The number of kidney transplants from January 1, 1988 to June 30, 2016 was 395,510.
The most common kidney transplants. In 2011, 11,835 deceased donor kidney transplants and 5,772 living donor kidney transplants were performed.
Kidney transplantation is used to treat people with end-stage kidney disease or kidney failure. Usually this kidney failure occurs due to diabetes or severe hypertension. For the most part, kidney transplants are more successful than dialysis and improve lifestyle and life expectancy more than dialysis .
In the 1960s. The only immunosuppressive drugs for organ rejection were azathioprine and prednisone. Because we had fewer immunosuppressive drugs in the early years after transplantation, kidneys from living donors were more likely to receive them than those from deceased donors.
Today, we have a variety of medications that help suppress the immune response in people who have had a kidney transplant. In particular, these drugs suppress a variety of immune responses, including those elicited by bacteria, fungi, and malignant tumors.
Agents used to suppress rejection are broadly classified as inductive or support agents. Induction agents reduce the likelihood of acute rejection and are administered at the time of transplantation. In people receiving renal treatment, these inducing agents include antibodies that preclude the use of steroids or calcineurin inhibitors (cyclosporine and tacrolimus) and their associated toxic effects.
Supportive care helps prevent acute rejection and loss of the kidneys. Typically, patients receive the following therapy: prednisone (steroids), a calcineurin inhibitor, and an antimetabolite (eg, azithioprine or, more commonly, mycophenolate mofetil). Supportive therapy adjusts over time.
Due to improvements in immunosuppressive therapy, loss of transplanted kidneys due to acute rejection is rare. As of December 2012, the number of kidney recipients surviving after five to five years of survival was 83.4 percent for kidneys from deceased donors and 92 percent for kidneys from living donors.
However, over time, the function of the transplanted kidney is impaired due to a poorly understood chronic process, including interstitial fibrosis, tubular atrophy, vasculopathy, and glomerulopathy. Therefore, the average life expectancy for living donor kidney recipients is 20 years, and for deceased donor organ recipients, 14 years.
Living volunteer donors must be free of any serious disease and deceased donors must not have any diseases that can be transmitted to the recipient, such as HIV, hepatitis, or metastatic cancer.
Donors are paired with recipients using blood group antigens (eg, blood group) and antigens from the major HLA histocompatibility gene complex. Kidney recipients that are more compatible with HLA types perform better than patients with mismatched HLA types. In general, first-degree relatives are more likely to express HLA-compatible transplant antigens. In other words, a first-degree relative is more likely to provide a viable organ that makes better use of a kidney than a kidney from a cadaver.
Kidney transplant surgery is relatively non-invasive when the organ is placed in the inguinal fossa without the need to open the abdomen. If all goes well, the kidney recipient can be discharged from the hospital in excellent condition within five days.
Kidneys from deceased donors can be stored for approximately 48 hours before transplantation. This time gives medical personnel ample time to recruit, match, select, and transport these organs.