Kidney Transplant: All You Need To Know

Introduction

A kidney transplant is a procedure whereby a healthy kidney from one person is surgically transferred into the body of a person whose kidneys are not functioning properly. It is typically used as a treatment for end-stage chronic kidney disease or kidney failure when the treatment techniques such as dialysis are no longer effective. The transplanted kidney will take over the role of filtering waste products from the blood, converting them to urine, thus preventing life-threatening levels of toxins from accumulating in the body. 

Kidney transplantation is a viable treatment option for patients with damaged kidneys or kidney failure.

• They must meet certain criteria, including a diagnosis of ESRD and the absence of any condition that is likely to prevent a successful transplant. 

• Candidates for kidney transplants should be able to withstand the effects of surgery.

• Candidates must also demonstrate an ability to comply with the medical and lifestyle requirements necessary for a successful transplant. These include maintaining a healthy weight, taking anti-rejection medications as prescribed, and avoiding exposure to toxins. 

• Candidates must also demonstrate a commitment to ongoing follow-up and follow-through with their medical team. 

Kidney Donations

Unlike many other organ donation types, donating a kidney while alive is possible because we only need one kidney to survive. This is termed a living donation. People willing to be kidney donors must undergo careful testing to ensure they are suitable donors and fit for the operation required to remove a kidney. Ideally, living donations are mostly close relatives as they are more likely to share the same tissue type and blood group as the recipient, which declines the risk of the body rejecting the kidney.

Kidney donations are also possible from people who have recently died, known as deceased kidney donation. However, this kind of kidney donation has a slightly lower chance of long-term success.

A potential donor must also meet specific criteria, including being a compatible match for the recipient and being in good health. The final decision for kidney transplantation should be made in consultation with a qualified medical team.

The Transplant Team

The transplant team includes the following members -

• The patient

• The family members of the patient- including spouse, parents, children, or any other family member the patient would like to involve.

• Transplant surgeon- the doctor who places the kidney in the patient's body.

• Nephrologist is a doctor who specializes in kidney health.

• The transplant coordinator is a specially trained nurse who will serve as the patient's point of contact, arrange the appointments, and educate the patient before and after the transplant regarding transplant-related queries.

• The pharmacist tells about all the medicines, fills the prescriptions, and helps avoid unsafe medicine combinations and side effects.

• A social worker is trained to help solve problems in the patient's daily life and coordinate care needs after the transplant.

• Dietitian is an expert in food and nutrition who teaches about the foods the patient should take and avoid and ways to plan healthy meals.

The transplant team helps provide the support and encouragement the patient needs throughout the transplant process.

Process for Getting a Kidney Transplant

The patient anticipating a kidney transplant should undergo the following steps-

• Get assessed as a suitable candidate for a kidney transplant by the physician.

• Get a referral to a transplant center for the relevant tests.

• In case of not having a living donor, enroll on a waiting list to receive a kidney. 

• Undergo monthly blood tests while waiting for a kidney.

• Reach the hospital to have a transplant as soon as a kidney is available; however, the transplant can be scheduled in advance in case of having a living donor.

Recovery After The Transplant

Many patients feel much better right after having transplant surgery. However, for some, it takes a few days for the new kidney to start working. The transplant recipient may have to stay in the hospital for several days to recover from surgery. Further, they'll receive regular follow-up schedules with the nephrologist after leaving the hospital.

The patient will be relieved of one or more anti-rejection medicines, such as immunosuppressants. These medicines may be associated with some side effects. Without these medicines, the immune system may treat the donor kidney as foreign or not owned and attack the new kidney.

There may also be some other medicines in the prescription, like antibiotics, to protect against infections. 

Clinical Complications and Associated Problems of Kidney Transplant

If the new kidney doesn't start working immediately, the patient may need dialysis treatments to filter wastes and extra salt and fluid from the body until it starts working. 

Some problems following kidney transplant are similar to other pelvic surgeries like-

•  Bleeding

•  Infection, particularly a bladder infection

•  Hernia

•  Pain or numbness along the inner thigh that usually resolves without treatment

•  Transplant rejection (usually not observed right after surgery and can take days or weeks) 

Transplant rejection- Transplant rejection often begins without the onset of symptoms. The patient may develop high blood pressure or notice swelling because the kidney isn't removing extra salt and fluid. The routine blood tests will reveal early signs of rejection.

The healthcare provider treats early signs of rejection by adjusting the medicines to help keep the body from rejecting the new kidney.

Lifestyle Management After a Kidney Transplant

A healthy lifestyle after a kidney transplant helps to minimize the risk of complications. It is important to-

•  Quit smoking 

•  Eat a healthy diet

•  Maintain healthy weight

•  Follow preventive measures to avert the risk of developing infections

•  Stay involved in healthy activities, including relaxing and spending time with family and friends.

Bottom Line

A kidney transplant is a relatively safe procedure and has undergone much advancement that increases its success rate and decreases the risk of complications. Following the healthcare provider's instructions before and after receiving the transplant is always recommended to derive the maximum benefit.