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Langenbeck's Archives of Surgery
Published in: Langenbeck's Archives of Surgery 1/2009

01-01-2009 | Current Concepts in Clinical Surgery

Renal transplantation today

Authors: Michael Neipp, Steffan Jackobs, Jürgen Klempnauer

Published in: Langenbeck's Archives of Surgery | Issue 1/2009

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Abstract

Background

The first successful renal transplant was carried out more than five decades ago between identical twins. At these early days, acute rejection was the limiting factor.

Discussion

Due to tremendous progress in immunosuppressive therapy and surgical technique, today, renal transplantation is the gold standard therapy for patients with end-stage renal disease. In fact, in comparison with chronic hemodialysis, renal transplantation offers an increase in quality of life while reducing comorbidities associated with dialysis treatment.

Results

Despite numerous beneficial achievements, no further improvement regarding patient outcome can be observed over the last two decades. Graft survival rates remain unchanged. The leading causes for graft loss are chronic allograft nephropathy and death with functioning graft. This might be related to a constant increase of the proportion of donors presenting extended donor criteria as well as a more liberal acceptance of candidates for a renal transplant.

Conclusion

In the near future, one has to focus more closely on the posttransplant patient care to minimize factors associated with chronic allograft damage. These include post-transplant diabetes, hyperlipidemia, high blood pressure, cytomegalovirus infection, etc.
Footnotes
1
Presented by H. Ekberg et al. at the “World Transplant Congress 2006”, 22.07.–27.07.2006, Boston, USA, Abstract number 49.
 
2
Presented by H. Ekberg et al. at the “World Transplant Congress 2006”, 22.07. – 27.07.2006, Boston, USA, Abstract number 49.
 
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Metadata
Title
Renal transplantation today
Authors
Michael Neipp
Steffan Jackobs
Jürgen Klempnauer
Publication date
01-01-2009
Publisher
Springer-Verlag
Published in
Langenbeck's Archives of Surgery / Issue 1/2009
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-008-0335-1

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