Kidney transplant

Overview

Kidney transplant is a major surgical procedure to remove diseased or failed kidney in a person and replace it with a healthy kidney extracted from a donor’s or deceased person’s body.

The kidney plays a special role in filtering and removing excess fluids, minerals and waste from the blood in order to produce urine. When the kidneys lose their ability to eliminate harmful waste and fluids from your body, it can lead to high blood pressure and kidney failure. An end-stage kidney disease is also known as end-stage renal failure, which can be treated with a kidney transplant procedure.

The reasons for kidney failure involve polycystic kidney disease, diabetes, uncontrolled and chronic blood pressure and chronic glomerulonephritis (scarring and inflammation of the tiny filters in the kidneys).

There are several benefits of a kidney transplant procedure that include better quality of life, fewer dietary restrictions, lower treatment cost and lower risk of death. A kidney transplant is the only solution for acute glomerular filtration rate which is less than or equal to 20 ml/min.

It should, however, be known that not all people can have a successful kidney transplant treatment. You need to be eligible for getting transplantation. Certain factors that may prevent kidney transplant are advanced age, severe heart disease, poorly controlled mental illness, dementia, drug or alcohol abuse, recently treated cancer, etc.

Only one donated kidney is sufficient to replace two failed kidneys. In that case, the donor and the recipient need to comply with specific obligations and matching criteria before the kidney is taken from the donor and transplanted in the recipient’s body.

As for a deceased donor’s kidney, there are other criteria to be met. How long you may have to wait for a deceased donor’s kidney depends upon the time of dialysis, degree of compatibility and matching between the donor and recipient, and expected survival post transplant. Sometimes, a match may be found within a few months, while it may take years for some people.

There are certain health risks associated with kidney transplant that include rejection of the donor kidney, complications arising from the surgery and side-effects of medications. A lot of factors need to be considered before getting a kidney transplant procedure. Take a look at the complications and risks associated with a kidney transplant surgery:

• Bleeding
• Blood clots
• Infections
• Death, stroke and heart attack
• Blockage of the ureter that connects the bladder and the kidney
• Cancer
• Rejection of the donated kidney, etc.

Special care is required post the transplantation procedure since there are possibilities of your body rejecting the donor kidney. You need to take prescribed medications that may, however, cause certain side effects such as acne, bone thinning, high blood pressure, high cholesterol, excessive hair growth, infections, weight gain, puffiness, etc.

Follow these guidelines for preparations before a kidney transplant:

Before the treatment

After the evaluation, your transplant team will tell whether you are suitable candidate for kidney transplant procedure. Remember, each transplant centre has its own eligibility criteria. If you are not accepted by one, you may apply to the other centres.

The donor may be a deceased donor or a living donor. Whichever donor you select, has to match the eligibility criteria before you get the transplant. Once everything matches and you are ready for the transplant, the surgery takes place.

• If you are suffering from kidney problems, check out with a doctor. If he recommends a kidney transplant, you are most likely to be referred to a transplant centre. You may choose a transplant centre as specified by your insurance company or a centre that you may choose by your own.
• Take a few factors into consideration when selecting a transplant centre- the success rate of transplantation procedure carried out by the centre, the types and number of transplants performed every year, whether the centre provides donation chain programs or paired donation, additional services provided by the centre (like coordinating support groups, helping with local housing, assisting with travel arrangements, etc), the latest technology used for the transplantation procedure, and so on.
• After you confirm a transplant centre, the next step involves assessing the centre’s eligibility requirements for the transplants and whether they meet yours.
• Before you are given a go signal for the kidney transplant, it is evaluated whether you are healthy enough to sustain lifelong post-transplant medications, whether your current medications may interfere with the transplant success, whether you are willing to take the medicines as directed by your transplant team.
• A series of tests and examination are done to ensure that your body is perfectly ready to accept a foreign kidney For the same, a thorough physical exam, imaging scans (like CT scans, MRIs, X-rays), blood tests, and psychological evaluation are performed by the doctor.

After the evaluation, your transplant team will tell whether you are suitable candidate for kidney transplant procedure. Remember, each transplant centre has its own eligibility criteria. If you are not accepted by one, you may apply to the other centres.

The donor may be a deceased donor or a living donor. Whichever donor you select, has to match the eligibility criteria before you get the transplant. Once everything matches and you are ready for the transplant, the surgery takes place.

How it is performed

• You are given general anaesthesia to help you sleep through the procedure. The surgery usually takes 2-3 hours, during which the surgical team monitors the person’s blood pressure, heart rate and blood oxygen level.
• An incision is done in the lower abdomen above the groin. The donor’s kidney is placed in the lower abdomen where it is connected with the recipient’s iliac vein and artery and the blood vessels. The bladder and the ureter are then connected with the kidney. Unless the native kidneys are causing any problems such as kidney stones, high blood pressure, they are left in place.
• After the procedure, the incision site is stitched close.

Recovery

After the surgery, the patient is required to spend several days or weeks in the hospital. During this time, the doctors keep a close monitoring of the patient and they look for any signs of complications. If yes, then that should be treated right away. It is normal to feel pain at the wounded site for several days. The new kidney may start making urine immediately after the surgery, or it may take several days before it starts functioning normally.

The recovery time of kidney transplant may take several days to weeks. Most patients can return to normal daily routine within 7-8 weeks of the surgery. You are strictly restricted from exercising or any heavy lifting jobs, until you fully recover. To speed up the recovery time, you need frequent checkups with your doctor to ensure that all the other organs in the body are responding well and your body has adjusted with the new kidney. You are supposed to take medications for the rest of your life.