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

talking you through renal transplant. And if you want written notes on this topic, as always,

you can follow along at zero definals.com slash renal slash transplant or in the renal section of the zero to finals medicine 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.

Doing a renal transplant typically adds 10 years to the life of somebody who's got end stage

renal failure compared with just using dialysis alone.

Let's first talk about donor matching.

Patients and donor kidneys need to be matched and they're matched based on the human

leukocyte antigen or HLA types and there's a type A, B and C. And these types live on chromosome 6.

So the genes coding for these different types of human lucite antigens, live on chromosome 6.

The patient and the donor kidneys don't have to fully match, and recipients can receive treatment to desensitize them to

the donor HLA when there is a living donor. The less they match, the more likely the transplant

is to fail. Next let's talk about the procedure itself. The patient's own kidneys are typically

left in place. The donor kidney's vessels are connected, which we call anastomosed,

with the patient's pelvic vessels, usually the external iliac vessels.

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

So they connect the donor kidney artery to the external

iliac artery, they connect the donor kidney vein to the external iliac vein, and they connect the ureter

to the bladder. The donor kidney is placed anteriorly in the abdomen and can usually be palpated

in the iliac fossa area.

So if you see a patient who's got a renal transplant,

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