The surgical technique of kidney transplantation has not changed significantly since the first transplants were performed. The improvements in dialysis, antibiotics, immunosuppressive medications, and postoperative complications management have, however, markedly improved patient and graft survival. As the success rate improved, the indications for renal transplantation continued to expand, so that it is now the preferred treatment for most patients with end-stage renal disease. Transplant recipients present new technical challenges because the population is ageing and the number of patients with prior surgical procedures is increasing.
The demand for renal transplantation has also resulted in an expansion of the criteria for acceptable donor organs. The anatomical variability of donor organs and recipients requires meticulous surgical technique at the time of organ recovery and transplantation, to minimise technical failure. Haemostasis is vital in these patients, especially when they are uraemic and already on dialysis. It is a known fact that kidney failure patients are more prone to bleeding and are frequently started on anti-coagulants in the perioperative period.
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