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The kidney transplant is a surgical procedure to place a healthy kidney received from a donor’s body whether deceased or alive into your body after removing your malfunctioned kidney. A donor, in this case, is a person who has died recently or still living. It is a known fact in medical practice that a person can survive with one kidney and doesn’t require both of its kidney’s to live, hence the person is allowed to donate one of his/her kidneys to probably one of their own family member and save him from an untimely death.
The donor kidney from a person who had just died is a deceased donor kidney and the donor kidney from a person who gave just one kidney and still alive is a living donor kidney. In case of no family member or absence of any kidney donor, you name will be placed on the National waiting list for a kidney from a deceased person.
This process is getting very popular among patients who have a little or no kidney function.
What is a kidney?
A kidney is bean-shaped organ, the size of a palm, located either side of the spine just below the rib cage. The primary objective of both kidneys is to filter and remove waste products, fluids and excess minerals from the blood and convert them to urine. If both the kidneys refuse to work properly and discontinue its function of converting waste products into urine, the waste products will build up in your body which is potentially a fatal condition.
Such waste products build up in your body will result in excessive blood pressure and end-stage kidney failure or chronic kidney diseases are some of the main reasons for needing a kidney transplant. Using “dialysis” technique to replicate the functions of the kidney is a lengthy and tiresome activity of filtering waste products from the bloodstream through a machine, so a kidney transplant becomes the last resort of the patients in the end.
Most common reasons that may lead to an end-stage renal disease:
- Chronic, under controlled high blood pressure
- Chronic Glomerulonephritis
- Polycystic kidney disease
People who withstand the effects of kidney transplant in order to successfully complete the surgery are eligible for the surgery and require continuous follow-up appointments and life-time consumption of immunosuppressant pills to reduce the chances of rejection.
- ABO incompatible kidney transplant
- Living-donor kidney transplant
- Pre-emptive kidney transplant
Unlike many other types of organ donation, the donor can possibly donate one kidney because a person can survive on one kidney. This is known as living kidney donor. Doctors will perform several tests to confirm the donor kidney matches your tissue and blood type. A tiny mistake or mismatch can enhance the chances of rejection and compel you for another kidney transplant surgery. Other evaluations regarding prior diseases, heart or lung diseases or cancer threats will be conducted to ensure the success of the transplant. Generally, a donor happens to be one of the family members with the identical blood type which reduces the risk of rejection but in case of mismatch, you will be placed on the National waiting list of the donor. Donation is also possible from the recently deceased people and the donor kidney removed from the deceased person is known as deceased donor kidney. Hence, this donor kidney slightly has lower chance of long-term success.
The transplant procedure
Kidney transplant generally takes 3 to 4 hours to complete and begins under the general anesthesia to make unconscious for the surgery. The surgeons will make an incision into the abdomen and the donor kidney will be placed in your lower abdomen, blood vessels from the donor kidney will be connected to arteries and veins in your body and the ureter from the donor kidney will be connected to your bladder. Blood will begin flowing through the donor kidney and the kidney will immediately begin filtering the blood, remove the waste and produce urine.
The donor kidney frequently starts to function just after connecting the blood vessels. Generally, infected or diseased kidneys are not detached unless you are suffering a severe infection of the kidney (pyelonephritis), kidney cancer, nephrotic syndrome, or extremely large polycystic kidneys. You and your donor both will be operated at the same time, usually in side-by-side rooms. One surgeon will perform the process of nephrectomy known as the removal of the kidney from the donor whether deceased or living while other surgeon makes the preparation to install the donated kidney in your system. In some cases, both operations are performed by the same surgeon.
Risks and Complications
- Rejection of Donor kidney
- Life-time consumption of immunosuppressant medication
- Bleeding, infection and wound healing problems
- Difficulty with blood circulation to the kidney and problem with flow of urine from the kidney.
- Failure of the donated kidney
- Some form of kidney disease may return after transplant.
Side-effects of anti-rejection medications
- Bone thinning (osteoporosis) and bone damage (osteonecrosis)
- Excessive hair growth or hair loss
- High blood pressure
- High cholesterol
- Increased risk of cancer, particularly skin cancer and lymphoma
- Puffiness (edema)
- Weight gain