Renal transplantation

In the UK, renal transplantation is the preferred treatment option for end-stage renal failure. Kidneys may be obtained from cadavers (80%) or from living-related or unrelated donors (20%). Absolute contraindications to organ donation include HIV and certain viral diseases (e.g. Jakob-Creutzfeld disease). The kidney transplant is performed by placing the new kidney in the right or left iliac fossa, the renal vein being anastomosed to the external iliac vein and the renal artery to the external or internal iliac artery. The main complications are rejection and infection. A long-term complication is an increased incidence in certain forms of cancer (especially skin cancers). Results of renal transplantation in the UK are good: one-year graft survivals are about 90%; 5-year graft survivals are about 75% and 10-year graft survivals are about 60%.