Kidney transplantation

Kidney Transplantation
Other names	Renal transplantation
Specialty	nephrology, transplantology
ICD-10-PCS	OTY
ICD-9-CM	55.6
MeSH	D016030
OPS-301 code	5-555
MedlinePlus	003005
[edit on Wikidata]

Kidney transplant or renal transplant is the organ transplant of a kidney into a patient with end-stage kidney disease (ESRD). Kidney transplant is typically classified as deceased-donor (formerly known as cadaveric) or living-donor transplantation depending on the source of the donor organ. Living-donor kidney transplants are further characterized as genetically related (living-related) or non-related (living-unrelated) transplants, depending on whether a biological relationship exists between the donor and recipient. The first successful kidney transplant was performed in 1954 by a team including Joseph Murray, the recipient's surgeon, and Hartwell Harrison, surgeon for the donor. Murray was awarded a Nobel Prize in Physiology or Medicine in 1990 for this and other work.^[1] In 2018, an estimated 95,479 kidney transplants were performed worldwide, 36% of which came from living donors.^[2]

Before receiving a kidney transplant, a person with ESRD must undergo a thorough medical evaluation to make sure that they are healthy enough to undergo transplant surgery. If they are deemed a good candidate, they can be placed on a waiting list to receive a kidney from a deceased donor.^[3] Once they are placed on the waiting list, they can receive a new kidney very quickly, or they may have to wait many years; in the United States, the average waiting time is three to five years.^[4] During transplant surgery, the new kidney is usually placed in the lower abdomen (belly); the person's two native kidneys are not usually taken out unless there is a medical reason to do so.^[3]

People with ESRD who receive a kidney transplant generally live longer than people with ESRD who are on dialysis and may have a better quality of life.^[3] However, kidney transplant recipients must remain on immunosuppressants (medications to suppress the immune system) for as long as the new kidney is working to prevent their body from rejecting it.^[3] This long-term immunosuppression puts them at higher risk for infections and cancer.^[5] Kidney transplant rejection can be classified as cellular rejection or antibody-mediated rejection. Antibody-mediated rejection can be classified as hyperacute, acute, or chronic, depending on how long after the transplant it occurs. If rejection is suspected, a kidney biopsy should be obtained.^[5] It is important to regularly monitor the new kidney's function by measuring serum creatinine and other labs; this should be done at least every three months.^[5]