Medical Conferences

To speak of renal transplantation in scientific terms must go back to the early twentieth century when Ullmann in 1902 announced the first kidney transplant in a dog, but it’s the middle of this century when this surgery becomes a real treatment option, especially from 1954 when Murray performed the first successful transplant between twin brothers.

The technique of transplantation has changed little over the decades, confined, in most cases, heterotopic in its location at the level of the iliac fossa with anastomosis of renal artery and vein to the external iliac vein and artery and ureter to the bladder as different techniques uréterocisto-neostomía.

There has been much evolution of surgical techniques but the emergence of new and improved immunosuppressive the cause of the excellent results obtained in the graft survival rate, reaching 90% in the first year in the most experienced centers, Although we must not forget that the best knowledge and management of the arteries and veins and the use of vascular patches have allowed a group of transplanted kidneys that were discarded years ago.

If it’s worth stopping, as far as regards renal surgery and transplantation in relation to the evolution of the graft. This technique was considered high risk since the first publications of Moore and Hume in 1969 came to report a 41% mortality even in 1989 Sharma published up to 39% of deaths, usually due to bleeding and infection, the need an important very fibrous tissue dissection and a vascular pedicle dissected again in its entirety until the anastomosis to the iliac vessels.

With this technique the surgical complications are rare and although mortality has decreased dramatically in the paper still Montanes National Urology Congress 1992 announced a 8.4% of deaths in the immediate postoperative period, like sepsis, pulmonary involvement either or the surgical bed, the most common cause of these deaths.