Surgical Procedures for End-stage Renal Disease (ESRD)En Español (Spanish Version)
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
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 kidneys. One year after kidney transplant from a living donor, approximately 90% of kidneys are still working compared to 70% to 90% of kidneys from someone who has died. One transplanted kidney does the work of 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 an increase in blood pressure. Moreover, blood tests will show deteriorating renal function. Drugs that keep your immune system from rejecting the kidney can keep the transplanted kidney working. Within the last decade or so, there have been major advances in the 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 kidney transplantation and using immunosuppressive drugs include:
- Heart disease
Adverse effects from immunosuppressive drugs:
- General cancer risk increases 10-15 times; the risk of cancer of the lymphatic system increases 30 times.
risk increases much more among African Americans than other ethnic groups.
Andrews, PA. Renal transplantation.
Brit Med J.
Brenner, BM., et al.
Brenner & Rector’s The Kidney. 9th ed. Philadelphia, PA: Saunders, 2011.
Chronic kidney disease. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated October 12, 2012. Accessed October 16, 2012.
Davis, CL, Delmonico, FL. Living-donor kidney transplantation: a review of the current practices for the live donor.
J Am Soc Nephrol.
Ferri, Fred, ed.
Ferri’s Clinical Advisor 2010. 1st ed. Philadelphia, PA: Mosby Elsevier, 2009.
Goldman L, Ausiello, D., eds.
Cecil Textbook of Internal Medicine. 23rd ed. Philadelphia, PA: Saunders, 2008.
End-stage renal disease. National Institute of Diabetes & Digestive & Kidney Diseases website. Available at:
Updated September 15, 2010. Accessed October 16, 2012.
Textbook of Family Medicine 2007. 7th ed. Philadelphia, PA: Saunders Elsevier, 2009.
Rakel, RE, Bope, ET.
Conn's Current Therapy. 60th ed. Philadelphia, PA: Saunders Elsevier, 2009.
Townsend, CM., et al.
Sabiston Textbook of Surgery. 18th ed. Philadelphia, PA: Saunders, 2007.
Wein, AJ., et al.
Campbell-Walsh Urology. 9th ed. Philadelphia, PA: Saunders, 2007.
Last Reviewed October 2012