Selection of patients for kidney organ transplantation

Renal transplantation is a viable alternative for most patients with end-stage renal disease, either before or after the institution of dialysis. Evaluation of potential recipients is necessary before transplantation and is mandatory to exclude patients who are likely to have a poor outcome. Such evaluation also may identify special problems and conditions in patients with end-stage renal disease who will require intervention before transplantation. Identification and evaluation of each transplant donor is also very important. Although organs from related living donors usually have better long-term function, survival, and fewer complications, most efforts in the transplantation community are spent attempting to extend the survival of cadaver kidney transplants. This goal could be accomplished by increasing availability of cadaver organs, improving histocompatibility of donor-recipient pairs, and improving available immunosuppressive therapy.