Selection of the patient for renal transplantation

1. The recipient must be in end stage renal failure (needs dialysis) or is rapidly approaching it.

2. The recipient must have a similar tissue type to the donor.

3. The recipient must have a reasonable life expectancy with a functioning kidney.

4. The recipient must be capable of taking immuno-suppressant drugs post transplantation.

The potential recipient is reviewed in the clinic to ensure that they will be suitable for transplantation.

The potential site of insertion of the new organ should be assessed. The new kidney will usually be inserted into the iliac fossa. If the patient has polycystic kidneys that are very large then they may need to be removed prior to transplantation.

Check that there is no evidence of occlusive arterial disease, that the patient has no history of claudication and that the femoral pulse is good.

It is felt that patients with renal failure due to systemic disease do worse than those with a local physical cause for the renal failure following transplantation. Patients with adult polycystic kidney disease, and reflux nephropathy do better than those with diabetes.