Kidney transplant is an alternative to dialysis in individuals who have severe renal disease. A kidney transplant is a surgical procedure that inserts a healthy kidney from a donor into your body. Your kidney(s) are left in place, unless they are causing problems like an infection or high blood pressure. The donor may be a living relative, a close friend whose tissue closely matches yours, or someone who has died and donated his or her organs, which accounts for two-thirds of transplanted kidneys. One year after kidney transplant from a living donor, approximately 90% of kidneys are still working compared to 70% to 90% of kidneys from someone who has died. One transplanted kidney does the work of two failed kidneys.

Rejection of the transplanted kidney occurs within 3 to 4 months after the surgical procedure. The symptoms of rejection include: fever, weight gain, reduced urine output, and an increase in blood pressure. Moreover, blood tests will show deteriorating renal function. Drugs that keep your immune system from rejecting the kidney can keep the transplanted kidney working. Within the last decade or so, there have been major advances in the development of immunosuppressive agents beyond the traditional drugs (such as steroids, azathioprine, and cyclosporine), including the following:

• Tacrolimus
• Mycophenolate mofetil
• Anti-interleukin 2 receptor antibodies
• Antithymocyte globulin
• Muromonab-CD3
• Alemtuzumab
• Sirolimus

Complications from kidney transplantation and using immunosuppressive drugs include:

• Heart disease
• Osteoporosis
• Adverse effects from immunosuppressive drugs:
  • General cancer risk increases 10-15 times; the risk of cancer of the lymphatic system increases 30 times.
  • Diabetes risk increases much more among African Americans than other ethnic groups.