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End stage renal disease (ESRD) is an epidemiological notion that starts from the idea that persistent kidney damage may be the consequence of many etiological factors. ESRD consists of the progressive nephron loss and renal function damage.
When the glomerular filtration rate (GFR) reaches a critical level below 60 ml/minute/1.73m2, adaptive renal and systemic mechanisms become harmful resulting in a reduction in the number of nephrons which leads to chronic kidney disease (CKD).
Kidney transplantation work in China started about 10 years later than abroad. However, the source of donors has gradually transitioned to donation after citizen’s death (DCD) since 2012, and kidney transplantation in China has made steady progress step by step. This chapter is aimed to elaborate the kidney transplant work in China from the history and immunological assessment, donor maintenance and donor quality assessment, operation methods, postoperative major complications, and application of immunosuppressive agents to the postoperative follow-up. Kidney transplantation is a meaningful and challenging work in current China, all the Chinese transplant surgery and scholar are devoting themselves to this work in order to give more effective help to the patients.
Post transplantation bone disease is a complex disorder markedly different from the mineral and bone disorders often seen in patients with Chronic kidney Disease (CKD). After kidney transplantation, patients exhibit various histologic abnormalities of bone despite restoration of kidney function . Bone disease after kidney transplant is a multifactorial process that includes continuing bone loss superimposed on pre-existing renal osteodystrophy . The severity of bone disease complications, the increase in the number of transplanted patients and the prolonged survival rate has generated interest in prevention and treatment of post-transplant bone disease...
Laparoscopic surgery for live donor nephrectomy has been well implemented in kidney transplant centres around the world since mid 1990s [1-3]. It has been demonstrated that laparoscopic surgery has the advantage of smaller incision, less pain, quicker recovery and better cosmetic appearance and comparable kidney graft function when compared with conventional open surgery [2,4-6]. There are various surgical techniques with two major approaches transperitoneal laparoscopy and retroperitoneal retroperitoneoscopy. Hand assistance to each of these two approaches has also been widely employed. There is no large clinical trial to demonstrate which technique is superior to another, although some literature reviews have found there is a tendency of less blood transfusion, less vessel injury, less conversion to open surgery and less delayed graft function rate in retroperitoneoscopic approach...