Kidney transplantation

Specialty of Urology

What is a kidney transplant?

A kidney transplant is an operation that involves placing a healthy kidney in a person with kidney failure. To do so a kidney donated by a healthy individual is required. This can either come from a living donor, related or not with the patient, or from a deceased person.

When are kidney transplantations needed?

This treatment is indicated for patients suffering from kidney disease who rely on dialysis to survive. The kidneys are responsible for filter waste and toxins, such as urea from the bloodstream. When your kidneys fail, these waste products and toxins remain at dangerous levels in your bloodstream, which can raise blood pressure and result in kidney failure. People with end-stage kidney disease often choose kidney transplantation over lifetime dialysis use because there are several benefits:

  • Better quality of life
  • Better life expectation
  • Fewer dietary restrictions

However, some patients with kidney failure are not suitable for kidney transplantation. For example, if they are very old, have heart disease, have alcoholism or drug addiction, or are impaired mentally. It is important that patients who have a kidney transplantation are compos mentis enough to be able to take essential anti-rejection medications following the transplant.

How is a kidney transplantation carried out?

When you receive a transplanted kidney, your own kidneys are not removed, unless medically required. Kidney transplantation requires sedation with general anaesthesia to ensure that you are not aware during the operation and feel no pain. The surgeon makes an incision in your abdomen and places the donated kidney into the lower abdomen. Next, the blood vessels of the donated kidney are connected to blood vessels in the lower abdomen, usually a vessel just above one of the legs. The donated kidney’s ureter is then connected to your bladder. This surgery takes up to four hours. The transplanted kidney begins to produce urine as soon as the blood begins to flow and performs the same function as the kidney that was deficient so that dialysis treatment can be suspended.

Preparation for a kidney transplant:

Once the medical specialist refers the patient to a transplant centre, a team will evaluate and examine them to verify that they meet the requirements for a kidney transplant. The patient must undergo various tests such as blood typing and tissue typing, heart tests and tests to check for any infections.

Once it is indicated that the patient meets all the requirements, they will be put on a waiting list. In the meantime, most people waiting for a kidney transplant undergo dialysis treatment. While the patient is on the waiting list it is important not to smoke or consume alcohol. In addition, you must maintain the weight recommended by the medical specialist following the diet indicated. It is also important to take any medication prescribed by the doctor.

An alternative to waiting for a kidney donation from a deceased donor is to be matched with a willing living kidney donor. Often this can be a family member, as they are more likely to be compatible.

Aftercare:

Some pain is expected after the transplantation, and you should be able to return home after a week. During this time, you will be closely monitored to ensure the new kidney is working. Most patients are able to return to work and normal activities 3-8 weeks after the transplantation. The operation is technically simple and after it, the patient can lead a normal life. You will need, however, to take medication for the rest of your life to prevent your body from rejecting the new kidney (these are called immunosuppressants).

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