Resumen de Renal transplantation
Richard Baker, Christopher J.E. Watson
Renal transplantation improves quality of life and usually increases longevity in individuals with end stage renal failure (ESRF), and is the preferred form of renal replacement therapy. Unfortunately, owing to excessive co-morbidities, only 30% of patients who develop ESRF are fit enough to be listed for transplantation. Early attempts at kidney transplantation were blighted by immunological rejection but the advent of potent immunosuppressive agents has raised 1-year graft survival rates to over 90%. This success is also attributable to improvements in histocompatibility testing, organ procurement, preservation methods and peri-operative care. Chronic deterioration of graft function remains a problem; long-term outcome has shown only minor improvement over the last two decades, although these results should be considered in the context of deteriorating organ quality as deceased donors become older with increasing co-morbidity. Overall transplant numbers have been bolstered by an increase in living donation facilitated by the use of innovative schemes such as altruistic donation and the paired donor exchange programme. It is important to realize that kidney transplant recipients (KTRs) swap one chronic illness (ESRF) for another, which mostly gives them a better and longer life, free of the need for regular dialysis.
