Kidney transplantation is another form of renal replacement treatment.
About 25% of patients presenting to dialysis will be candidates for kidney transplantation.
The surgery and immediate post transplant management occurs at the Royal North Shore Hospital; patients return to my clinics for long term followup.
Kidney transplantation from a live kidney donor
Generally the kidney donor would be a relative or an altruist.
This is the ideal form of kidney transplantation, the kidney is relatively young, very healthy and often well matched.
The kidney operation is planned and run smoothly with minimal cold ischaemia.
Cold ischaemia is that time a kidney is being transported in a near zero environment, generally a frozen slush.
Kidneys that are transported from interstate, often have quite protracted cold ischaemic times, which may adversely effect the function of the kidney transplant down the track.
Kidney transplantation from a cadaver
The kidney is sourced from a brain dead kidney donor who has suffered either a cerebrovascular catastrophe or some form of trauma such as a motor vehicle accident which has rendered the patient brain dead.
Candidates for cadaveric transplantation often have to wait a considerable period of time (in the ACT the average time is 5.5 years), the kidneys are often older and less healthy, and often mismatched.
Nonetheless, just slightly more than 50% of kidney transplantation are from cadaveric donors.