Tissue taken from another individual; donated tissue is noted to be foreign by the hosts immune system, so we must suppress the immune system

Types of transplant

• Decreased heart beating donors - brain stem death
• Non-heart beating donors
• Live donation
  • Directed and undirected
  • Paired donation
  • Financially procured (illegal in most countries)

Patient assessment

• Patient with life expectancy >5 years
• Extensive assessment process
  • Immunology - tissue typing and antibody screening
  • Virology to exclude active infection e.g. HBV, HIV
  • Assess cardiorespiratory risk
  • Assess peripheral vessels
  • Assess bladder function
  • Assess mental state
  • Assess any co-morbidity/PMHx which may influence transplant or be exacerbated by immunosuppression
  • Independent assessment
• No survival benefit until after 3 months

Contraindications

• Malignancy - known untreated malignancy, solid tumour in the last 2-5 years
• Active HCV/HIV infection
• Untreated TB
• Severe IHD that can't be treated surgically
• Severe airway disease
• Active vasculitis
• Severe PVD
• Hostile bladder