Kidney Transplant – Procedure, Risk and Treatment

Kidney Transplant – Procedure, Risk and Treatment

What is Kidney transplant?

Kidney transplant, also known as a renal transplant is a major surgical procedure, in which a healthy kidney from a deceased or living donor is placed in a human who has kidney failure at end-stage renal disease (ESRD). This happens when both of your kidneys stop working, which results in the accumulation of waste and other toxic substances in your body which can further raise your blood pressure and ultimately lead to kidney or renal failure.

Kidney Anatomy and Functions-

The kidneys are the internal organs of a human, which are essential for life. They are two bean-shaped organs placed on each side of the spine below your rib cage in the lower abdominal activity on the back wall. Kidneys are roughly the size of your fist about 4 to 5 inches long. Their main function is to filter out waste and other toxins from the blood by producing urine, which is then excreted from the body.

To ensure the proper functioning of the body, these kidneys perform several major functions. They include-

  • Maintain body fluid balance by filtering out the waste and other toxins from your blood. This waste is then turned into urine and stored in the bladder. And once you feel that the bladder is full, the urine is passed out from the body through the urethra.
  • Regulate blood pressure by releasing hormones.
  • Produce erythropoietin for regulating the production of red blood cells in the bone marrow. 
  • Control the acid-base balance 
  • Regulate the concentration of electrolyte (salt) in the body.

Kidney Transplant

When a kidney failure or End Stage Renal DIsease (ESRD) occurs, both the kidneys stop functioning, which results in the accumulation of waste in the body, making you sick. There are two ways to treat this- Dialysis and Kidney Transplant. Dialysis is a mechanical process used to clean the blood by filtering out the waste products.

Kidney transplant is considered over a lifetime of dialysis and only one kidney is needed to replace the functioning of the two previous kidneys which stopped functioning. Kidney from a living person is also an option as an individual can live a healthy life with just a single kidney functioning properly. This new donor kidney is transplanted in your lower abdomen. The artery and the vein of the new kidney are connected with your artery and vein. Once the connection is done, the blood will start flowing through the new kidney and resume the work of filtering out the waste from the blood and excreting it out of your body in the form of urine. Sometimes, it may take weeks for the new kidney to start functioning. Kidney transplant will treat ESRD and allow you to live a normal and healthy life once again.

Why is Kidney Transplant done? What are the reasons of Kidney Transplant?

Kidney transplant is done when both the kidneys have stopped working by more than 90%, leading to the endangerment of your life. Multiple reasons for kidney failure include-

  • Diabetes
  • Chronic high blood pressure
  • Glomerulonephritis, a situation in which glomeruli, tiny filters within your kidneys get damaged by inflammation and eventual scarring.
  • Polycystic kidney disease

Who cannot get a kidney transplant done?

Sometimes, there are certain reasons, due to which getting a kidney transplant is not possible. They are-

  • Severe cardiovascular disease
  • Cancer (active or recently treated)
  • Alcohol or drug abuse
  • Uncontrolled mental illness or dementia
  • Infections like- tuberculosis, hepatitis, or bone infections
  • Problem in liver

Kidney Transplant Procedure-

Kidney transplant Evaluation Process

To find an identical kidney, from a living donor or deceased donor, there are certain tests that need to be conducted to find out your blood type and tissue. These results are then used to match with a donor kidney for transplant. They are-

Blood Type Testing – To prevent the risk of your body rejecting the new kidney, your blood is tested to find its type, out of- A, B, AB, or O. For transplant, the donor blood type should either be the same or at least compatible unless special treatment is being done which can allow any blood type. Compatible blood types-

    • For recipient with blood type A, donor type – A, O 
    • For recipient with blood type B, donor type – B, O
    • For recipient with blood type AB, donor type – A, B, AB, O
    • For recipient with blood type O, donor type – O

Tissue Typing – Once a donor with a compatible blood type has been found, the next test conducted is a tissue typing test known as human leukocyte antigen typing (HLA). This test is done to compare antigens. Inherited from parents,  antigens are genetic markers found in everyone that distinguish every individual. Although not necessary, compatible tissue typing plays a very important role in a long-lasting kidney transplant.

Crossmatch – A human body forms antibodies, who destroy any foreign material present in the body. And since the donor kidney is also a foreign object, crossmatch is done to see if your body forms antibodies against the donor kidney. Cross Matching is done by mixing a sample of donor’s blood and your (recipient) blood in the lab. If the test results are negative, your body will most likely not reject the donor kidney. However, if the test results are positive, special treatment needs to be done to reduce the antibodies in the recipient’s body before the kidney transplant.

Additional tests might be done to ensure that the donor is healthy and no medical problem is transferred from the donor’s body to the recipient’s body.

Kidney Donation from a Living Person-

Instead of waiting for a kidney from a deceased person, a donor kidney from a willing living person is also an option. Generally, for a proper match, family members are the best option. But unrelated people like- friends, co-workers can also donate a kidney (willingly).

Kidney Donation from a Deceased Person-

If you are unable to find a living donor, you will be put on a waiting list for a deceased donor kidney. You might have to wait for years to get a kidney transplant from a deceased donor.

While you are waiting for a kidney transplant, you need to maintain a healthy lifestyle as you will be more prepared for the kidney transplant. Do regular exercising, and don’t do any sort of substance abuse. And take your prescribed medication.

Kidney transplant Surgery Procedure

  • Once you have been called for kidney transplant from a living or a deceased donor to the hospital, you will be prepared for the surgery.
  • You will be administered anesthesia before the surgeon begins with the transplant. And your heart rate, blood pressure, and blood oxygen level will be measured during the roughout of the procedure.
  • The original two kidneys are not removed, instead a third kidney added. The original kidneys will only be removed if you have pain, kidney stones, high blood pressure, or infection.
  • An incision is made in the lower part of the abdomen at either of the sides. 
  • The new kidney is placed there and the artery and vein carrying blood from the new kidney are surgically connected to the artery and vein present in your pelvis.
  • The ureter of the new kidney is also connected with the bladder for the flow of urine.
  • The incision is then closed with stitches.
  • To help you pee, the surgeon might also insert a tiny tube called a stent into your ureter.
  • This surgery takes about 3 to 5 hours to complete.

Post Procedure After Care

  • Once the surgery is complete, you will be taken to another room for recovery, where your vitals will be continuously monitored.
  • You might have to stay in the hospital for more than a week depending upon the speed of recovery. During this time, you will feel pain at the incision site, which will heal gradually.
  • The transplanted kidney might start making urine immediately or might take some while. Kidneys donated from a family member generally start working faster than a kidney from a deceased or an unrelated donor.
  • Before leaving the hospital, you will be given instructions by the doctor regarding the medication you will have to take for the rest of your life, so that your body doesn’t reject the new kidney. The medication (immunosuppressants) prevent our immune system from attacking the donor kidney.
  • You will be called to the hospital for regular checkups.
  • You will be able to return to normal activities in about six weeks or it may take longer depending upon certain conditions.

What are the risks of a Kidney Transplant?

A kidney transplant carries some risks. They are-

  • Bleeding
  • Blood Clots
  • Infection
  • Leakage at the incision site
  • Stroke
  • Heart attack
  • Transplanted kidney fails and gets rejected
  • Blockage in the urethra

The immunosuppressants which you have to take for the rest of your life also carry some risks. They include-

  • Bone thinning
  • Weight gain
  • High risk of cancer
  • Acne
  • High blood pressure
  • Hair growth or hair fall in excess

Care At Home-

At home, there are certain things you need to keep in mind to ensure the proper functioning of the donor kidney. They are-

  • Take medication regularly
  • Eat a healthy and proper diet
  • Exercise daily, after the wound has healed
  • Don’t lift heavy objects for a short while

FAQ

Q-1. What is the kidney transplant cost in India?

Kidney transplants in India cost Rs. 5-6 lakhs (Purely indicative). After the surgery, it could cost Rs. 15,000 a month for the aftercare and another Rs.

Q-2. Is kidney transplant a major surgery?

Kidney transplants in India cost Rs. 5-6 lakhs (Purely indicative). After the surgery, it could cost Rs. 15,000 a month for the aftercare and another Rs.

Yes, kidney transplant is a major surgery and thus involves a higher rate of risk.

Q-3. What is the Kidney Transplant success rate?

According to the national Organ Procurement and Transplantation Network, the success rate after a kidney transplant with a living-donor kidney was reported as 97% at 1 year and 86% at 5 years.

Q-4.Why is kidney transplant better than dialysis?

There are many reasons why getting a kidney transplant is better than dialysis. They are-

  • Kidney transplant patients live longer than people who get dialysis.
  • A person who is on dialysis has to follow a strict diet, whereas people who opt for kidney transplant can eat more freely.
  • Dialysis patients have low energy levels as compared to kidney transplant patients and can thus return back to their normal work life much quicker.     

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