Kidney transplantation – expectations and persistent dilemmas

Abstract:

Kidney transplantation is a widely accepted treatment method in patients with chronic kidney failure. However, it still raises many questions about who should perform the transplantation; whether the transplantation is an elective operation; what are the organisational issues related to organ transplantation and, especially, expanded criteria donors; what patient evaluation before the transplantation surgery should consist of; and what issues in kidney explantation and transplantation and immunosuppressive therapy are still unresolved. Since 1970’s, when the survival of cadaveric organs was less than 50%, our knowledge of immunohistocompatibility and management of cadavers has significantly increased. Today, the 5-year survival of cadaveric kidneys is above 80% due to higher quality of perfusion solutions, improved surgical techniques, and availability of more potent immunosuppressive drugs. Further advancements in all segments of transplantation medicine are expected to lead to even better treatment results and greater safety of patients 

Key words:
graft rejection; immunosuppressive agents; kidney transplantation; tissue donors