Renal transplantation

Kidney transplantation is a procedure of placing one kidney from a healthy person into the patient's body. This new kidney does all the work that the failed kidneys cannot do.

For advanced and permanent kidney failure, this is the best treatment option that allows the patients to live much like they lived before their kidneys failed.

Kidney transplantation does not involve the removal of the old organ for replacement with the new, but the old kidneys are left in place and a new kidney is placed beneath the abdomen.

Kidney transplant is used when there is severe chronic kidney failure that cannot be reversed. This surgery cannot be done if patient has an active infection, another life-threatening disease such as cancer, or severe heart or lung disease.

Transplant procedure

Kidney transplant surgery takes from 4 to 6 hours. During surgery, the healthy kidney from donor will be placed in the lower abdomen. Blood vessels from the donor kidney will be connected to arteries and veins in the body. Blood is then able to flow through the new kidney, and the kidney will begin to filter and remove wastes and produce urine and thus begin to perform all of the functions that the failing kidney cannot.

In most cases, diseased or damaged kidneys are not removed unless there is a severe infection of the kidney, uncontrolled blood pressure or extremely large kidney.

To get ready for kidney transplantation
Patient receives a kidney from a member of the family or from any person whose blood type and tissue type matches with the patient or from a person who has recently died (cadaver donors). It is very essential that both patient's blood type and the donor's blood type — whether Type A, B, AB, or 0 — be compatible/matched. Tissue type of both must also be compatible. HLA (human leukocyte antigens) blood test is done to determine tissue type. Blood will also be tested to determine whether it has antibodies to other tissue (Lymphocyte cross match).
All donors will be carefully screened to prevent any transmissible diseases like HIV, HbsAg, etc.

After surgery:

• Regular follow-up should be done to know about the success of the transplant.
• In some cases, it may take time for the new kidney to produce urine, so patient may have to receive dialysis and take medicines that help the new kidney get rid of excess water and salt from your body.
• There is always a chance of rejection of the new kidney, no matter how good it is. The chance of accepting the new kidney depends on patient's age, race and medical condition.
• Special drugs will be given to help prevent rejection called immunosuppressants that needs to be taken everyday. Sometimes these drugs cannot stop the body from rejecting the new kidney, and then the patient will have to go back to some form of dialysis and possibly wait for another transplant.
• Immunosuppressants like corticosteroids are given to suppress the immune system. Usually, a combi natio n of mycophen olate mole til, prednisone, azathioprine, and cyclosporine are taken. These medications are used to help the body from rejecting the new kidney. These need to be taken for the rest of the life.
• Treatment with these drugs may cause side effects which include
• • Weakening of immune system, which can lead to infections
• • Changes in look, appearance, and face may get fuller
• • Weight gain
• • Development of acne or facial hair
• • Development of acne or facial hair cataracts, diabetes, extra stomach acid, high blood pressure, liver disorders and bone disease