Rationale for kidney transplantation

Rationale for kidney transplantation

• Kidney transplantation improves life expectancy and quality of life when compared with dialysis. However, only approxi - mately one-third of patients with ESRD are fit enough to with - stand transplant surgery and long-term immunosuppression. Successful transplantation frees patients from the rigors of dialysis and eliminates uraemic symptoms . Transplant kidneys produce normal levels of erythropoietin and this reverses the anaemia of chronic renal disease. Transplant patients therefore have more energy and better exercise capacity than patients on dialysis. There are also no fluid or dietary restrictions after transplantation. Importantly , for women of child-bearing age pregnancy is also possible after a successful kidney transplant. Life expectancy is higher in the transplant population with 5-year survival of >85% compared with <50% for patients on dialysis. However, these figures cannot be directly compared as there is selection bias because only relatively fit patients are o ff ered transplantation.