الفهرس 
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Abstract
Transplantation is the optimal form of renal replacement therapy for patients with end stage renal disease. Transplantation, as the term is used in immunology, refers to the act of transferring cells, tissues, or organs from one site to another. The desire to accomplish transplants from the realization that many diseases can be cured by implantation of a healthy organ, tissue, or cells (a graft) from one individual (the donor) to another in need of the transplant (the recipient or host). Pretransplantations studies should include assessment of renal function, general health, an imaging study of the renal vasculature, human leukocyte antigen typing, cross-matching, and measurement of the panel reactive antibody (PRA) titer. All donors should be in good health and should not have conditions that may compromise their renal function in the future. The human leukocyte antigens (HLAs) are encoded by the major histocompatibility complex (MHC), a cluster of genes located on the short arm of chromosome 6. There are three major categories of HLA typing methods, based on the procedure employed; serologic typing, cellular typing and DNA based typing. Other immunologic factors are found to play a role in allograft failure. These factors include: • Minor Histocompatibility Antigens. • MHC class I related chain A (MICA). • MHC encoded genes (HLA-DMA, -DMB, and LMP2). • Cytokine gene polymorphism. • Donor C3 allotype. It was found that despite significant advances in the field of renal transplantation, long-term graft survival has not dramatically increased. The reasons for this varied, but include the persistent impact of infectious diseases on transplant recipients. Viral infections continue to be a potential contributor to graft failure, but also a cause of severe mortality and morbidity. Chemical immunosuppression required for successful maintenance of the allograft is a double edged sword, as it is needed for the maintenance of the allograft and it produce a powerful complications. Therefore the interplay between immunosuppression and complications is a major concern in renal transplantation.