A kidney transplant is a surgical procedure performed to treat kidney failure, where a healthy kidney is placed from a living or deceased donor into the person whose kidneys are no longer functioning properly. Our kidneys, two bean-shaped organs present on each side of the spine, located below the rib cage, help our bodies remove waste, minerals and fluids from our blood by producing urine. However, when the kidneys are no longer able to filter properly, harmful levels of fluid and waste can accumulate in the body, which can cause the blood pressure to rise and eventually result in kidney failure. When the kidneys have lost around 90 percent of their functioning abilities, it is called end-stage renal disease.
End-stage kidney diseases can be caused by:
- Chronic glomerulonephritis, which is an inflammation and scarring of the fillers in the kidneys
- Polycystic kidney disease
- Chronic and uncontrolled high blood pressure
People, who are suffering from end-stage renal diseases, need to have their waste removed via a machine or require a kidney transplant in order to survive.
Why it is Performed
A kidney transplant is a treatment, often chosen to treat kidney failure. It can help the patient suffering from kidney failure to live longer and better. Kidney transplant can lead to:
- Lower death risk
- Better quality of life
- Fewer restrictions on diet
- Lower cost of treatment
For some people, however, a kidney transplant can be riskier than dialysis. Conditions that can prevent you for a kidney transplant include:
- Severe heart problems
- Old age
- Active or recently treated cancer
- Dementia or any similar mental illness
- Alcohol abuse
- Drug abuse
If a compatible donor is not available, your name might be placed on the waiting list so that you can receive a kidney from a deceased donor.
The amount of time you will need to wait depends on the compatibility between you and the donor, time on dialysis as well as the transplant waitlist. Expected survival post-transplant can also be a factor. Some people can get a match within a few months, while others even need to wait several years.
There are two kinds of donors:
Living donors- The body can function perfectly well with only one healthy kidney, a family member with two healthy kidneys can sometimes choose to donate one of the kidneys to the patient. For this, the donors’ blood and tissues will need to match the ones of the patient.
Receiving a kidney from a family member is a safe option, as it reduces the risk of the body rejecting the kidney, and it also enables you to bypass the multiyear waiting list for a deceased donor. When your body receives a kidney from an unrelated donor, it is also more likely to reject it.
Deceased donors- Deceased donors also known as cadaver donors, are people who have passed away usually due to an accident, rather than a disease. Either their donor themselves or their family can choose to donate their organs and tissues.
If your doctor is recommending a kidney transplant, you will be referred to a transplant center, but you can choose a transplant center of your choice as well or from your insurance company’s list.
When you are considering a transplant center, remember to learn about how many transplants they perform each year. Also find out if different donation programs are offered by the center, as this can increase your chances of receiving a living-donor kidney. Also consider the total costs that will be incurred and what kind of additional services the transplant center provides.
Once you have selected your transplant center, you will be evaluated in order to determine whether you meet their eligibility requirements for a transplant.
You will be assessed to determine whether you-
- Are healthy enough to go through a surgery and tolerate life-long medications after the transplant.
- Have any conditions that can interfere with the success rate of the transplant.
- Are willing and able to take medications as you will be directed.
The evaluation process can often take several days and it will include a thorough physical exam, blood tests, psychological evaluation, imaging studies such as X-ray and MRI, etc. Once the evaluation is complete, your transplant team will let you know whether you have been accepted as a candidate for a kidney transplant. However, if one center doesn’t accept you, you can apply at another, as each of them has its own eligibility criteria.
Once you have passed the evaluation, stay in touch with the transplant team and keep them updated regarding any significant changes in your health. When you are waiting for a donated kidney, you should make sure that the transplant team knows how to contact you at all times. Keep your packed hospital bag handy and also make arrangements for transpiration to the transplant center in advance.
Maintaining your health
Whether you are waiting for a donated kidney or your transplant surgery has already been scheduled, it is important that you keep yourself as healthy as you can, so that you are ready for the surgery when the time comes. This can help speed your recovery as well. Follow a balanced diet and exercise regularly. Take your medications as prescribed by your doctor. Avoid smoking.
If you are receiving the organ from a living donor, your doctor can schedule the transplant in advance. However, if you are waiting for a deceased donor who is a close match for your tissue type, you might need to rush to the hospital at any moment.
After arriving at the center, you will have to give a sample of your blood for an antibody test. If it results in a negative crossmatch you will be cleared for the surgery.
The transplant is done under general anesthesia, so you will be put into sleep during the surgery. Once you are asleep, the doctor will make an incision in your abdomen, and place the donor kidney inside, after which they will connect all the arteries and veins from the kidney to your arteries and veins. This will let the blood start flowing smoothly through the new kidney soon.
Your doctor will next attach the new kidney’s ureter to your bladder so that you can urinate normally. The doctor won’t remove your original kidneys from your body unless they have been causing problems.
Once a kidney transplant is successful, your new kidney will filter your blood, due to which you will no longer require dialysis. To prevent your body from rejecting the new kidney, medications will be required so that your immune system can be suppressed. However, this causes your body to become more vulnerable to infection. Therefore, your doctors can also prescribe antibacterial, antiviral and antifungal medications.
It is quite important that you take all your medications as prescribed by your doctor because even if you skip them for a short period, your body can reject your new kidney. If your medications are causing any side effects, you need to contact the transplant team immediately.
A kidney transplant is a serious surgery and therefore, as with any major surgery, several risks are associated with this procedure. Some of these risks include
- Internal Bleeding
- Formation of blood clots
- Ureter leakage or blockage
- Donated kidney getting rejected by the body
- Donated kidney failing
- Stroke or heart attack
Despite these risks, a kidney transplant is still considered the best option for a person suffering from chronic kidney ailments or end-stage renal disease. After the procedure, one might need to take anti-rejection medication for the rest of their lives. Therefore, it is best to consult with your doctor whether you should be going for a transplant.