by AK Team
WHAT IS KIDNEY TRANSPLANT?
Kidney transplant is basically a surgical procedure in which the damaged kidneys of the the patient, that is the receiver are replaced by the healthy kidneys of the donor. The newly placed healthy kidney performs all the functions that were supposed to be performed by the two damaged kidneys.
Not all kidney related diseases require a kidney transplant, some of them can be cured by proper treatment and medication.
KIDNEY STRUCTURE AND FUNCTION
- Kidneys are present in pairs at the posterior side of the abdominal cavity, on either side of the spine
- The right kidney is generally slightly smaller and lower than the left one, so that there is space left for the liver
- Each kidney weighs about 125-170 grams (g) in males and 115-155 grams (g) in females.
- A tough fibrous capsule, that is known as the renal capsule, surrounds each kidney.
- A fat layer serves the kidney for protection.
- There are endocrine glands, the adrenal glands that are present on top of both the kidneys.
- On the inner side of each kidney are present a number of pyramid-shaped lobes each of which consists of an outer renal cortex and an inner renal medulla.
- Nephrons are the structural and functional unit of kidney and they flow between these sections and they are the urine producing structures of the kidney.
- The main function of the kidney is to maintain homeostasis, that is to manage fluid levels-electrolyte and water levels- that is all the factors that keep the internal environment of the body consistent and comfortable.
- Excretion of waste products and toxic substances form the body
- Maintain pH
- Osmolality regulation
- Regulating blood pressure
- Secretion of active compounds
WHEN IS A KIDNEY TRANSPLANT IS REQUIRED?
When a person has kidney failure, that is also known as an end-stage renal disease (ESRD), the person either needs a dialysis or a kidney transplant to live.
Kidney transplant is considered one of the best treatment option for people who are facing kidney failure as it can increase ones chances of living a longer and healthier life.
A person may get a kidney transplant when his or her kidneys are close to failure, before that he need to start dialysis, or he can start dialysis while he waits for a kidney transplant.
Below listed are some of the causes of end-stage kidney disease:
- Diabetes – This is the most common cause of kidney failure around almost all parts of the world. High levels of blood sugar over a period of time, gradually damages the filters in the kidneys and this results in chronic disease that is called diabetic nephropathy and this gradually progresses leasing to an end stage kidney failure.
- High blood pressure (hypertension) – When the blood pressure of the tiny blood vessels in the kidney increases, it causes a chronic irreversible damage leading to kidney disease.
- Glomerulonephritis – The inflammation of blood vessels and other parts of the nephrons lead to slow damage and scarring and it can happen in patients with autoimmune diseases like lupus and ANCA vasculitis.
- Renal artery stenosis – Renal artery stenosis refers to the blockages in the arteries that bring food to the kidneys over a period of time.
- Interstitial nephritis – Interstitial nephritis is an allergic reaction of the kidney. Some certain medicines or herbal products can lead to inflammation in the interstitial compartment causing chronic kidney disease.
- Polycystic kidney disease – In this several large cysts or hollow spaces are formed within the kidney that makes its normal functioning a bit difficult . it is an inherited condition.
- Congenital problems – It occurs before birth and manifests when the kidneys loose over maximum , that is 90% of their functional capacity.
TYPES OF KIDNEY TRANSPLANT
The type of kidney transplant depends on the type of the donor and the time of transplantation. Based on the type of donor and the time the transplant is being done, there are basically two types of kidney transplant:
- Deceased donor kidney transplant
- In deceased donor kidney transplant the donor of the new healthy kidney is a person who has just died of brain death
- The new kidney is then transplanted into the person who’s kidneys are damaged.
- The donated kidney is first stored in cold storage or is connected to a machine to keep the oxygen and nutrients supply intact until the kidney transplant procedure is carried out.
- Living donor kidney transplant
- In living donor kidney transplant the healthy kidney is donated by a person who is still alive.
- Only one donated kidney can take over the functioning of the two damaged or failed kidneys.
- In most of the cases, the living donor is a person from the patient’s family itself as genetically related family members are most likely to be compatible living donors for kidney transplant.
KIDNEY TRANSPLANT SURGERY PROCEDURE
- PRE-OPERATIVE PHASE
- In pre-operative phase the matching process is done
- The patient has to undergo certain blood tests to determine his or her blood type (A, B, AB, O) and human leukocyte antigen (HLA).
- HLA is a group of antigens that are located on the surface of the white blood cells and they are responsible for the body’s immune response.
- If the patient’s HLA matches the donor’s HLA type, it like that the body will not consider the new kidney as a foreign body and will accept it.
- Once a potential donor is found, another test is done to make sure that the patient’s antibodies will not attack the donor’s organ.
- If there is no antibody reaction, then the transplant procedure may proceed further.
- OPERATIVE PHASE
- Kidney transplant is done under general anesthesia.
- Once the patient is asleep, the doctor makes an incision in the patient’s abdomen and places the donor kidney and they connect the arteries and veins from that kidney to the patient’s arteries and veins and this will force the blood to start to flow through the new kidney.
- The doctor will also attach the new kidney’s ureter to the patient’s bladder so that he she can urinate normally.
- The patient’s original kidney will be left in his body unless they cause any problem such as high blood pressure or any infection.
- POST-OPERATIVE PHASE
- The patient after the surgery will be taken into the recovery room and until all his conditions are normal they will transfer him in the normal hospital room.
- The patient usually needs to stay in the hospital for up to a week.
- After the discharge the patient has to take immunosuppressant drugs as directed to reduce the risk of any kind of infection.
- The patient will need to regularly follow up with his doctor for atleast after one to two months after the surgery.
RISKS OF KIDNEY TRANSPLANT
The risk that a kidney transplant may carry along itself may include:
- Blood clots
- Allergy to general anesthesia
- Heart attack
- Failure of donated kidney
- Blockage of ureter
RECOVERY AFTER SURGERY
Almost all kidney transplant surgeries are very successful. The recovery after the kidney transplant surgery may take almost up to six months depending upon individuals situation.