Overview of the Entire Transplantation
of The Kidney

Transplantation of the kidney is never a real cure. When patient’s are in the advanced stage of kidney failure, medical personnel may recommend a transplantation.

When such a patient has a successful transplantation, he/she will be required to take medicine and some types of foods and drinks may be recommended.

After the change of the organs, the new kidney will replace the functions of the failed kidneys BUT will require ongoing medication. The advantage of this is that the kidney change and medication to support it are far cheaper than the dialysis option.

 

The transplantation Process

The transplantation process is a surgical procedure in which the kidney transplant team replaces the failed kidneys with a healthy one into the body of the patient. The new kidney takes the functions of the failed one and also any role which is played by dialysis.

This surgical process may not be recommended to all patients. The medical personnel may rule out transplantation as an option if the condition or infection affecting the kidneys would make the transplantation process dangerous and unsuccessful. But if transplantation is recommended, then a potential donor has to be found.

 
 

The new kidney to replace the failed ones can come from two sources/donors:

• Deceased donor
• Living donor

1. Deceased donor. This is the leading source of kidney donation. In this instance, a potential donor makes the decision to donate his kidneys in the event of his/her death.

There are various organizations which take care of the donations, and the potential donor has to approach any of them with the intention of donating and fill in the necessary documentations. He/she is provided with a card which indicates that incase of one’s death then his/her kidneys are to be taken by the organization concerned with the donations and transplantations.

The number of patients waiting for such donations is high and has been rising in the recent years contrary to the number of potential donors which doesn’t match such growth. This results to the number patient’s waiting list for such kidneys donations to be high.

2. Living donor. Here, kidneys are donated by family and friends or to some extend well-wisher of the patient. Medical compatibility test has to be carried out to ascertain if the donor’s kidneys will match with the recipients body. Also the potential donor will have to be tested to ensure that the donation won’t endanger the life of the donor.

 

Kidneys from these donors are advantageous over those of the deceased donor because of several reasons as indicated below:

• The patient doesn’t have to spend a lot of money as they wait for kidneys from deceased donors
• Kidneys from family members are very likely to be compatible
• Kidneys coming from family members or friends don’t take time to be available. This can significantly reduce the costs of dialysis a patient incurs as he/she waits for a kidney with a perfect match

Before the transplantation process is commenced, a patient has to undergo medical tests at the transplant center. This pre-transplantation evaluation may be scheduled in regular appointments prior to the real process to completely ascertain the success of the real process.

Some of the factors evaluated include:

• Blood type and other matching factors that will determine if the patient’s body will accept the new kidney
• Presence of other complicated diseases like cancer, some advanced cardio-vascular diseases and other serious infections are determined because if present, then the chances of a successful transplantation are minimal
• The general health of the patient is determined to see if he/she is healthy enough for the surgery
• In the case of a living donor, he/she will also have to undergo medical evaluations to ascertain that the kidney to be donated will match with the patient’s body and minimize chances of rejection
• The medical team will also have to counsel the patient of the importance to follow and adhere to post-transplant schedule of medicine given and ensure that the patients fully understands this obligation

 

The Real Transplant

When a kidney matching a kidney has been found for a patient in the waiting list or in the case of donation from family, friends or well-wishers, and medical evaluation shows that the patient is a good candidate, then the real procedure is scheduled.

For those on the waiting list, they will have to be ready for the very moment that the kidney becomes available. They should visit the Transplantation Center immediately. Once there, the patient’s blood will be tested for the antibody cross-match test. If the test results negative, it means that the patient’s antibodies won’t react and the transplantation can proceed as scheduled.

Anesthesia is administered to the patient so as to induce sleep throughout the surgical procedure which normally takes 3-4 hours.

The transplantation surgeon will make an incision on the patient’s lower abdomen area. The new kidney will be attached on the patient’s artery and veins with those of the new kidney, while ureter from the new kidney will be attached to the patient’s ureter.

 
 

For living donors, the procedure can be scheduled at the most convenient time. When both the patient and the donor are ready, they are operated at the same time in the same transplant center. A team for the transplantation will work on removing the kidney from the donor, a process called nephrectomy, while another team will work on placing the kidney to the recipient.

 

Post-transplantation care and advice

After a successful transplantation process, the recipient will have to take medication to prevent the body from rejecting the new kidney.

The body of a human being has an immune system which can sense any foreign body such as bacteria and work on removing them. This also happens to the new kidney and may cause rejection of the kidney. Medication is therefore given to suppress the immune response from doing so.

These drugs are called immunosuppressants. Also other drugs can be introduced to treat other health problems and infections which may arise from the process because immunosuppressants work on reducing the patients immune system thus making one to be susceptible to infections.

The medical team will also recommend the foods which can be taken by the patient but the foods are more favorable than those taken by a person undergoing dialysis. For example, salty foods are supposed to be avoided because they can easily lead to high blood pressure which is a real threat to the new kidney.

Even though a patient adheres to the medication and the recommended foods, the body may still reject the kidney and the patient may have to go back to dialysis or to the waiting list and register for another kidney donation. This is possible only if the body is found still fit for another transplantation.

Therefore after the transplantation process, the patient should look out for signs of the kidney rejections which include:

• Fever
• Soreness in area of surgery
• Change in the volume of urine or presence of bloody stains in the urine

Incase of these signs, the patient should seek medical advice immediately.