Clinical aspects: focusing on key unique organ-specific issues of renal transplantation

Kidney transplantation is the treatment of choice for patients with end-stage renal disease because of improved patient survival and quality of life as compared with dialysis. Successful transplantation requires the prompt recognition and appropriate management of both the immediate posttransplant surgical and medical complications as well as subsequent issues like recurrent disease and chronic rejection that affect long-term graft survival. Guidelines for understanding and managing some of the more important early and late kidney-specific transplant problems, including urologic complications, delayed graft function, acute and chronic rejection, BK polyoma virus infection, and recurrent glomerular disease, are reviewed.