Urology

Kidney Transplant Treatment

Renal Transplantation

A kidney transplant is an operation to transfer a kidney from one person (donor) to another (recipient). If it is suitable, a kidney transplant is the best treatment for people who have kidney failure.

What is Kidney Transplant?

A kidney transplant is a surgical procedure to replace a non-functional or damaged kidney with a healthy one. It is one of the most common organ transplant surgeries performed today.

The kidneys are two bean-shaped organs, each located on either side of the spine below the rib cage. Each one is about the size of a closed fist. The main role of the kidneys is to filter waste products and purify the blood. If the kidneys are not able to perform this function, waste products can build up in the body, which could be life-threatening.

What Happens When Kidneys Fail?Page Image

Harmful waste builds up in the body, which may lead to:

  • High Blood Pressure
  • Edema (Fluid build-up)
  • Salts and Acids get out of balance
  • Decreased RBCs
  • Weak Bones

All of these can be harmful and/or deadly to the body.

Common causes of end-stage renal disease include:

  • Diabetes
  • Chronic, uncontrolled high blood pressure
  • Polycystic kidney disease

People with kidney disease need to have waste removed from their blood via a machine (dialysis) or a kidney transplant to stay alive and have a functional body.

Who can have a kidney transplant?

Most people who need a kidney transplant can have one, as long as:

  • they're well enough to bear the effects and side effects of surgery
  • the transplant has a good rate of success
  • the person is willing to comply and afford the recommended treatments required after the transplant

Kidney Transplant

About 30% of people with kidney failure can have a kidney transplant. This surgery replaces 2 failed kidneys with 1 healthy one. About two-thirds of kidney transplants come from non-living (deceased) donors. But family members (spouse and friends (living, unrelated donors)) can donate safely if tests show that the donor will have nearly normal kidney function after giving up 1 kidney.

A kidney transplant is usually placed in the lower belly without removing the failed or damaged kidneys. The artery and vein of the new kidney are joined to an artery and a vein in the pelvis just next to recipient’s bladder. The tube that drains urine from the kidney to the bladder (ureter) attached to the new kidney is joined to recipient’s bladder or to one of the recipient’s ureters. In a non-adult recipient, the blood vessels from a large adult kidney transplant are usually joined to the recipient’s aorta (the largest artery in the body) and inferior vena cava (the largest vein in the belly).

Types

  1. Deceased-donor kidney transplant
  2. Living-donor kidney transplant

Deceased-donor kidney transplant

When a kidney from someone who has recently passed away is removed with the consent of the family or from a donor card and placed in a recipient whose kidneys have failed and/or no longer function properly and is in need of kidney transplantation then the transplant is a deceased-donor kidney transplant.

Living-donor kidney transplant

A living-donor kidney transplant is the removal of a kidney from a living donor and placement into a recipient whose kidneys are damaged and/or no longer function properly. One healthy/functioning kidney is needed to replace two failed kidneys, which makes living-donor kidney transplant an alternative to the deceased-donor kidney transplant.

How long do kidney transplants last?

There are a number of factors on which life of a transplanted kidney depends. These include whether the kidney came from a living donor or not, how well the kidney is matched in terms of blood group and tissue type, and the age and overall health of the person receiving the donation (an also the health of donor if the transplant is Living-donor kidney transplant).

If you have a kidney transplant that fails, you can usually be put on the waiting list for another transplant and you may need dialysis in the meantime.

What are the Risks involved?

Kidney transplantation can treat advanced kidney disease and kidney failure, but it is not a cure or permanent treatment. Some forms of kidney disease may return after transplant, also there might be an infection in the kidneys.

The health risks associated with kidney transplant include those associated directly with the surgery, rejection of the donor organ and side effects of taking medications needed to prevent your body from rejecting the donated kidney.

Deciding whether a kidney transplant is right for the recipient is a personal decision that deserves careful thought and consideration of the serious risks and benefits associated with it. Talk through your decision and review with your friends, family, and other trusted advisors.

Complications of the procedure

Kidney transplant surgery includes a risk of significant complications, which includes:

  • Blood clotting
  • Bleeding
  • Leaking from or blockage of the ureter (that links the kidney to the bladder)
  • Infection
  • Failure of the donated kidney
  • Rejection of the donated kidney
  • An infection or cancer that can be transmitted with the donated kidney from a donor to recipient
  • Death, heart attack and stroke

During the procedure

  • Kidney transplants are performed with general anesthesia, so the recipient is not aware of the happenings during the procedure. The surgical team monitors the recipient’s heart rate, blood pressure and blood oxygen level throughout the procedure.

During the surgery:

  • The surgeon makes an incision (a small opening) and places the new kidney from the donor in the recipient’s lower abdomen. Unless the recipient’s own kidneys are causing complications such as high blood pressure, stones in kidney, pain or infection, they are left in place.
  • The blood vessels of the new kidney are attached to blood vessels in the lower part of the recipient’s abdomen, just above one of the recipient’s legs.
  • The new kidney's ureter — the tube that links the bladder to the kidney— is connected to the recipient’s bladder. After the procedure

After your kidney transplant, the recipient can expect to:

  • Spend several days (could be weeks or a month) in the hospital.
  • Have frequent checkups as you continue recovering.
  • Medications will be continued for the rest of your life.

Kidney Transplant in India

  • The cost of Kidney Transplant Surgery in India Subcontinent ranges between 10,000 $ to 14000 $.
  • The recipient has to stay approximately 10 days in the hospital and 30 days outside the hospital. 
  • Kidney donor and recipient should be relatives, as it is illegal in India to get a local donor.
  • Medical tests to be done are blood tests, X-Ray, ECHO, ECG, Cardiac Stress Test, Compatibility Tests, Colonoscopy, Prostate Exam, and Cancer Screening.

Results

90% of the transplanted kidneys work well at the end of 1 year. About 4% of kidney transplants stop working each year after that. The new kidney is always at risk for rejection, so it is necessary to take all of your drugs as you are told by your doctor. A kidney from a living donor has a better chance of lasting than one from a non-living donor. The chance that kidney disease will come back in the transplant depends on the original cause of kidney failure and the donor.

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