Kidney transplant recipients are patients who have received a donor kidney as treatment for irreversible kidney failure, most often end-stage renal disease in which the native kidneys can no longer adequately filter waste, balance electrolytes and regulate fluid. Transplantation is the preferred renal replacement th…
Kidney transplant recipients are patients who have received a donor kidney as treatment for irreversible kidney failure, most often end-stage renal disease in which the native kidneys can no longer adequately filter waste, balance electrolytes and regulate fluid. Transplantation is the preferred renal replacement therapy for suitable candidates, generally offering better survival and quality of life than maintenance dialysis. Recipients may receive organs from living or deceased donors, and their care begins with evaluation of medical and immunological suitability and continues with lifelong management after surgery. The central clinical task is preventing rejection of the allograft through immunosuppressive therapy while limiting its complications, namely infection, malignancy and drug toxicity; immunosuppression is increasingly individualised, including by genetic determinants such as single-nucleotide polymorphisms affecting drug metabolism and immune reactivity. Early graft function can be compromised by delayed graft function, influenced by donor factors and intra-operative haemodynamics in living kidney transplantation, while longer-term surveillance monitors for acute and chronic rejection, recurrent or de novo renal disease, cardiovascular risk and skin and lymphoproliferative malignancies arising under immunosuppression. Graft function is followed through laboratory testing, imaging and, when indicated, biopsy. The experience of recipients is also shaped by organ availability, donor evaluation and the ethics of donation. Comprehensive, multidisciplinary follow-up is essential to preserve graft and patient survival in kidney transplant recipients.
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