Urology - renal transplant

Question 1

How are donor and patient kidneys matched?

Answer 1

Based on the human leukocyte antigen (HLA) type A, B and C on chromosome 6.

They don’t have to match fully, but the closer the match, the less likely there is to be organ rejection and the better the outcomes.

Question 2

Procedure outline of renal transplant

Answer 2

Donor kidney blood vessels are anastomosed with the external iliac vessels

Ureter anastomosed with bladder

Kidney is placed in the iliac fossa, there will be a hockey stick scar

Question 3

Medical treatment after the transplant

Answer 3

Life-long immunosuppression

E.g. tacrolimus, mycophenolate, prednisolone, cyclosporin

Question 4

Side effect of tacrolimus

Answer 4

Tremor

Question 5

Side effect of cyclosporine

Answer 5

Gum hypertrophy

Question 6

Complications of renal transplant

Answer 6

Transplant rejection
Transplant failure

Complications related to immunosuppressants:

• IHD
• T2DM (steroids)
• Increased risk of infections may involve more unusual pathogens
• N-H Lymphoma
• Skin cancer (particularly SCC)

Question 7

What are some potential unusual infections that can occur secondary to immunosuppression?

Answer 7

PCP
CMV
TB