Principles of Renal Transplantation

Renal transplantation is regarded as the primary treatment for all patients with established grade 5 chronic kidney disease (CKD), requiring replacement, as long as they are medically fit for the procedure. In practice, only around 40–50% of the UK renal failure population are fit enough for surgery. The Renal Association (RA) guidelines suggest that patients should be offered kidney transplantation if it offers a likelihood of increased life expectancy following grafting. The RA guidelines also recommend that patients should be listed within 6 months of starting dialysis, and both RA and the British Transplant Society (BTS) recommend transplantation prior to commencement of dialysis wherever possible.