Kidney transplantation

Kidney Transplantation


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

  • Living relative –close relative of patient, such as, 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
  • Tumours
  • Uncontrolled hypertension
  • Obstructions  due to calculi

 

Facts and figures

  • National Kidney Foundation has estimated that approximately 350,000 people in 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 US
  • First human-to-human kidney transplant was performed in 1911, by Dr L.J. Hammond, Philadelphia

 

Advantages

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

 

Disadvantages

  • After kidney transplantation, patient has to take immunosuppressive medicines lifleong
  • Long waiting period
  • Patient becomes susceptible infection due to immunosuppressive medicines

 

Risk and complications

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

 

Preoperative Preparation

  • Full body physical examination
  • Blood, urinalysis
  • USG, X-Rays, ECG etc
  • After eligibility, patients have to wait for donor kidney
  • Relatives and patients are informed about procedure, including the risks as well as  follow up care
  • Surgeon should be consulted week before to know medicine requirement and medicines stopped
  • Have 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, night before surgery is scheduled
  • Medical tourists are advised to prepare for a long trip

 

Post operative care

  • Patient is kept in the ICU post surgery for 3-4 days. Vital signs are monitored and after patient stabilizes, he/she is shifted to a room, and monitored. Up to 3 weeks hospital stay is possible
  • Liquid diet is prescribes post surgery. Patient can eat low salt solids gradually
  • 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 first 3 months after surgery to avoid infections.

 

Dos, Don’ts and Precautions:

  • Do follow doctor prescribed diet. 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 diet gradually
  • 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 hosiptal.
  •  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. A successful transplantation can help the patient to live a healthy and long life.