Transplantation

Abstract

Renal transplantation is the best modality of renal replacement therapy available for most patients with end-stage renal disease and is one of the breakthroughs in medical science in recent decades. Our knowledge of HLA typing, cross-match testing, recipient preparation, donor management, and postoperative care have advanced and brought widespread benefits, and these are crucial for clinicians to formulate an appropriate treatment regimen. Great effects should be paid to selection and preparation of kidney transplant recipients because of the risks from immunosuppressive therapy. Reducing acute rejection episodes and minimizing ischemic damage is the main goal of immunosuppressive therapy. The general concepts that most clinicians agree useful include induction therapy and maintenance treatment. Delayed graft function after kidney transplantation is usually defined as the need for dialysis during the first postoperative week, anuria, or failure of prompt azotemia resolution, and most studies suggest that patients with DGF have worse long-term outcomes than patients with immediate function. Although the outcomes of renal transplant patients have improved over the years, this population continues to show significant morbidity and mortality due to infection. Transplantation team should attempt to achieve a balance between preventing allograft rejection and maintaining immune system integrity.