Complications of renal transplants

-Delayed graft function.
This is usually rare in living donor transplants. In cadaveric tranplants, cold ischemia time remains the best predictor of delayed graft function. While most delayed-graft-function kidneys eventually function, they do have a somewhat diminished lifespan compared with kidneys that function immediately.

-Vascular-related and ureter-related complications.
1. Arterial stenosis associated with the abrupt onset of hypertension.
Management includes percutaneous techniques such as angioplasty or placing of stents.
2. Venous thrombosis associated wit graft infarction.
Management includes thrombolytic agents and in cases of graft infarction, prompt nephrectomy as it leads to sepsis.
3.Ureteral obstruction due to distal obstruction, clot, edema, or technical problems associated with the ureteroneocystostomy.
Management is typically by radiologic or cystoscopic stent placement and stricture dilatation.
4. Urine leak. If small, managed by bladder decompression via Foley catheter, if large, exploration and repair.

- Perivascular lymohatic vessels leakage manifested as swelling, pain, and impaired renal function within the first year following transplantation.

-Chronic rejection has immunologic and nonimmunologic components. As a broad classification for progressive graft failure, risk factors include initial poor function of the graft and a history of acute rejection episodes.

-Cancer: Certain cancers, such as basal cell carcinoma, Kaposi sarcoma, carcinoma of the vulva and perineum, non-Hodgkin lymphoma, squamous cell carcinoma, hepatobiliary carcinoma, and carcinoma in situ of the uterine cervix, occur more frequently in people who have undergone kidney transplantation.

-Relapse: A small number of people who undergo transplantation for certain kidney disease experience a return of the original disease after the transplant.

-High blood cholesterol level

-Liver disease

-Weakening of the bones

-Women who wish to become pregnant are usually told to wait for 2 years after the operation. Many women have taken their pregnancies to term after transplantation, but there is an increased risk of kidney rejection and fetal complications.

References:
http://www.emedicinehealth.com/kidney_transplant/page5_em.htm
http://www.emedicine.com/med/topic3406.htm