TY - CHAP M1 - Book, Section TI - Chapter 36. Renal Transplantation A1 - Flechner, Stuart M. A2 - McAninch, Jack W. A2 - Lue, Tom F. PY - 2013 T2 - Smith & Tanagho's General Urology, 18e AB - The first successful kidney transplant from a live donor to his identical twin brother was done in 1954. Since then, kidney transplantation has progressed from an experimental procedure to the preferred method of renal replacement therapy around the world. There are three primary reasons for the worldwide acceptance of renal transplantation: (1) transplant recipients enjoy a prolongation of survival compared with dialysis (Wolfe et al, 1999), (2) recipients report an improved quality of life (Joseph et al, 2003), and (3) it is less costly than that of dialysis (USRDS, 2010). At the end of 2010 in the United States, there were about 382,000 patients receiving dialysis therapy, with an incident rate of about 342 per million population, and over 165,000 living with a kidney transplant (USRDS, 2010). In 2010, there were 16,889 kidney transplants performed in the United States, 10,622 from deceased donors and 6277 from live donors (UNOS Web page). However, more than 88,847 patients were actively waiting for a kidney, and the gap between the number waiting and available organs widens every year (Wolfe et al, 2010). Currently, 1- and 5-year kidney graft survival ranges between 89–95% and 66–80%, depending on donor source (Figure 36–1). The major reasons leading to improved outcomes are more potent, yet selective immunosuppression, better surgical techniques, more sensitive tissue typing and crossmatching, and better prophylaxis and treatment of morbid infections. There is also an emerging consensus that preemptive transplantation, immediately prior to the need to dialysis, is advantageous, reducing much morbidity and even mortality (Kasiske et al, 2002). SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=56949477 ER -