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 renal transplant

or in the urology section of the zero to finals surgery book.

So let's get straight into it.

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

This typically adds 10 years to life compared with 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. The patient and the donor kidneys do not have to match fully, but the closer they match, the

less likely there is to be organ rejection and the better the outcomes.

The person who's going to have the kidney transplant can receive treatment to desensitize them

to the donor's HLA type in preparation for transplant

from a living donor. There won't be enough time to desensitize them to a deceased donor because

the kidney needs to be transplanted quickly. Let's talk about the procedure. The patient's own kidneys

are left in place.

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

the external iliac vessels.

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

The donor kidney is placed anteriorly in the abdomen, which means it can usually be palpated in the Iliac fossa area.

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

after the kidney transplant.

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