Renal transplantation

Renal transplantation is the preferred treatment option for end-stage renal failure in the appropriate patient. The kidney may come from a deceased donor or a living donor. The kidney is placed extraperitoneally in the iliac fossa, the renal vessels are usually anastomosed to the iliac vessels and the ureter to the dome of the bladder. Complications relating to the operation include renal artery thrombosis, renal vein thrombosis, renal artery stenosis, lymphocoele, ureteric obstruction and ureteric leakage. Graft survival of 90% at one year and 80% at 5 years may be expected, the two major causes of graft loss being chronic allograft nephropathy and death with a functioning graft usually from cardiac disease.