<P> In the 1980s, experimental protocols were developed for ABO - incompatible transplants using increased immunosuppression and plasmapheresis . Through the 1990s these techniques were improved and an important study of long - term outcomes in Japan was published . Now, a number of programs around the world are routinely performing ABO - incompatible transplants . </P> <P> The level of sensitization to donor HLA antigens is determined by performing a panel reactive antibody test on the potential recipient . In the United States, up to 17% of all deceased donor kidney transplants have no HLA mismatch . However, HLA matching is a relatively minor predictor of transplant outcomes . In fact, living non-related donors are now almost as common as living (genetically) - related donors . </P> <P> In most cases the barely functioning existing kidneys are not removed, as removal has been shown to increase the rates of surgical morbidity . Therefore, the kidney is usually placed in a location different from the original kidney . Often this is in the iliac fossa so it is often necessary to use a different blood supply: </P> <Ul> <Li> The renal artery of the new kidney, previously branching from the abdominal aorta in the donor, is often connected to the external iliac artery in the recipient . </Li> <Li> The renal vein of the new kidney, previously draining to the inferior vena cava in the donor, is often connected to the external iliac vein in the recipient . </Li> </Ul>

Where is a transplanted kidney placed in the body