Indications and Timing

  • Sergio Stefoni
  • Maria Piera Scolari
  • Irene Capelli
Chapter

Abstract

The indications for transplant and its timing, key factors in solid organ transplantation, are easier to define for kidneys with respect to other organs. The indication for kidney transplant is chronic renal failure quantified on the basis of the residual glomerular filtration rate reached by patients when treatment, if administered, has proved ineffective (Fig. 15.1) and changes to the renal parenchyma are definitive and irreversible. To determine the timing, i.e., when to proceed to transplantation, a distinction must be made between theory and practice. In theory, transplant should be entertained when residual kidney function is around 10–15 %, irrespective of the start of regular dialysis treatment. However, this “early” optimal timing is only feasible if a living donor is available. In practice, almost all patients undergo kidney transplant when they have reached the terminal stage of uremia, the start of regular dialysis treatment, and after placement on the renal transplant waiting list.

Keywords

Renal failure Uremia Kidney transplant Organ replacement Transplant timing 
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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Sergio Stefoni
    • 1
  • Maria Piera Scolari
    • 1
  • Irene Capelli
    • 1
  1. 1.Nephrology, Dialysis and Transplantation Unit, Department of Experimental, Diagnostic and Specialty MedicineS.Orsola University HospitalBolognaItaly

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