Editing Kidney transplantation (section)

{{Short description|Medical procedure}}
<!--"Indications", "Contraindications", "Deceased donors" sections have no citations, other sections have paragraphs without citations-->
{{Infobox medical intervention
|  Name        = Kidney Transplantation
|  Image       = kidtransplant.svg
|  ICD10       = {{ICD10PCS|OTY|0/T/Y}}
|  ICD9        = {{ICD9proc|55.6}}
|  MeshID      = D016030
|  OPS301      = {{OPS301|5-555}}
|  synonyms = Renal transplantation
|  MedlinePlus = 003005
}}
'''Kidney transplant''' or '''renal transplant''' is the [[organ transplant]] of a [[kidney]] into a patient with [[chronic kidney disease|end-stage kidney disease]] (ESRD). Kidney transplant is typically classified as deceased-donor (formerly known as cadaveric) or living-donor transplantation depending on the source of the donor organ. Living-donor kidney transplants are further characterized as genetically related (living-related) or non-related (living-unrelated) transplants, depending on whether a biological relationship exists between the donor and recipient. The first successful kidney transplant was performed in 1954 by a team including [[Joseph Murray]], the recipient's surgeon, and [[J. Hartwell Harrison|Hartwell Harrison]], surgeon for the donor. Murray was awarded a [[Nobel Prize in Physiology or Medicine]] in 1990 for this and other work.<ref>{{cite journal |vauthors=Shrestha B, Haylor J, Raftery A |date=March 2015 |title=Historical Perspectives in Kidney Transplantation: An Updated Review |journal=Progress in Transplantation |publisher=[[Sage Publishing]] |volume=25 |issue=1 |pages=64–69 |doi=10.7182/pit2015789 |eissn=2164-6708 |pmid=25758803 |s2cid=26032497}}</ref> In 2018, an estimated 95,479 kidney transplants were performed worldwide, 36% of which came from living donors.<ref>{{cite web | url = http://www.transplant-observatory.org/wp-content/uploads/2020/10/glorep2018-2.pdf | title = International Report on Organ Donation And Transplantation Activities: Executive Summary 2018 | author = <!--Not stated--> | date = October 2020 | website = Global Observatory on Donation and Transplantation | publisher = ONT/WHO | archive-url = https://web.archive.org/web/20210321045858/http://www.transplant-observatory.org/wp-content/uploads/2020/10/glorep2018-2.pdf | archive-date = 21 March 2021 | url-status = live | access-date = 24 March 2021}}</ref>

Before receiving a kidney transplant, a person with ESRD must undergo a thorough medical evaluation to make sure that they are healthy enough to undergo transplant surgery. If they are deemed a good candidate, they can be placed on a waiting list to receive a kidney from a deceased donor.<ref name="National Kidney Foundation"/> Once they are placed on the waiting list, they can receive a new kidney very quickly, or they may have to wait many years; in the United States, the average waiting time is three to five years.<ref>{{cite web |author=<!--Not stated--> |date=19 October 2023<!--from page source--> |title=The Kidney Transplant Waitlist – What You Need to Know |url=https://www.kidney.org/atoz/content/transplant-waitlist |access-date=23 March 2024 |publisher=[[National Kidney Foundation]] |at=What is the average wait time for a kidney transplant?}}</ref> During transplant surgery, the new kidney is usually placed in the lower [[abdomen]] (belly); the person's two native kidneys are not usually taken out unless there is a medical reason to do so.<ref name="National Kidney Foundation"/>

People with ESRD who receive a kidney transplant generally live longer than people with ESRD who are on [[Kidney dialysis|dialysis]] and may have a better quality of life.<ref name="National Kidney Foundation">{{cite web |author=<!--Not stated--> |date=19 October 2023<!-- from page source --> |title=20 Common Kidney Transplant Questions and Answers |url=https://www.kidney.org/atoz/content/kidney-transplant |access-date=23 March 2024 |publisher=[[National Kidney Foundation]]}}</ref> However, kidney transplant recipients must remain on [[immunosuppressants]] (medications to suppress the immune system) for as long as the new kidney is working to prevent their body from rejecting it.<ref name="National Kidney Foundation"/> This long-term immunosuppression puts them at higher risk for infections and cancer.<ref name="Management of Kidney Transplant Recipients">{{cite journal |vauthors=Voora S, Adey DB |date=June 2019 |title=Management of Kidney Transplant Recipients by General Nephrologists: Core Curriculum 2019 |journal=[[American Journal of Kidney Diseases]] |type=Core curriculum |volume=73 |issue=6 |pages=866–879 |doi=10.1053/j.ajkd.2019.01.031 |pmid=30981567 |doi-access=free}}</ref> Kidney [[transplant rejection]] can be classified as cellular rejection or antibody-mediated rejection. Antibody-mediated rejection can be classified as hyperacute, acute, or chronic, depending on how long after the transplant it occurs. If rejection is suspected, a [[kidney biopsy]] should be obtained.<ref name="Management of Kidney Transplant Recipients"/> It is important to regularly monitor the new kidney's function by measuring [[serum creatinine]] and other tests; these should be done at least every three months.<ref name="Management of Kidney Transplant Recipients"/>