In comparison with other organ transplantations, renal transplantation has in recent years shown significant progress. It turned to be a routine and highly physiological method of treatment of patients with terminal renal failure who had been on chronic dialysis treatment. For a successful outcome of renal transplantation essential is the early and competent ascertaining that brain death of the potential donor has occurred. Intensive care (resuscitation) starts for saving the life and when this is impossible, the efforts turn into measures for conditioning the donor. Thus both kidneys are preserved for transplantation. Another important prerequisite for successful renal transplantation is the adequate sampling, effective perfusion and adequate storage of the donor kidneys. The donor-recipient couple is selected by up-to-date immunologic studies. The authors debate in brief the indications and contraindications for organ donorship, the legal aspects in establishing the brain death diagnosis. Measures for conditioning the donor and the surgical technique for obtaining the kidneys, their perfusion and storage are discussed.

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