What is a Kidney Transplant?

A kidney transplant is a surgical procedure done to transfer a healthy kidney from a living or deceased donor into a person that has little to no kidney function.

Kidney Transplant: Process, Rejection Symptoms, And Recovery

What Is A Kidney Transplant?

A kidney transplant is a surgical procedure done to transfer a healthy kidney from a living or deceased donor into a patient that has little to no kidney function.

The kidneys are two organs found on each side of the spine, shaped like beans and just below the rib cage. The main role of the kidneys is to filter waste products, minerals, and fluid from the blood and convert them to urine. If the kidneys start to lose their proper function, waste products can build up, which can raise your blood pressure and result in kidney failure (end-stage kidney/renal disease).

When the kidneys lose approximately 90% of their normal function, end-stage renal disease occurs. 

Why Is Kidney Transplant Done?

The loss of kidney function, known as end-stage chronic kidney disease or kidney failure, is the most common reason for needing a kidney transplant.

With the help of a blood-filtering procedure knows as dialysis, it is possible to partially replicate the functions of the kidney. However, as dialysis can be time-consuming, a kidney transplant is usually the most convenient and long-term treatment for kidney failure.

Common causes of end-stage kidney renal disease include:

  • Diabetes
  • Chronic and rampant high blood pressure
  • Chronic glomerulonephritis — an inflammation and eventual scarring of the tiny filters within your kidneys (glomeruli)
  • Polycystic kidney disease

Who Are Good Candidates For Kidney Transplants?

Not all patients are recommended to have transplants as sometimes the procedure may be riskier than dialysis.

Conditions that may prevent you from being eligible for a kidney transplant include:

  • Older age
  • Serious cardiovascular (heart) disease
  • Active or recently treated cancer
  • Neurodegenerative diseases such as dementia  
  • Alcohol or drug abuse
  • Severe infection, such as tuberculosis, bone infections, or hepatitis
  • Liver disease

To determine whether you are a good candidate for a kidney transplant, you will be evaluated at a transplant center.

This evaluation usually involves several visits to assess your physical, psychological, and familial conditions. Your doctors will give you a complete physical exam to ensure your health for the surgery, including doing tests on your blood and urine.

If you are approved for a transplant, you and your team will then determine which type of procedure is a good match for your condition.

Types Of Kidney Donations

There are two major types of kidney transplants, Deceased-Donor Kidney Transplant, and Living-Donor Kidney Transplant.

 

Deceased-donor kidney transplant:

This is when deceased donors, also called cadaver donors, who have usually died from accidents rather than a disease, choose to donate their organs for transplant.

The decision to donate can either be done by the donor themself priorly or by the victim’s family after.

 

Keep in mind that your body is more likely to reject a kidney from an unrelated donor. However, a deceased donor organ is a good alternative if you don’t have a family member or a relative who’s willing or able to donate a kidney.

 For this type of donation, you will have to be registered in a waiting list to receive organs for transplant.

The amount of time needed for a deceased donor organ to match with you depends on:

  • The transplant waitlist
  • Degree of compatibility between you and the donor,
  • Your time on dialysis
  • Expected survival after transplant

Some people can get a donor match within a few months, and for others, it may take several years.

 

Living-Donor Kidney Transplant:

Because the body can function properly with just one healthy kidney, a family member or a relative with two healthy kidneys can choose to donate one of them to you.

Receiving a kidney from a family member is always preferable and advantageous since it reduces the risk that your body will reject the kidney, and it enables you to bypass the waiting list for a deceased donor.

 

How You Prepare For A Kidney Transplant

During your evaluation for a transplant, you may undergo:

  • A complete physical exam
  • X-ray, MRI or CT scans
  • Blood tests – to determine your blood type and your Human Leukocyte Antigen (HLA)
  • Psychological evaluation

 For preparations, you need to complete a set of steps to determine whether a donated kidney will be suitable for you. These tests include:

Blood typing: It is always preferable to get a kidney from a donor whose blood type matches or is most compatible with your own.

Tissue typing: If you find a donor whose blood type is matching or compatible with you, the next step is a test to do a tissue typing test, known as Human Leukocyte Antigen (HLA) typing.

HLA is a group of antigens located on the surface of your white blood cells. Antigens are responsible for your body’s immune response.

If your HLA type is compatible with the donor’s HLA type, there are fewer chances that your body will reject the kidney. The more antigens you have that match those of the donor, the greater the chance of a successful transplant.

Crossmatch: After you have found a donor, whether it be a living or a deceased one, you need to undergo what’s called a Crossmatch.

For this final matching test, a small sample of your blood will be mixed with the donor’s blood in the lab. This test determines whether antibodies in your blood will react against specific antigens in the donor’s blood and attack the donor organ.

 If your blood shows no antibody reaction, you have what’s called a “negative crossmatch.” This means that the transplant can take place and you and your donor are a good match.

What Happens During A Kidney Transplant?

Kidney transplants are performed under general anesthesia, meaning you will be asleep during the procedure. The anesthetic will be injected into your body through an intravenous (IV) line in your hand or arm. The anesthesiologist will monitor your vital signs including your heart rate, blood pressure, and blood oxygen levels throughout the procedure.

Generally, a kidney transplant can take anywhere between 3-5 hours, and follows these steps:

  1. The skin over the surgical site will be cleansed with an antiseptic solution.
  2. Your surgeon will make a long incision(cut) into your lower abdomen on one side.
  3. The donor kidney will be placed into your abdomen and connect the organ’s renal artery and vein to your external iliac artery and vein.
  4. After the artery and vein are attached, your doctor will check the blood flow through these vessels to see if there is any bleeding. 
  5. The donor ureter (the tube that drains urine from the kidney) will be connected to your bladder.
  6. Your doctor will leave your original kidneys in your body unless they’re causing problems, such as high blood pressure or infection.
  7. Then, your doctor will close the incision with stitches or surgical staples depending on their technique.
  8. Your transplant team may place a drain in the incision site to reduce swelling.
  9. Lastly, they will apply a sterile dressing or bandage to your incision site.  

What Happens After Your Kidney Transplant?

A hospital recovery can usually take up to a week so you will have to stay in the hospital for that time.

After the surgery, you will wake up in a recovery room. The hospital staff will monitor your vital signs regularly. When they ensure your stability, you will be taken into a hospital room.

You will be regularly monitored for urine output. Living-donor kidneys may start to make urine relatively sooner. Urine production in a deceased donor kidney may take longer.

You may need to proceed with dialysis until urine output is normal.

Your doctor will put you on immunosuppressive (anti-rejection) medications to stop your body from rejecting the new kidney. You’ll need to take these drugs regularly every day to lower the chances of your body rejecting the donor’s kidney.

When your doctor determines that you are ready to be discharged from the hospital, your transplant team will give you specific instructions to know how and when to take your medications. It is crucial you stick to the schedule to prevent any chances of rejection.

After you are discharged you will need to have regular check-ups with your doctor to evaluate how well your new kidney is functioning. They may also give you additional medications for potential infections.

You will need to monitor yourself and immediately tell your physicians if you start to develop rejecting symptoms, which are covered in our Risks And Side Effects section.

Rejection Symptoms may include:

  • Body ache
  • Chills
  • Headaches
  • Fever
  • Urinating less than usual
  • High blood pressure
  • Sudden weight gain
  • Pain or tenderness over the area where your transplant was done
  • Feeling very tired
  • Swelling
  • Bleeding

Recovery At Home

  • Keep the surgical area clean and dry
  • Don’t drive until you are cleared to do so by your physician
  • Avoid any activity or position that causes pressure to be placed on the new kidney
  • Check your weight and blood pressure every day, as a sudden increase can mean you are going into rejection
  • Avoid places in which you may be exposed to anyone who may be sick for the first few months after your surgery.

Kidney Transplant Risks And Side Effects

According to Mayoclinic Kidney transplantation can treat advanced kidney disease and kidney failure, but it is not a cure. Some forms of kidney disease may return after transplant.”

You may experience:

  • Complications from the procedure itself
  • Anti-rejection medication side effects
  • Rejection of the donor organ

Complications From The Procedure

Kidney transplant surgery can have risks of threatening complications during the procedure, such as:

  • Blood clots and bleeding
  • blockage of the ureter
  • urine leakage
  • Narrowing of an artery
  • Infection
  • Cancer or another disease that can be transmitted with the donated kidney
  • Rejection or failure of the donor kidney
  • Death, heart attack and stroke

Anti-Rejection Medication Side Effects

To prevent any risks of rejection of the new kidney, you will have to take immunosuppressive medication. A combination of 2 or 3 different medications is usually prescribed.

These medications can cause a range of side effects, including:

  • Diabetes
  • The extra hair growth or hair loss
  • High blood pressure
  • High cholesterol
  • Abdominal pain
  • Diarrhea
  • Swollen gums
  • Mood swings
  • Bone thinning (osteoporosis) and bone damage (osteonecrosis)
  • Increased risk of cancer, particularly skin cancer and lymphoma
  • Infection
  • Puffiness (edema)
  • Weight gain
  • Acne

With these medications, the goal is to find the right dose so that it will be high enough to reduce the risks of rejection, yet low enough that you experience as few or no side effects as possible.

Life After A Kidney Transplant

After a successful kidney transplant, your new kidney will start to function properly and filter your blood, therefore, you will no longer need dialysis.

It is vital to take all your medicines as prescribed by your doctor since skipping your medications even for a short period, can cause your body to reject

It is estimated that 90 percent of transplant recipients who get their kidney from a living donor live for at least five years after surgery. About 82 percent of those who received a kidney from a deceased donor, live for five years afterward.

Diet And Exercise

After a successful transplant, your doctor may recommend you to make adjustments to your diet, to keep your new kidney healthy and functioning perfectly.

Some of your medications might induce hunger and increase your appetite and therefore make you more susceptible to gain weight. It’s important to reach a balanced and healthy eating habit with the help of a dietitian.

They may recommend:

  • Eating at least five servings of fruits and vegetables each day
  • Having enough fiber in your daily diet
  • Drinking low-fat milk or eating other low-fat dairy products, which is important to maintain optimal calcium and phosphorous levels
  • Maintaining a low-salt and low-fat diet
  • Following food safety guidelines
  • Staying hydrated by drinking adequate water and other fluids each day

After your recovery, and once you are cleared by your doctor, you may want to start exercising to help boost your energy levels and increase your strength.

Working out can also reduce stress and improve your overall physical and mental health. Physical activities such as walking, riding a bike, low-impact weight training, swimming, and other physical activities you enjoy daily can all be a part of a healthy, active lifestyle after transplant.

Bottom line

Kidney transplants are major surgeries. It is crucial to be communicative with your health care physician to make sure you are thoroughly prepared for the upcoming procedure.

If you are planning to use organs from a deceased donor, it can be emotionally challenging to be waiting on and on in the wait-list. Remember to talk with your doctor during these overwhelming times. Joining certain support groups for recipients can also be helpful to guide you through anything you may be feeling.

At the end of the day, the most important thing is to stay healthy by reducing stress and any other complications, to ensure good transplant outcomes.

You can make any inquiries you may have via our free medical consultation services. Our team of experts is ready to answer and guide you through any uncertainties regarding your conditions or treatments.

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