The complications can be divided into early and late complications.

The early complications include acute rejection, thrombosis (blockage) of the blood vessels supplying the kidney, urinary leakage, collections of lymph fluid in the wound and wound infection.

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Thrombosis of the blood vessels occurs in 1-3% of cases, leading to death of the transplanted kidney. Once thrombosis occurs, the transplanted kidney must be removed. Urine leakage from the point at which the ureter is joined to the bladder occurs in 10% of cases, but can usually be corrected surgically.

There are different types and degrees of early rejection. The transplanted kidney undergoing rejection does not function well and is often painful and tender. It is often possible to treat rejection successfully with increased dosages of immunosuppression, but sometimes the kidney needs to be removed.

The main long-term complications are related to the life-long immunosuppressive medication that recipients must take to prevent rejection. Most transplant units use a combination of prednisolone, azathioprine and cyclosporin-A.

Complications include increased risk of infection, and problems with the bone marrow caused by the drugs.

Patients whose immune systems are compromised are more likely to develop cancer than people of a similar age whose immune systems are unimpaired. These patients are predisposed to infections with cancer-causing viruses and the immunosupressant drugs themselves may have a direct role in promoting tumours because they can cause cell changes. A large study looking at tumours that developed in renal transplant patients found skin cancer (39%) and lymphoma (12%) to be the two most common cancers. Less common cancers included Kaposi sarcoma (4%), carcinoma of the cervix (4%) and renal tumours (4%).

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