Kidney transplantation is one of the treatment option for kidney disease. A kidney transplantation can offer freedom from dialysis, improved physical and mental health, a better quality of life, and an increased life span. A kidney transplant is a surgery to place a healthy kidney from a living or deceased donor into a person whose kidneys no longer function properly. When the kidneys loose the filtering ability, harmful levels of fluid and waste accumulates in the body, which can raise the blood pressure and result in end stage renal disease or kidney failure. End stage renal disease occurs when about 90% of the functioning is lost. There certain common causes of end stage renal disease like diabetes, chronic uncontrolled blood pressure, polycystic kidney diseases and chronic glomerulonephritis. People with end stage renal disease need to have waste removed from their bloodstream via dialysis or a kidney transplantation.
ADVANTAGES OF KIDNEY TRANSPLANTATION
Major benefits of successful kidney transplantation are-
- Better degree of replacement of renal function and better quality of life.
- Freedom from dialysis- patients avoid complications, cost and time.
- Longer life expectancy
- Lesser dietary and fluid restrictions
- Cost-effectiveness
DISADVANTAGES OF KIDNEY TRANSPLANTATION
Kidney transplantation offers many benefits but has certain disadvantages like-
- Risk of major surgery- kidney transplantation is a major surgical procedure under general anaesthesia that has potential risks both during and after surgery.
- Risk of rejection- there is no 100% guarantee that the body will accept the transplanted kidney.
- Regular medication- transplant patients will need to take immunosuppressive medicines regularly for as long as their donor kidneys are functioning.
- Risk related to immunosuppressive drugs- drugs that suppress the immune response and rejection may lead to severe infections. There are side effects of drugs like high blood pressure, high blood cholesterol and sugar levels.
CONTRAINDICATIONS
Kidney transplantation is not recommended if the patient has-
- A serious active infection
- Active or untreated malignancy
- severe psychological problems or mental retardation
- unstable coronary artery disease
- severe peripheral vascular disease
- antibodies against the donor kidney
- other severe medical problems
LIKELY SOURCES OF KIDNEYS FOR TRANSPLANTATION
There are 3 sources of kidneys for transplantation-
- living related donors- blood relatives of the recipient up to the 4th degree of consanguinity
- living non-related donors- like friends, spouses or relatives
- deceased (cadavers) donors- from victims of brain death
TRANSPLANT SURGERY
Before surgery, medical, psychological and social evaluation is done to ensure fitness and safety of both the recipient and the donor (in living- kidney donor transplant). Testing also ensures proper blood group and HLA matching and tissue cross-matching.
Kidney transplantation is a teamwork of the nephrologists, transplant surgeon, pathologist, anaesthesiologist and supporting medical and nursing staff. After a thorough explanation of procedure a careful reading of consent form, consent of both the recipient and donor is obtained.
In living- kidney donor transplant surgery, both the recipient and donor are operated simultaneously. This major surgery lasts from three to five hours and is performed under general anaesthesia. In living-kidney donor transplant surgery, usually the left kidney is removed from the donor either by open surgery or laparoscopy. After removal, the kidney is washed with a special cold solution and placed into the right lower part of the abdomen of recipient.
In most cases, the old diseased kidneys of the recipients are not removed. When the source of kidney is a loving donor, the transplanted kidney usually begins functioning immediately. However, if the source is a deceased kidney donor, the transplanted kidney may take a few days or weeks to begin functioning.
After the transplant, the nephrologist supervises the monitoring and medications of the recipient. Gujarat Kidney Hospital is one of the best kidney hospitals in Vadodara.
