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Kidney Transplantation in the Context of Renal Replacement Therapy

Division of Nephrology and Comprehensive Transplant Center, Ohio State University, Columbus, Ohio

Correspondence: Dr. Todd E. Pesavento,395 West 12 Avenue, Ground Floor, Columbus, OH 43210. Phone: 614-293-4997; Fax: 614-293-3073; E-mail: todd.pesavento{at}osumc.edu

Kidney transplantation has dramatically evolved from a life-saving yet unproven therapy for patients with renal failure to a mature field that is the preferred treatment for those suffering from ESRD. Patients who receive a transplant experience a 68% lower risk of death compared with those waiting on dialysis for a transplant. This benefit is afforded to all patient subgroups including the elderly (70 yr), and diabetics, who can gain 11 yr of extra life with transplantation. Prolonged transplant wait times result in a higher risk of death but this can be ameliorated with preemptive transplantation. Future challenges will focus on appropriate organ allocation and addressing long-term renal function and comorbid conditions so patients can enjoy the full benefits of transplantation.