Kidney Transplant

About Kidney Transplant

Kidney transplantation is the preferred treatment for many people with end stage kidney disease, generally offering longer survival and better quality of life than long term dialysis. It is the most common solid organ transplant. The first successful kidney transplant was performed in 1954 in Boston by Joseph Murray and colleagues between identical twins, work for which Murray later shared the Nobel Prize. Kidneys come from deceased donors or from living donors, often relatives or partners, and living donor kidneys tend to function for longer. The new kidney is usually placed in the iliac fossa of the lower abdomen outside the peritoneal cavity; its artery and vein are connected to the iliac vessels and its ureter to the bladder. The native kidneys are usually left in place unless they are causing problems, as in some cases of very enlarged polycystic kidneys or chronic infection. Some kidneys from deceased donors take time to start working, a situation called delayed graft function, during which temporary dialysis may be needed. Surgical complications include blood clots in the transplant vessels, leaks or narrowing of the ureter, and collections of lymph fluid called lymphoceles. Lifelong immunosuppressive medication is needed to prevent rejection, which raises the risk of infections and some cancers. Living donor nephrectomy is now usually performed laparoscopically, which has made recovery easier for donors. Paired kidney exchange programs allow incompatible donor and recipient pairs to swap kidneys with other pairs.