Kidney Transplant

Kidney transplant surgery is a surgery to transplant a healthy kidney from a donor to a person having severe kidney disease. Kidneys are vital organs that help to remove waste products from the blood. It also performs many other functions to keep you healthy.

If your kidney does not work properly, you will have a lot of problems. Some of these can also put you in danger. Dialysis to remove the waste products from the blood with the help of a machine is the most common treatment. But after some time you will need to have it very often.

In such situations, a kidney transplant is the best option. You will get the kidney from a healthy living donor or deceased or a brain-dead person. The person donating the kidney is called a donor, and you will be the recipient.

The blood groups of the donor and recipient must be compatible. To get a kidney from a deceased donor, you will have to enroll in a registry and wait for your turn.

In a living donor transplant, you get the kidney from a healthy person willing to donate one of his kidneys. The person will be someone you know well or an acquaintance. It is essential to ensure that the donor is not doing it for any gains.

During the transplant, the doctor will place the new kidney in your abdominal cavity above your diseased kidneys. It is not necessary to remove the diseased kidney from your body. After placing the kidney, the doctor will connect the renal blood vessels to it. The new kidney will then start filtering waste from your blood and help you have a healthy life.

The donor will not have any problems with his health by donating a kidney. Your body will be able to function with a single kidney.

When to do a kidney transplant?

You will need a kidney transplant when both your kidneys fail. In acute kidney failure, the kidneys may start to function after treating the cause. Chronic kidney failure happens over a long time. In such cases, the chances of kidney function getting better are very less. In such a case, you will need a kidney transplant.

Some of the diseases that may cause kidney failure are

• Pyelonephritis or recurrent urinary infections
• Glomerulonephritis
• Interstitial nephritis
• Polycystic kidney disease
• Conditions causing prolonged obstruction of urinary tract
• Type 1 and Type 2 diabetes
• High blood pressure

Who cannot have a kidney transplant?

A few things can prevent one from having a kidney transplant. These include

• Repeated infections in the body
• Kidney cancers that have spread to other organs
• Severe heart, lung, liver diseases, etc
• Having a drinking problem

How to find a kidney donor?

The main requirements for a donor are he or she should 

• Be in good physical and mental health
• Both the kidneys are healthy
• Be above 18 years and less than 65 years old
• Not have diseases like diabetes, cancer, hepatitis, high blood pressure, and any infectious disease
• Not be a smoker

One of the other vital requirements is that they should not be doing it for any financial or material gains. Ideally, the donor should be someone whom you know well. A close family member or a friend will be an ideal donor.

The donor will have a complete body check-up to ensure that he or she is in perfect health. 

It is also essential to get the consent of a close family member of the donor before the transplant. The doctors will also make sure that the donor is in good mental and emotional health. The donor should have a thorough understanding of the procedure of transplant.

Kidney transplant procedure- What does it involve?

The first step is to get a donor willing to donate.

You and the donor will have some tests to ensure that you both are fit enough to have the surgery.

The doctors will then do some matching tests. These include

• Blood type testing- To know the blood groups and to check for compatibility
• Tissue typing – This is to identify the compatibility of human leukocytes antigens. Your HLA and the donor HLA should match perfectly. Brothers and sisters are usually the best matches.
• Crossmatch testing - You will have this test to ensure that your body will not reject the donor's kidney straight away.

After completing these tests, the doctors will send you both for a counseling session. During this, the doctors will explain the procedure, its risk, complications, etc. 

Kidney transplant procedure:

There are many steps for a kidney transplant. The doctors will first remove the kidney from the donor. The next step is to transplant it to the body.

During surgery, both of you will have general anesthesia. It means you will both sleep through the procedure. The duration of the surgery will be around 3 to 4 hours.

The doctors will start the surgery by operating on the donor. They will remove one of the donor's kidneys along with the ureters. For this, the doctors will make a cut in the side of the abdomen.

The doctors will then start the operation on you by making a cut in the skin on the side of the abdomen. The next step is to place the donor kidney in the abdomen. Your diseased kidney will be left in place unless there is an infection or other problems with it.

In the next step, the doctors will attach the blood vessels to the new kidney. The blood will then start flowing into it and make it work.

The surgeons will then attach the ureters to the urinary bladder. The urine will then start slowly trickling into the bladder. There will be a stent in the ureters to keep it open. The doctors will remove this stent at a later time.

Once everything is fine, the doctors will close the incision in the abdomen using sutures or staples.

The doctors will then move you to the observation room.

Things to do after kidney transplant

You will have to make some changes in your life after a kidney transplant. These will help your new kidney to function better and prevent any complications. Some of these are

• Stop smoking if you do
• Maintain a healthy diet
• Keep your body weight within limits
• Do exercises regularly 
• Avoid drinks and recreational drugs
• Before taking any medicines, check with your doctor.
• Drink lots of fluids. Avoid dehydration
• If you have a fever, headache, muscle pain, diarrhea, vomiting, etc., go to your doctor. Never ignore it.
• Keep your blood pressure, blood sugar, etc. under control.

All these are small adjustments in life, but the benefit is a healthy kidney and a healthy life.

Signs of kidney transplant rejection

Some of the most common symptoms of kidney transplant rejection are:

• Fever
• Swelling pain or tenderness on the side of the abdomen
• Raised blood creatinine level
• High blood pressure
• Mood changes like depression
• Extreme fatigue

If you have any of these signs, you need to go to the doctor very fast.

Kidney transplant risks and complications

Some of the common risks of kidney transplant are

• Reaction to medicines and anesthesia
• Blood loss during surgery
• Infections of the surgical wound
• Delay in wound healing

Apart from these, there can be some complications as well. 

• Rejection of the kidney- Your body may reject the donor kidney anytime. To prevent this, you will have to take immunosuppressants for the rest of your life. If you stop this, your body may reject the kidney
• Chances of infection- By having immunosuppressants, your chances of getting infections are more. It is because the drugs lower the immunity of your body.
• Fluid collection around the kidney- It will put pressure on the kidneys and harm it
• Blood clots – This can happen shortly after the surgery. Clots may form in the blood vessels leading to the kidney and stop the flow of blood to it. You will have medicines to dissolve the clots.
• Urine Leakage – There could be a leakage of urine from where the ureter joins the bladder. Urine may seep out and accumulate in the stomach or leak out through the incision.