Kidney Transplantation

Kidney Transplantation

Kidney transplantation is performed to replace diseased or malfunctioning kidney with a healthy kidney of a dead or living donor. The replaced kidney functions normally just as the original. The kidney donor maybe

  • Living relative –a close relative of a patient, such as a sibling, parent or child
  • Living un-related- spouse or friend
  • Deceased donor- recently dead person did not have known chronic kidney disease

Why is it needed?

Kidney transplantation is advised in the case of last/ end-stage renal disease or kidney failure due to :

  • Chronic glomerulonephritis
  • Tuberculosis, chronic pyelonephritis or other long term infection
  • Diabetic nephropathy
  • Congenital defects like polycystic kidneys
  • Tumors
  • Uncontrolled hypertension
  • Obstructions  due to calculi

Facts and figures

  • National Kidney Foundation has estimated that approximately 350,000 people in the US suffer from End-stage renal disease
  •  67,000 people die from kidney failure annually
  • On average, approx 16,000 kidneys are transplanted annually in the US
  • First human-to-human kidney transplant was performed in 1911, by Dr. L.J. Hammond, Philadelphia

Advantages and Disadvantages

Advantages

  • Kidney transplant extends patient life
  • Dialysis not required after kidney transplantation, thus saving patient’s energy, time and money
  • Improves the quality of life of the patient as he can eat normal food

Disadvantages

  • After kidney transplantation, the patient has to take immunosuppressive medicines lifelong
  • Long waiting period
  • The patient becomes susceptible infection due to immunosuppressive medicines

Risk and complications

  • Reaction to medication or anesthesia
  • Breathing problems
  • Bleeding
  • Kidney rejection
  • Infection
  • Bladder leakage
  • Internal organ damage
  • Death

Pre-operative and Post-operative Care

Preoperative Preparation

  • Full-body physical examination
  • Blood, urinalysis
  • USG, X-Rays, ECG, etc
  • After eligibility, patients have to wait for a donor’s kidney
  • Relatives and patients are informed about the procedure, including the risks as well as  follow up care
  • The surgeon should be consulted week before to know medicine requirement and medicines stopped
  • Have an arrangement for help after surgery with family and friends
  • Arrangement of blood transfusion, during or post-surgery
  • Preparation of  home for recovery after surgery as advised
  • Do not drink or eat anything post-midnight, the night before surgery is scheduled
  • Medical tourists are advised to prepare for a long trip

Post Operative care

  • The patient is kept in the ICU post-surgery for 3-4 days. Vital signs are monitored and after the patient stabilizes, he/she is shifted to a room and monitored. Up to 3 weeks of hospital stay is possible
  • A liquid diet is prescribed post-surgery. The patient can eat low salt solids gradually
  • The patient can slowly walk then resume daily life gradually
  • Patients are taught how to change dressing etc. Any symptom/s of infection or rejection before hospital discharge is monitored. Patients have to take extreme care for the first 3 months after surgery to avoid infections.

Dos, Don’ts, and Precautions:

  • Do follow the doctor-prescribed diet. The patient has to eat food which has less salt
  • Follow –up regularly while monitoring signs of infection and rejection
  • Liquid diet is prescribed post-surgery. Low salt solids are to be included in the diet gradually
  • The patient should walk slowly first, then start to resume normal day to day activities
  • Patients are instructed about their dressing care, how to monitor symptoms of infection or rejection etc before being discharged from hospital.
  •  Patients have to be extremely careful after surgery to avoid infections

Kidney Transplantation patients have to consume immunosuppressive medicines lifelong. Complete recovery can take about 6 months. Post-transplant, constant medical care and doctor guidance can prevent complications. Successful transplantation can help the patient to live a healthy and long life.