Kid. transplantation
Indications
² E S R D * Chr. G.N.
* Cong. P. cystic kid.
* Obstruction. Uropathy.
* Amyloidosis.
* Pyelonephritis.


Recurrence of disease may occur after transplantation
e.g. : 1- membr. Prolif G.N. type II.
Lupus nephritis.
G. pasture $.


Preoperative

A B O & H L A for Donor & Recipient.
Donor all routine investig.
angio - scan - I.V.P.
Recipient micturating cystogram to exclude reflux.

Operative

Nephrectomy.
Kid. perfusion to wash blood capillaries to
Q microthrombi.
We try to shorten Cold Ischaemia ( the time after
nephrectomy till transplantation).
Hot ischaemia (the time between clamping of renal vs till nephrectomy)
The kid. is transplanted in the pelvic cavity with vascular anastomosis with the iliac vs & uretero vesical anastomosis.

Post - operative : (to Q rejection)

Steroids.
Azathioprine.
Cyclosporine.
Episodes of acute rejection treated by methyl prednisolone.

Common complication:
§ A. T. N.
§ Rejection
Renal V. thrombosis.
Renal A. thrombosis.
Urine leakage at uretrovesical anastomosis.
Complications from immunosuppression.
Recurrence of the primary renal disease.
e.g. membr. Prolif, FSGS.