The approach to a patient with a renal transplant includes many special considerations. These are a few that we discussed.
Was the donor living or not? Why does this matter?
One reason, is that the risk for renal artery stenosis at the surgical anastomosis differs. In deceased donor transplants, the renal artery is longer as the aorta can be excised with the renal artery, where as this cannot be done with living donor transplants.
Pre-transplant CMV status of the patient and donor? Why does this matter?
The risk for post-transplant CMV is higher when the donor is seropositive for CMV and the recipient is seronegative for CMV.
What malignancies is this population at risk for?
Squamous cell carcinomas (use sunscreen) and PTLD (Post-Transplant Lymphoproliferative Disorder, not Portland).