Recent progress transplantation, in particular methods of postoperative patients, a positive effect both on the course and the outcome of the surgery after kidney transplantation. The problem of long-term outcome of kidney transplantation and risk factors for late termination of donor organ function is the focus of Transplantation and Nephrology. The best option is transplantation of a kidney transplant from a living related donor. This allows operation as planned, before the start of dialysis, while avoiding the long wait donor organ. The advantage of using a living related donor is and the best results of transplantation due to a genetic proximity of donor and recipient, and the optimum condition of the transplanted organ.
Complications developing during the first 3 months after kidney transplantation are associated with ischemic damage of the graft, acute reaction to the transplant recipient's body, surgical and pharmacological aggression.
It is recognized that the main cause of death of transplanted kidneys in long-term period after surgery is chronic rejection, which manifests itself by gradual reduction of kidney function with the outcome in chronic renal failure.
This pathology may develop several months after transplantation and 5 years after surgery, it is observed in 35-70% of recipients. Clinical symptoms of early stages of chronic rejection is scarce. Health and condition of patients is disturbed a little. Characteristic changes in the urine in the presence of a protein and arterial hypertension. Violations of well-being arises only in the later stages of chronic rejection. It is due to the growth of kidney failure, and characteristic of her intoxication.
Diagnosis of rejection was based on data from laboratory and instrumental methods. The most informative method is a biopsy of the kidney with a pathologic study. The main complex of therapeutic measures aimed at slowing the rate of rejection. Massive hormonal therapy is ineffective and fraught with dangerous complications. Chronic rejection crises are the most common reason for removal of kidney transplants.
Continuous improvement of surgical techniques, advances in modern pharmacology help to improve the results of renal transplantation, improving survival in the coming time after surgery, and in the long run.
