Renal transplantation is the surgical transfer of a healthy kidney from a living or deceased donor to a recipient with kidney failure, replacing the lost excretory, regulatory, and endocrine functions of the native organ. It is the treatment of choice for end-stage renal disease because it typically affords better s…
Renal transplantation is the surgical transfer of a healthy kidney from a living or deceased donor to a recipient with kidney failure, replacing the lost excretory, regulatory, and endocrine functions of the native organ. It is the treatment of choice for end-stage renal disease because it typically affords better survival and quality of life than maintenance dialysis, restoring filtration and the body's fluid, electrolyte, and acid-base balance. The transplanted kidney is usually placed in the pelvis and connected to the recipient's vessels and urinary tract, and graft survival depends on immunological compatibility, particularly blood group and human leukocyte antigen matching. Recipients require lifelong immunosuppression to prevent acute and chronic rejection, which is mediated by cellular and antibody-driven responses and managed by balancing drug efficacy against infection, malignancy, and toxicity. Early graft function can be compromised by ischemic injury and intraoperative hemodynamic factors, producing delayed graft function, while later complications include rejection, recurrent disease, and drug-related effects. Surveillance combines laboratory monitoring, Doppler ultrasonography, and biopsy, and molecular profiling such as single-nucleotide polymorphism analysis is studied to individualize immunosuppressive therapy. Outcomes are also shaped by donor source and the ethics of living donation and organ allocation. Research in this area addresses rejection and its personalized management, post-transplant complications, graft function, and living-donor and allocation considerations.
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