Surgical Procedures for End-stage Renal Disease (ESRD)
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A kidney transplant may be a treatment option for ESRD.
Kidney transplant is an alternative to dialysis in individuals who have severe renal disease. A ]]>kidney transplant]]> is a surgical procedure that inserts a healthy kidney from a donor into your body. Your kidney(s) are left in place, unless they are causing problems like an infection or high blood pressure. The donor may be a living relative, a close friend whose tissue closely matches yours, or someone who has died and donated his or her organs, which accounts for two-thirds of transplanted kidney. One year after kidney transplant from a living donor, approximately 90% of them are still working as compared to 70% to 90% of kidneys from someone who just died. The one transplanted kidney does the work of your two failed kidneys.
Rejection of the transplanted kidney occurs within 3 to 4 months after the surgical procedure. The symptoms of rejection include: fever, weight gain, reduced urine output, and increase in blood pressure. Moreover, blood tests will show deteriorating renal function. Within the last decade or so, there are major advances in the drug development of immunosuppressive agents beyond the traditional drugs (such as steroids, azathioprine, and cyclosporine), including the following:
- Mycophenolate mofetil
- Anti-interleukin 2 receptor antibodies
- ]]>Antithymocyte globulin]]>
Complications from renal transplantation and the use of immunosuppressive drugs include the following:
Andrews PA. Renal transplantation. Brit Med J. 2002;324:530-534.
Davis CL, Delmonico FL. Living-donor kidney transplantation: a review of the current practices for the live donor. J Am Soc Nephrol. 2005; 16:2098-2110.
National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/ .
Textbook of Surgery . 16th ed. WB Saunders Co; 2001.
Last reviewed April 2009 by ]]>Rosalyn Carson-DeWitt, MD ]]>
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