Kidney Transplant I: Introduction

A kidney transplant replaces a non-functioning kidney with a donor organ, typically for patients with end-stage renal disease.

Recipient selection for kidney transplant includes evaluation of factors like cardiovascular disease, including coronary artery disease, poorly controlled diabetes, obesity, or inability to quit smoking, as these conditions may disqualify candidates.

Key contraindications include advanced cancers, chronic respiratory failure, untreated infections like tuberculosis, and psychosocial issues, including poor treatment adherence.

Next, histocompatibility studies, such as Human Leukocyte Antigen typing and crossmatching, assess donor-recipient compatibility to reduce the risk of rejection.

Donors can be living or deceased; living donors undergo health evaluations, kidney function tests, infection screening, and imaging studies like CT scans. For deceased donors, healthcare providers must maintain cardiovascular function and ventilation until organ retrieval to preserve organ viability.

However, living donor kidneys offer advantages like faster recovery due to reduced “cold time,” which is the period the kidney remains outside the body.