Renal transplantation--substitution therapy in advanced stage uremia.

Advanced stage chronic renal failure (CRF) uremia represents one of the most severe metabolic "catastrophes" of the organism. The current therapeutic possibilities consist in: hemodialysis, peritoneal dialysis and renal transplantation. This paper presents the experience of the Urological Surgery, Dialysis and Renal Transplantation Center of the "Fundcni" Clinical Institute in renal transplantation, the single complete morphological and functional therapeutic option in CRF. During the last 10 years, renal transplantations with kidneys from brain dead donors (multiorgan harvesting) to an adult (1997), a child (1999), a diabetic recipient (1998) and an unephric child due to bilateral Wilms' tumor (2005) were performed at "Fundeni" Renal Transplantation Center as a national première. The immunosuppression protocols are complex, modern and adapted to the immunological risk. A number of 870 renal transplantations with 82% functionality rate of the grati at 10 years were performed and reported. Among these, 152 transplants were performed using kidneys harvested from brain dead donors. Owing to obtained results (60% of all transplanted and functional orgmans in Romania on December 2007) and to its achieved performances, the Fundeni Center represents a reference point on the European map of renal transplant.