Renal Transplant

Question 1

Contraindications to renal transplantation?

Answer 1

Active/chronic infection
Malignancy
Iliac vessel stenosis
Severe ischaemic heart disease

Question 2

Principles behind contraindications to renal transplantation?

Answer 2

Immunosuppression post-transplant may worsen infection/malignancy
Surgery may allow infection/malignancy to spread
Vessel stenosis and/or heart failure mean the transplanted kidney is unlikely to be perfused well enough to function properly

Question 3

What are posteriorly urethral valves?

Answer 3

Affect male newborns

- cause mild or severe obstruction of the urinary tract

Question 4

Why are posterior urethral valves a problem?

Answer 4

With no treatment, the urinary tract (and bladder) can become high-pressure and the kidneys can fail

Question 5

How do posterior urethral valves affect renal transplant decision-making?

Answer 5

• Transplanting a new kidney onto a high-pressure tract is likely to accelerate failure of the transplant
• However, this doesn’t contraindicate the transplant and if it is a severe problem, an ileal conduit or neobladder can be formed as an alternative