Parmi toutes les études/cohortes existantes en transplantation rénale, peu d’entre elles étudient l’impact des paramètres pharmacologiques. L’utilisation d’un auto-questionnaire, en complément du dossier médical, a été validée pour le recueil de ces données. La comparaison du dossier médical et des auto-questionnaires pour la déclaration des événements indésirables a permis de mettre en évidence des différences. Les infections étaient les événements indésirables les plus déclarés par les médecins alors que les patients n’en déclaraient que très peu. L’observance, évaluée par l’auto-questionnaire, diminuait entre la 1ère et la 3ème année post-greffe, tout comme la sensation d’euphorie et de renaissance. En effet, le score de qualité de vie (QdV) de la dimension « Santé mentale » du ReTransQol diminuait entre ces deux périodes. En revanche, la peur de la perte du greffon du patient augmentait comme démontrée par la diminution du score de QdV de la dimension « Peur de la perte du greffon ». La QdV, évaluée par des questionnaires génériques ou spécifiques aux greffés rénaux, est aussi un paramètre important à prendre en compte dans le suivi des patients. Les propriétés psychométriques de la 2nde version du ReTransQol, ainsi que sa reproductibilité et sa sensibilité aux changements ont été validées dès le 3ème mois post-transplantation rénale. L’étude de pharmaco-économie Ephegren, suite de la cohorte Epigren, va notamment étudier les rapports coût-efficacité et coût-utilité des stratégies immunosuppressives et anti-cytomégalovirus. Ainsi, des recommandations pourront être proposées afin d’homogénéiser les pratiques et diminuer les coûts de prise en charge des greffés rénaux. / Among all existing studies/cohorts in kidney transplantation, only a few study the impact of the pharmacological parameters. In addition to the clinical file, the use of a self-administered questionnaire has been validated to collect these data. Comparison between clinical file and self-administered questionnaire concerning the reporting of adverse events highlighted some differences. Infections were the most reported adverse events by the physicians while the patients declared only a few. Adherence evaluated with the self-administered questionnaire decreased between the first and third post-transplantation year and so did the feeling of euphoria and revival. The « Mental health » dimension of the quality of life (QOL) ReTransQol score decreased over this period. However patients’ fear of losing the graft increased as shown by the decrease of the « Fear of losing the graft » dimension of the QOL score. QOL, evaluated by generic and kidney-transplanted-specific questionnaires is also an important parameter that must be considered in patient follow-up. Psychometric properties of the second version of the ReTransQol, as well as its reproducibility and its sensitivity to changes have been validated as early as the 3rd post-kidney-transplantation month. The pharmacoeconomic study Ephegren, development of Epigren cohort, will study the cost-effectiveness and cost-utility ratio of immunosuppressive and anti-cytomegalovirus strategies. Guidelines will then be proposed to standardise the treatments and decrease the management costs of kidney-transplant recipients.

African Americans (AA) are more susceptible to end-stage renal disease (ESRD) for several reasons. Treatment options for patients with ESRD include dialysis therapy and transplantation, with the latter typically producing better outcomes. AA are less likely to complete the medical evaluation process, which requires patients to consult with doctors and undergo a series of tests and examinations. This study sought to determine the factors that predict completion of the medical evaluation for AA ESRD patients using a mixed methods design. Participants consisted of transplant professionals (N=23) recruited from nine transplant centers in the Mid-Atlantic, Mid-Western and Southeastern parts of the United States, and kidney patients (N=30 patients) recruited from one transplant center in the Mid-Atlantic region. Semi-structured interviews and nominal focus groups were conducted to gather qualitative data; quantitative survey data were also collected. The results revealed factors classified as impacting patients at the individual-level and systemic level, and others classified as health-related and informational/educational. Participants ranked insurances issues, limited income, lack of a personal means of transportation, lack of patient motivation, the number of procedures required to complete the evaluation, scheduling difficulties and time constraints as top barriers to completing the medical evaluation process. Top motivators consisted of informational support, social support, religious beliefs, patients’ desire to get off dialysis, support from the transplant staff, center-based education, patient’s knowledge of the benefits of transplantation and patient navigators. These findings provide valuable information on factors that impact AA renal patients’ completion of the medical evaluation.

Background: We evaluated the concept of whether liver failure patients with a superimposed kidney injury receiving a simultaneous liver and kidney transplant (SLKT) have similar outcomes compared to patients with liver failure without a kidney injury receiving a liver transplantation (LT) alone. Methods: Using data from the United Network of Organ Sharing (UNOS) database, patients were divided into five groups based on pre-transplant model for end-stage liver disease (MELD) scores and categorized as not having (serum creatinine (sCr) <= 1.5 mg/dL) or having (sCr > 1.5 mg/dL) renal dysfunction. Of 30,958 patients undergoing LT, 14,679 (47.5%) had renal dysfunction, and of those, 5,084 (16.4%) had dialysis. Results: Survival in those (liver failure with renal dysfunction) receiving SLKT was significantly worse (P < 0.001) as compared to those with sCr < 1.5 mg/dL (liver failure only). The highest mortality rate observed was 21% in the 36+ MELD group with renal dysfunction with or without SLKT. In high MELD recipients (MELD > 30) with renal dysfunction, presence of renal dysfunction affects the outcome and SLKT does not improve survival. In low MELD recipients (16 - 20), presence of renal dysfunction at the time of transplantation does affect post-transplant survival, but survival is improved with SLKT. Conclusions: SLKT improved 1-year survival only in low MELD (16 - 20) recipients but not in other groups. Performance of SLKT should be limited to patients where a benefit in survival and post-transplant outcomes can be demonstrated.

Le cytomégalovirus (CMV) est l’agent responsable de l’infection opportuniste la plus fréquemment rencontrée en transplantation d’organe. Chez les receveurs séronégatifs qui reçoivent un rein provenant d’un donneur séropositif, 50 % de ces patients peuvent développer une virémie, et 30 % une maladie. A court terme, malgré les traitements anti-viraux, elle est responsable d’une morbidité non négligeable. A long terme, le CMV est associé à une augmentation de la fréquence des sténoses artérielles, plus d’infections associées, plus de rejet aigu, plus de lésions de fibrose interstitielle et d’atrophie tubulaire, une moins bonne survie des greffons et des patients. La cohabitation et la coévolution du CMV avec l’homme depuis des milliers d’années ont aboutie à un état d’équilibre entre le virus et son hôte. Le virus s’est profondément adapté à son hôte afin d’échapper à la réponse immune. En réponse à cela, la réponse immunitaire anti-CMV occupe une part unique et majeure au sein de la réponse immune de l’hôte. Les lymphocytes T CD8+ spécifiques du CMV représentent par exemple 10.2% des lymphocytes T CD8+ mémoires. Avec l’âge, ils s’accumulent et peuvent représenter jusqu’à 30% du pool total de lymphocyte T CD8+. Le système immunitaire sous la contrainte du virus s’est donc refaçonné de façon à garder le contrôle du virus. Depuis 1999, un nouvel acteur de cette réponse immunitaire a été identifié : les lymphocytes T gamma delta Vdelta2-negative. Ces cellules sont impliquées habituellement dans la lutte contre les différents stress d’origine microbien et non microbien (tumeur). Elles interviennent plutôt localement (dans les épithéliums) par différents mécanismes et sont désormais considérées comme des effecteurs intermédiaires entre l’immunité innée et l’immunité adaptative. Leur expansion dans le sang est associée à la guérison de la maladie et à la résolution de l’infection à CMV. Elles ont par ailleurs in vitro une réactivité croisée contre des cellules infectées par le CMV et des cellules tumorales. Les lymphocytes T gamma delta Vdelta2-negative sont donc une représentation supplémentaire de l’énorme impact du CMV sur le système immunitaire de l’hôte. Dans ce travail, nous avons pu étendre et approfondir leur rôle en transplantation d’organe. Nous avons tout d’abord décrit que les lymphocytes T gamma delta Vdelta2-negative avaient un phénotype et une cinétique d’expansion exactement superposable aux lymphocytes T CD8+ spécifiques du CMV in vivo. Nous avons ensuite observé que l’expansion des lymphocytes T gamma delta Vdelta2-negative induits pas l’infection à CMV s’associait à une survenue moindre de cancer à long terme chez les patients transplantés rénaux. Nous avons pu montrer que leur activation était sous la dépendance d’une interaction entre leur TCR et un ligand. Enfin, une autre voie d’activation dépendante du CD16, faisant intervenir les complexes immuns CMV-IgG anti-CMV a aussi été identifiée. Nos travaux depuis 10 ans ont donc démontré que les lymphocytes T gamma delta Vdelta2-negative occupaient une place majeure dans la réponse immune anti-CMV au même titre que les lymphocytes T CD8+. L’intégration de ces cellules à l’immunologie anti-CMV devrait permettre de mieux comprendre certains effets indirects induits par le virus, et pourrait être utile dans le suivi de la réponse immune anti-CMV en transplantation d’organe. L’identification de leur ligand pourrait permettre enfin de tester assez rapidement de nouveaux protocoles d’immunothérapie anti-virale ou anti-tumorale. / Cytomegalovirus (CMV) infection is the most frequent opportunistic infection encountered in solid-organ transplantation. Fifty percent of seronegative kidney transplant recipients (KTR) who receive a kidney from a seropositive donor may develop a CMV infection which causes a disease in 30% of cases. In the long term, CMV is associated with an increased incidence of arterial stenosis, more opportunistic infections, more acute rejection episodes, more interstitial fibrosis and tubular atrophy, and a poorer graft and patient survivals. For thousands years, the co-evolution between the CMV and the immune system allowed to a state of equilibrium between the virus and the host. The virus has deeply adapted to its host in order to escape the immune response. In response, the anti-CMV immune reaction takes up an important and unique place. For example, the CMV-specific CD8+ T cells represent an average 10.2% of the memory CD8+ T cell compartment in CMV-seropositive healthy individuals. With age, these cells accumulate and can represent around 30% of CD8+ T lymphocytes. Therefore under the long-lasting pressure of the virus, the immune system has redesigned in order to keep the control of the virus. Since 1999, a new actor was identified within the immune system: the Vdelta2-negative gamma delta T cells. These cells are involved against various microbial and non microbial stresses. They act locally in epithelia by different mechanisms and are now considered as intermediate effectors between innate and adaptive immunity. In vivo in KTR, their blood expansion is associated with the resolution of CMV infection. In vitro, they share a cross-reactivity against CMV-infected cells and tumor cells. Therefore, the Vdelta2-negative gamma delta T cells are new representatives of the huge impact of CMV on the host immune system. In this work, we were able to extend and get further insight into their role in organ transplantation. In vivo, we first described that Vdelta2-negative gamma delta T cells displayed a phenotype and an expansion kinetic similar to that of CMV-specific CD8+ T cells. Next, we observed that the CMV-induced Vdelta2-negative gamma delta T cells expansion was associated with a lower occurrence of cancer in long-term KTR. In vitro, experiments of transfer of gamma delta TCR allowed us to show that their activation against tumor ligands was TCR-dependent and that different tumor ligands could be recognized by each Vdelta2-negative gamma delta TCR studied. In addition, we observed that the recognition of CMV-infected cells was not only TCR-dependent, but under the dependence of a multi molecular complex involving co stimulatory signals. Finally, we also identified a new CD16-dependent pathway of activation in gamma-delta T cells, involving IgG-opsonised CMV. In summary, Vdelta2-negative gamma delta T cells take up a major place within the anti-CMV immune response in addition to CD8+ T lymphocytes. The integration of these cells to the anti-CMV immunology should provide a better understanding of some indirect effects of the virus and could be useful to monitor the immune response against CMV in solid-organ transplant recipients. Moreover, identification of their ligands could provide interesting tools for new protocols of anti-CMV and anti-tumor immunotherapy.

Clinical trials in kidney transplantation suffer from several major issues including: 1) Unfeasibility due to low short-term event rates of hard outcomes and 2) Reliance on a composite outcome that consists of unequal endpoints that may generate misleading results. This thesis attempts to explore and apply methods to solve these issues and ultimately, improve kidney transplantation trials. We present a secondary analysis of the ACE trial in kidney transplant using composites with alternative graft function surrogate endpoints. Typically, kidney transplant trials—including the ACE trial— use a time-to-event composite of death, end-stage renal disease (ESRD), and doubling of serum creatinine. Instead of doubling of serum creatinine, we investigated the use of percentage declines of estimate glomerular filtration rate (eGFR) within a time-to-event composite of death and ESRD. Additionally, we present an application of an innovative analysis method, the win ratio approach, to the ACE trial as a way of lessening concerns associated with unequal composite endpoints. Composites of death, ESRD, and either a 40%, 30% or 20% decline in eGFR did not alter original ACE trial results, interpretations, or conclusions. The win ratio approach, and the presentation of a win ratio, generated very comparable results to a standard time-to-event analysis while lessening the impact of unequal composite endpoints and making fewer statistical assumptions. This research provides a novel, trial-level application of alternative endpoints and analysis techniques within a kidney transplant trial setting.

Introdução: o transplante renal é o tratamento de escolha para uma significativa porção dos pacientes com perda crônica terminal da função renal. A rejeição aguda é uma importante complicação pós-transplante e entre outras disfunções agudas tem na biópsia do enxerto o padrão ouro para o seu diagnóstico. No entanto as biópsias apresentam uma série de limitações e riscos sendo necessário que se desenvolva biomarcadores não invasivos capazes de identificar disfunções do enxerto. Objetivos: analisar e quantificar a expressão dos microRNAs miR-142-3p, miR-155 e miR-210 em amostras de sangue periférico, urina e tecido renal coletadas de pacientes que submetidos à transplante renal que desenvolveram disfunção do enxerto. Métodos: estudo com delineamento transversal e executado no Laboratório de Biologia Molecular aplicado à Nefrologia (LABMAN), do Centro de Pesquisa Experimental do Hospital de Clínicas de Porto Alegre. As amostras são de pacientes submetidos a transplante renal que necessitaram de biópsia, por critério clínico. A expressão dos miRNAs miR-142-3p, miR-155 e miR-210 nos materiais biológicos (tecido renal, sangue periférico e células do sedimento urinário) foi avaliada através da técnica de reação em cadeia da polimerase quantitativo em tempo real. Resultados: foi encontrada, no sangue periférico uma diminuição estatisticamente significativa na expressão do miR-142-3p no grupo de pacientes com rejeição aguda (n=23) quando comparado ao grupo com outras causas de disfunção do enxerto (n=68) (P = 0,01). Não houve diferença entre os grupos na expressão do miR-155 e do miR-210, tampouco para o miR142-3p nos demais compartimentos. Conclusão: miR-142-3p mostra uma expressão diferenciada de rejeição aguda de enxertos renais, há um envolvimento deste marcador no grupo de biomarcadores moleculares em potencial para a disfunção do enxerto renal. / Background: kidney transplantation is the treatment of choice for a significant portion of patients with end-stage kidney disease. Acute rejection is a major post-transplant complication among other acute disorders and has on graft biopsy the gold standard for diagnosis. Biopsy, however it is an invasive and potentially harmful procedure so it is desirable to develop new noninvasive markers for diagnosing graft dysfunction. Objective: to analyze and quantify the expression of microRNAs miR-142-3p, miR-155 and miR-210 in the peripheral blood, urinary sediment and kidney tissue obtained from patients who developed graft dysfunction after kidney transplantation. Methods: crosssectional study performed at the Laboratory of Molecular Biology applied to Nephrology (Labman), Center of Experimental Research from Hospital de Clinicas de Porto Alegre. The samples are from kidney transplant patients who undertook indication biopsies as a part of investigation of graft dysfunction. Micro-RNAs expression was evaluated by quantitative real-time polymerase chain reaction. Results: it was found that in peripheral blood, a significant decrease in the expression of miR-142-3p occurred in patients with acute rejection (n = 23) as compared to the group of patients with other causes of graft dysfunction (n = 68), (P = 0.01). No other significant differences were found in gene expression of miR-155 and miR-210, neither for miR142-3p in the other urine or kidney tissue. Conclusion: miR-142-3p presents differential expression in the peripheral blood of patients with rejecting kidney grafts. The role of miRNAs as biomarkers for kidney graft dysfunction is worth be further explored.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-01-11T16:56:50Z No. of bitstreams: 1 lucianesenradesouzabraga.pdf: 2197940 bytes, checksum: 0ad10886dccd0f71b9cda0d9562287bd (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-25T17:09:45Z (GMT) No. of bitstreams: 1 lucianesenradesouzabraga.pdf: 2197940 bytes, checksum: 0ad10886dccd0f71b9cda0d9562287bd (MD5) / Made available in DSpace on 2016-01-25T17:09:45Z (GMT). No. of bitstreams: 1 lucianesenradesouzabraga.pdf: 2197940 bytes, checksum: 0ad10886dccd0f71b9cda0d9562287bd (MD5) Previous issue date: 2015-04-19 / Desde o primeiro transplante renal bem sucedido, que a clínica vêm sendo monitorada, medida e descrita, de forma a nortear a atividade transplantadora em todo o mundo. Neste trabalho, avaliamos dados de prontuário médico de todos os pacientes transplantados renais entre janeiro de 2002 e dezembro de 2012, acompanhados no Núcleo Interdisciplinar de Estudos e Pesquisas em Nefrologia da Universidade Federal de Juiz de Fora (NIEPEN-UFJF). Este estudo, retrospectivo e de coorte, foi idealizado a partir da coleta de dados para alimentação do Cadastro Nacional de Transplantes (CNTx), tendo como objetivo principal descrever a sobrevida de pacientes e do enxerto renal, bem como o impacto de diferentes variáveis clínicas sobre estes desfechos, em um serviço de baixa atividade transplantadora. Foram incluídos 162 pacientes, com média de idade de 44 ± 11,5 anos, dos quais 92% tiveram doador vivo relacionado. A sobrevida dos pacientes, do enxerto e do enxerto censurada para óbito foram analisadas através do método de Kaplan-Meier, e sua associação com os fatores de risco estudados foi verificada por meio do teste log-rank, ou pelo modelo de Cox, conforme indicado. A sobrevida dos pacientes em 1, 3 e 5 anos foi de 88,6%, 86% e 82,9%, respectivamente. A sobrevida do enxerto foi de 86,9%, 83% e 77%, e a sobrevida do enxerto censurada para óbito foi de 98,1%, 96,6% e 92,9% para os mesmos períodos. A maioria das perdas de enxerto ocorreram durante o primeiro ano pós-transplante, devido a infecções. Após ajustes estatísticos, observamos que pacientes com idade acima de 42 anos (HHR 3,94, IC 1,39 a 11,13), com doador falecido (HHR 11,41, CI 1,2 a 108,35) ou escolaridade entre 8 e 11 anos apresentaram risco aumentado de perda do enxerto, de forma independente. Em resumo, apesar da elevada mortalidade observada no primeiro ano pós-transplante, as taxas de sobrevida de pacientes e do enxerto foram similares àquelas descritas em grandes bases de dados preexistentes. Acreditamos que a melhoria do cuidado no período pós-transplante é fundamental no sentido de melhorar as taxas de sobrevida, especialmente em centros de baixa atividade transplantadora, que correspondem a cerca de 30% da atividade transplantadora nacional, mas representam enorme potencial para crescimento do número absoluto de transplantes no Brasil, nos próximos anos. / Since the first successful kidney transplant, performance data have been monitored, measured and reported in order to guide transplant activity worldwide. In this paper, we evaluated clinical data from medical records of all kidney transplant recipients followed at the Núcleo Interdisciplinar de Estudos e Pesquisas em Nefrologia of the Federal University of Juiz de Fora (NIEPEN-UFJF), from January 2002 to December 2012. This is a retrospective cohort study, first conceived from periodical data feeding of the Brazilian National Transplant Control Database (CNTx). The main goal was to describe patient and graft survival, as well as clinical and demographic variables affecting them, in the setting of a low activity transplant center. We studied 162 patients, with a mean age of 44 ± 11.5 years, and 92% had a living donor. Patient, graft and death-censored graft survival rates were assessed by Kaplan-Meier analysis, and their association with the studied risk factors was assessed through log-rank test, or Cox model, as suitable. Patient survival at 1, 3 and 5 years was 88.6%, 86% and 82.9%, respectively. Graft survival was 86.9%, 83% and 77%, and death-censored graft survival was 98.1%, 96.6% and 92.9% for the aforementioned time points. Most grafts were lost due to patient death caused by infections, which mainly occurred within the first posttransplant year. After statistical adjustments, we observed that age over 42 years (HHR 3.94, CI 1.39 to 11.13), deceased donor (HHR 11.41, CI 1.2 to 108.35) and schooling time between 8-11 years were independently associated with graft loss. In summary, despite a high early mortality rate, patient and graft survival rates we observed are similar to those described in large databases. We believe that improvements in long-term posttransplant care are a key issue to improve survival rates, especially in low-activity transplant centers, which in Brazil account for roughly 30% of transplant activity, but also represent a great potential source of growth in number of transplants in years to come.

O mecanismo de imunorregulação gerado pelo catabolismo do triptofano pela IDO protege o feto contra a resposta imunológica materna. Neste estudo, esse mecanismo foi em avaliado em gestantes imunossuprimidas e portadoras de transplante renal. Examinou-se a expressão da IDO e sua atividade nos compartimentos placentários de gestantes saudáveis e portadoras de transplante. Células produtoras de IDO e IFN-<font face=\"Symbol\">g foram imunolocalizadas na região vilosa e região decidual em ambos os grupos analisados, com mudanças no tipo celular envolvido nestas expressões nas gestantes transplantadas. Os níveis de IDO e sua atividade, assim como seus fatores de regulação NF-kB, IFN-<font face=\"Symbol\">g e IL-10 estavam diminuídos na região vilosa. No compartimento decidual a atividade enzimática da IDO estava aumentada nas gestantes transplantadas, mas não dos seus reguladores. Sendo assim, eixo de imunorregulação gerado por IDO-IFN-<font face=\"Symbol\">g na interface placentária de gestantes portadoras de transplante renal responde diferencialmente a insultos ocasionados pela utilização de imunossupressores durante a gestação. / The mechanism of immunoregulation generated by the catabolism of tryptophan by IDO protects the fetus against maternal immune response. In this study, this mechanism was evaluated in renal transplanted pregnant women and immunosuppressed. We examined the expression and activity of IDO in placental compartments of healthy pregnant women and patients with transplants. IDO and IFN-<font face=\"Symbol\">g producing cells were imunolocalizated in villous and decidual region in both groups analyzed, with changes in cell type involved in these expressions in pregnant patients transplanted. The levels and activity of IDO, as well as their regulatory factors NF-kB, IFN-<font face=\"Symbol\">g and IL-10 were decreased in the villous region. In the decidual compartment IDO activity was increased in pregnant women transplanted, but not their regulators. Thus, the axis of immunoregulation generated by IDO and IFN-<font face=\"Symbol\">g in placental interface of pregnant women with renal transplantation responds differently to insults caused by the use of immunosuppressive drugs during pregnancy.

No description available.

Bakgrund:Njurtransplantation är den lämpligaste behandlingen vid kronisk njursvikt. Efter njurtransplantationen påverkas patienternas livskvalitet.   Syftet:Att undersöka upplevd livskvalitet hos patienter som genomgått njurtransplantation, vilka faktorer som påverkade livskvaliteten samt om det fanns någon skillnad i upplevd livskvalitet hos njurtransplanterade patienter jämfört med normalbefolkningen och dialyspatienter.   Metod:Litteraturöversikt där tio artiklar från databasen PubMed valdes ut, dessa artiklar kvalitetsgranskades och analyserades. Hälso-relaterad livskvalitet användes som teoretisk utgångspunkt.   Resultat:Studiens resultat kategoriserades i fysisk livskvalitet, psykisk livskvalitet, social livskvalitet samt läkemedlens påverkan på livskvaliteten. De njurtransplanterade rapporterade en förbättrad livskvalitet jämfört med innan transplantationen. Dock uppnådde de inte samma livskvalitet som normalbefolkningen då faktorer i samtliga kategorier påverkade de njurtransplanterades livskvalitet negativt. De njurtransplanterade upplevde sämre muskelstyrka, komplikationer efter transplantationen, högre grad av psykisk stress samt ett ökat behov av emotionellt stöd. De upplevde även biverkningar från den immunsuppressiva medicineringen vilket sänkte livskvaliteten. Njurtransplanterade patienter upplevde dock att deras livskvalitet förbättrades i hög grad jämfört med innan transplantation då de inte längre var i behov av dialys.   Slutsats:Trots att livskvaliteten inte uppnår normalbefolkningens upplevda livskvalitet ökar de njuransplanterades livskvalitet tillräckligt mycket för att en njurtransplantation ska förbättra livet för en patient med kronisk njursvikt. / Background: Kidney transplantation are the most suitable treatment for chronic kidney failure. The kidney transplantation affects the patients’ quality of life.   Aim:To investigate experienced quality of life amongst patients that has undergone kidney transplantation, which factors that affected quality of life as well as if there were any difference in experienced quality of life among kidney transplanted patients compared to the general public and dialysis patients.   Method: A literature review where ten articles from the database PubMed were selected, these articles were examined and analyzed. Health-related quality of life were used as a theoretical basis.   Results:The results of this study were categorized in physical quality of life, mental quality of life, social quality of life and pharmaceutical effects on quality of life. The kidney transplanted patients reported an improved quality of life compared to before the transplantation. However, the kidney transplanted patients did not achieve the same quality of life as the general public because of various factors that affected the quality of life negatively. The kidney transplanted patients experienced reduced muscle strength, complications related to the transplantation, a higher level of psychological stress and an increased need of emotional support. They did also experience side effects from the immunosuppressive treatment which affected the quality of life negatively. Kidney transplanted patients did however experience that their life quality improved to a great degree compared to before the transplantation, because they were no longer in a need of dialysis.   Conclusion:Although the quality of life doesn’t reach the general public's perceived quality of life, the kidney transplanted patients experience an improved life quality. A kidney transplantation therefore improves the life of a patient with chronic kidney failure.