There is an almost 40-years history of renal transplantation. Kidney transplants are the second most common organ transplant (corneal transplant is number 1) in the United States with over 9.000 cases (adult and pediatric) per year. Indications for pediatric renal transplantation include symptoms of uremia not responsive to standard therapy, failure to thrive, delayed psychomotor development, fluid overload, and metabolic bone disease due to renal osteodystrophy. There are many kidney disorders that result in end-stage renal disease but the major indication in chronic glomerulonephritis.
Between 80-90 percent of transplantation kidneys are functioning 2 years after operation. The main problem is graft rejection. Living-related 1 year graft survival is 90 percent, with 85 percent 2-year and 75 percent 5-year survival. The corresponding figures for cadaver transplants are 76, 71 and 62 (1992). The half-life of cadaveric kidney is about 8 years. This compares poorly with the average of 12 and 26 years for living-donor kidneys matched for one and two haplotypes (tissue-typing factors) respectively.
The longer a patient with kidney disease remains on dialysis while waiting for a kidney transplant, the more likely the patient is to die prematurely even after receiving a new kidney.
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