Introduction When the first renal transplants were being performed in the early 1960s the immunosuppressive properties of corticosteroids were already noted, and steroids were successfully used to reverse episodes of…

Introduction Whereas calcineurin inhibitors (cyclosporine and tacrolimus) block early signaling events and cytokine production, both azathioprine and mycophenolates, often termed antiproliferatives, exert effects downstream in the cell cycle, interfering with…

Sirolimus and its closely related analog everolimus are potent immunosuppressive agents that impair lymphocyte activation and proliferation by inhibiting the mammalian target of rapamycin (mTOR), also known as the mechanistic…

Kidney transplantation is a major surgical procedure that involves both vascular and ureteric anastomoses, and it is usually performed by a dedicated transplant surgeon, although in the past it was…

The ability of the urinary bladder to store urine at low pressure and to empty completely at intervals with simultaneous relaxation of the sphincter complex is essential to preserve the…

The first description of anesthesia for kidney transplantation (KTx) appeared in the early 1960s. It details the pioneering efforts in Boston with living related KTx between identical twins. The only…

Historical Background The study of histocompatibility accelerated during the 1960s when the pioneers of clinical kidney transplantation recognized that graft destruction was mediated through immunologic mechanisms. In 1961 the introduction…

Deceased Donor Nephrectomy Deceased donor renal donation predominates as the source of transplantable kidneys. In the US, deceased donors provide approximately 13,000 kidneys per year or 70% of the available…

Introduction At the start of the first transplant programs, the donor and recipient would be operated in the same surgical center. The only preservation method therefore undertaken would be to…

Introduction Worldwide the population of patients with chronic kidney disease (CKD) is expanding, leading to increasing numbers of patients hitting end-stage renal failure (ESRF) and requiring renal replacement therapy (RRT)….