and increase in GFR occur in the remaining kidney.
Slight risk of poteinuria and hypertension.
Meta-analysis of data from donors followed for >20y confirmed safety of kidney donation.

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