Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be

talking to you about renal transplant. And you can find written notes on this topic at zero to

finals.com slash transplant or in the renal section of the second edition of the zero to finals medicine book.

And you can find flashcards and questions to train your knowledge on this content

and help you remember the information longer at members.02finals.com.

So let's get straight into it.

A renal transplant is where a kidney is transplanted into a patient with end-stage renal failure.

It typically adds 10 years to life compared to just using dialysis,

and it significantly improves the quality of life.

Let's talk about donor matching.

The patient and the donor kidneys are matched based on the human leukocyte antigen, or HLA, type A, B, and C on chromosome 6. They don't

have to match fully, but the closer they match, the less likely there is for organ

rejection to occur and the better the outcomes. In patients receiving a transplant from a living

donor, they can receive treatment to desensitize them to the donor HLA in preparation for the transplant.

Next let's talk about the procedure.

The patient's own kidneys are left in place.

The donor kidney blood vessels are connected or anastomosed with the pelvic vessels,

usually the external iliac vessels.

The ureter of the donor kidney is anastomose directly with the bladder.

The donor kidney is left anteriorly or forward in the abdomen

and can usually be palpated in the Iliac fossa in one side of the lower abdomen.

A hockey stick incision is typically used and there will be a hockey stick scar.

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