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Nephrol Dial Transplant (2002) 17: 552-556
© 2002 European Renal Association-European Dialysis and Transplant Association

Editorial Comment

Preparation of the dialysis patient for transplantation

Martin Zeier and Eberhard Ritz

Department of Medicine/Nephrology, University of Heidelberg, Heidelberg, Germany

Keywords: bacterial infection; cardiovascular risk; dialysis; hepatitis B; hepatitis C; living related transplantation; renal transplantation

Introduction

Successful kidney transplantation improves the quality of life and prolongs the survival of uraemic patients compared to long-term dialysis treatment [1–3]. Nevertheless renal transplantation is plagued by several problems. To minimize the complications during the peri- and postoperative period careful evaluation of the recipient prior to transplantation is essential. In addition regular check ups are necessary while the patient is on the waiting list.

It is useful to proceed according to a ‘shopping-list’ (Table 1Go) which specifies which examinations are required at what point in time.


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  		Table 1.  Pre-transplant examinations for patients on the transplant waiting list (‘shopping list’)

 

Cardiovascular investigation—vessels and heart are the Achilles heel in the transplanted patient

Stenosis of iliac and lower extremity vessels prior to transplantation
The iliac vessels must be evaluated to establish whether vascular anastomosis between graft and iliac vessels is possible. It is necessary to exclude by appropriate examination stenosis of the pre-anastomotic iliac vessels [4] (which after transplantation will cause a clinical tableau resembling graft artery stenosis), as . . . [Full Text of this Article]

Cardiac performance of the patient on the waiting list
Evaluation of carotid arteries
Cardiovascular prevention

Blood pressure control
Control of serum phosphate concentration and hyperparathyroidism
Control of dyslipidaemia
Treatment of anaemia
Exclusion of chronic bacterial or viral infections

Chronic bacterial infections
Chronic viral infections
Malignancy in uraemic patients on the waiting list

Recurrence of native kidney disease [30]

Immunological investigation of patients on the waiting list

Feasibility of living donor transplantation

Notes

References


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