Kidney transplantation means implanting a kidney from one person (donor) into the patients (recipient’s) body, through a major surgery. After transplant, no dialysis treatment is required.
Eligibility of the donor
The transplanted kidneys can come from a donor, living or dead (cadaveric donor). Amongst the living donors, the donor can be related to the patient or can be unrelated. In most of the cases the old diseased kidneys are not removed from the body of the recipient. The new kidney is transplanted in an area which is medically known as the iliac fossa, which is at the waist on the right side. The new kidney is attached to the vein and artery in this area and the ureter is attached to the urinary bladder of the recipient.
Criteria of donating:
1. Healthy adults Between the age of 18 to 55 years
2. Does not have kidney related illness
3. Does not have diabetes, high blood pressure, cardiac problems
4. Does not have hereditary kidney problems
One kidney can be donated because life can be sustained on one kidney. The donor can live a normal life even with one kidney.
Receiving a Kidney ?
Waiting list people fulfilling the below criteria can receive a kidney.
1. Should be below 60 years of age,
2. Having no history of cancer
3. Must not have Hepatitis
4. No cardiac disease
5. No active auto-immune disease (SLE)
6. Must not be having bladder problems or have been treated for it
7. Mentally stable
8. Having no infections
After a patient chooses transplantation as an option for treatment of kidney failure, the patient will either have to search a donor on his own or register himself in a waiting list of a transplant institute. Then the patient has to wait till a suitable kidney has been procured for him. This wait is generally quite long and can take years. Till that time the patient has to continue on dialysis.
Procedure done before transplant
1. Blood group matching (ABO matching),
2. Human Lymphocyte Antigen (HLA) typing and matching is done before a donor is decided.
Before the transplant, doctors have to ensure that the kidney will not fail or, in other words, will not be rejected by the recipients body. There are legal formalities to be done before transplantation is done to ensure that the donor is genuine and is donating at his free will and not by force. It is to be ensured that no illegal commercial transaction take place.
The recipient may have to stay in the hospital for at least 15-30 days after operation so that the Nephrology team can monitor progress of the transplant and assist the patient is getting well soon and for ensuring that the transplant is working properly.
The donor has to stay in the hospital after the transplant operation for at least a week. This stay is necessary to ensure that the other kidney is functioning properly and the wound of the transplant is healing fast.
Body Rejection
When something, foreign enters our blood, our immune system is activated. The only objective of this system is to keep foreign or harmful elements out of our body and keep the body healthy. When this system is activated, the foreign body s engulfed and destroyed inside our body itself. When a kidney is transplanted into a recipient’s body, the recipient’s body recognizes it as a foreign material and tries to ill it or destroy it. If this happens, the transplanted kidney will Iso fail and the patient will have to go back on dialysis or be ready for a new transplant.
To not let this happen, two things have to be ensured:
1. The transplanted kidney has to have the best tissue match with the recipient’s body (which is ensured by doctors by doing various tests before transplant occurs)
2. The immune system has to be suppressed so that it does not fail the kidney.
The failing of the kidney after transplantation is called Rejection. After rejection occurs, the patient has to go back on dialysis or get ready for next transplant to extend his life. Chances of rejection can be decreased by the following two steps: Proper tissue matching and cross matching prior to transplantation and appropriate and regular dose of immunosuppressive agents.
A transplant patient, if taking good care, can survive for as long as 15-20 years. The patient can lead a normal active life without any problems. After Transplant, immunosuppressive drugs have to be taken regularly for rest of the life. If a patient becomes careless and irregular in taking these drugs, the chances of rejection increase.