Advances made in kidney transplants

Kidney transplants represent a fundamental pillar in the comprehensive treatment of Terminal Chronic Renal Failure (TCRF), which today occurs in over 100 cases per 1 million inhabitants every year. In Catalonia, approximately 50% of patients suffering from TCRF prevalent diseases are bearers of a functioning kidney transplant. The widespread introduction of kidney transplants in our country has improved the health and quality of life of sufferers, and represents an important saving for the health system.

Kidney transplants have undergone a massive evolution since they began in the early 1960s. Improvements in kidney preservation techniques, reduction in incidence of acute rejection thanks to the introduction of new immunosuppressive drugs and more effective control of infections have all increased the survival of the renal graft over the short and medium term. Unfortunately, however, chronic damage to the renal allograft results in an annual failure of 4% of organs. Furthermore, the transplant recipients develop malignancies more frequently than the general population, and are at a higher risk of suffering cardiovascular accidents and complications deriving from the prolonged use of the immunosuppressive drugs employed to prevent acute and chronic rejection, and which often exert an indiscriminate effect on the immune system. The progress that has been made in kidney transplants is essentially focused on preventing damage from ischemia/reperfusion, designing new immunosuppressive drugs (selectively directed against immune-response mechanisms), improving control of the antibody response to the graft, introducing pro-telerogenic guidelines and developing biomarkers that enable refinement in the use of immunosuppressive drugs, to reduce the dose and morbidity, and which should lead to a personalised medicine in kidney transplants.