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Kidney transplants generally offer the best outlook for patients with end-stage kidney disease. Most centers have patient and organ survivals of over 90% at one year, and more than 80% at three years. By 10 to 15 years, about 50% of transplanted kidneys are still functional. Kidneys from living related donors do better than from deceased donors.
However, this success is not without its costs. The patient's immune system identifies the transplanted kidney as a foreign organ and tries to destroy it. This is called rejection. In order to avoid rejection, almost all kidney transplant recipients require life-long treatment with medications that suppress their immune response (immunosuppressive therapy).
This has several unwanted consequences. Because the immune system is suppressed, the patient has a higher risk of infection and cancer. This requires aggressive cancer screening.
The immunosuppressive medicines themselves have side effects, which may include high blood pressure and high cholesterol, increased risk of diabetes, and other problems.
The success of a kidney transplant depends in part on close followup and meticulous adherence to the medicine regimen.
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