A kidney transplant is a surgical procedure to place a kidney from a live or deceased donor into a person whose kidneys no longer function properly. Your kidneys remove excess fluid and waste from your blood. When your kidneys lose their filtering ability, dangerous levels of fluid and waste accumulate in your body — a condition known as kidney failure or end-stage kidney disease. A kidney transplant is often the best treatment for kidney failure. Only one donated kidney is needed to replace two failed kidneys, making living-donor kidney transplantation an option. If a compatible living donor isn't available for a kidney transplant, your name may be placed on a kidney transplant waiting list to receive a kidney from a deceased donor. The wait is usually a few years.
A kidney transplant is recommended for persons who have serious kidney dysfunction and will not be able to live without dialysis or a transplant. Some of the kidney diseases for which transplants are done include the following conditions:
With disease these nephrons become damaged, the kidneys can lose their filtering abilities. This means high and life threatening levels of waste products and chemicals in the body. When the kidneys have lost around 90% of their filtering ability, the person is said to have end stage kidney disease
Common causes of end stage kidney disease include:-
Diabetes – These patients have a continuous high blood sugar. This high blood sugar can damage the filters in the kidneys, leading to long-term kidney damage and finally kidney failure. This is called diabetic nephropathy.
High blood pressure or hypertension – This is another common cause of kidney disease and failure. High blood pressure in the tiny blood vessels to the kidney leads to damage and prevents the filtering process from working properly.
Blockages in the arteries - That bring blood to the kidneys over time called renal artery stenosis is another cause of end stage renal disease
Another condition is called polycystic kidney disease which is an inherited condition. There are several large cysts or hollow spaces formed within the kidney that make its normal functioning difficult.
There may be congenital problems in development of the kidneys. This has occured since before birth and manifests when over 90% of the kidney function is compromised.
Disease of the immunity, such as systemic lupus erythematosus (SLE) in which the immune system of the body fails to recognise the kidney as its own.
Patients in whom kidney transplant cannot be performed include:
- Those with a widespread cancer,
- Those with an active infection,
- Those with liver or heart disease,
- Those with AIDS.
The most widely used operating technique is the Gibson incision. First a cut is made over the lower abdomen through which the donated kidney put into place. Unless there is an indication like an infection or cancer the recipient’s own kidney is left in its position.
As a next step the blood vessels from the lower abdomen are attached to the donated kidney much like the original kidney. This ensures that the donated kidney has the blood supply that it needs to function properly. Finally the ureters that take the urine from the kidneys into the urinary bladder for the stage are attached to the donated kidney. This surgery is a complex one and may take around three to four hours to complete.
After the procedure the skin is tied up with sutures or stables, leaving a tube behind to drain blood and fluids collecting in the operative area. The Patient is wheeled back to a recovering room.
Pain medications are provided for pain relief. Antibiotics are given intravenously for prevention of infections. Immunity suppressing medications including ciclosporin, azathioprine, mycophenolate mofetil, tacrolimus, sirolimus or Prednisolone is begun as soon as possible to prevent the body rejecting the new donated kidney.
Most patients can leave the hospital in five to seven days. In around 7 out of 10 people who have a kidney transplant, their new kidney begins working immediately after surgery. In some it may take around 4 to 6 weeks to function normally. If this is the case, the patient requires dialysis during this time. Patients need to be followed up for life.
The Kidney Transplant Surgery is a highly delicate procedure, thus requires great attention even at home. If the patient feels any health issue during the post surgery period, it must undergo a check-up immediate.