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Renal transplantation 

Renal transplantation
Chapter:
Renal transplantation
Author(s):

P. Sweny

DOI:
10.1093/med/9780199204854.003.210703_update_001

Update:

Renal transplant statistics have been updated. Discussion of extended criteria donors, dual kidney transplants and increasing prevalence of living donation. Data on renal transplantation in HIV-positive recipients.

Updated on 25 May 2011. The previous version of this content can be found here.
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date: 17 October 2017

Renal transplantation is the preferred option for the treatment of endstage chronic renal failure in patients for whom there are no major medical contraindications. In well-selected recipients, both life expectancy and quality of life are superior to treatment with long-term dialysis. However, as the dialysis population continues to grow, the gap between supply and demand for renal transplantation is widening. Attempts to bridge this gap have included (1) relaxation of the criteria for a suitable deceased donor (expanded/extended criteria or ‘marginal donors’); (2) reversion to the procurement of kidneys from donors with cardiac death (DCD donors, previously known as non-heart beating donors); and (3) encouragement of living donation—including techniques for desensitization of recipients, also paired exchanges, both to circumvent blood group incompatibilities or preformed antibodies that would otherwise bar transplantation....

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