Kidney Transplant – What to Expect, Procedure and Types

Kidney Transplant – What to Expect, Procedure and Types

Kidney transplant is a surgical procedure in which a healthy kidney from a (live or deceased) donor is placed into the body of an individual whose kidneys does not function properly.

What are Kidneys?

Kidneys are two bean-shaped (each about the size of a fist) organs placed on either side of the spine just underneath the rib cage. Their main function is to filter and remove excess and waste fluid from the blood. When they lose their filtering ability, high levels of fluid and waste accumulate in the body, leading to kidney failure (end-stage renal disease or end-stage kidney disease).

Most common causes of end stage kidney disease include:

• Diabetes
• Chronic, uncontrolled high blood pressure
• Chronic glomerulonephritis, an inflammation and eventual scarring of the tiny filters within the kidneys
• Polycystic kidney disease

What are the Types of Kidney Transplants available?

• Deceased-donor kidney transplant is a surgical procedure to give kidney failure patient a healthy kidney from a person who just died. However, to get kidney from a dead or deceased donor, the patient must be evaluated with the transplant team first.
• Living-donor kidney transplant is a surgical procedure to give you kidney failure patient a healthy kidney from a person who is alive – a person with two healthy kidneys can choose to donate one.
• Pre-emptive kidney transplant is getting transplantation before the beginning of dialysis. It is considered to be an ideal renal replacement therapy in acute kidney injury or advanced chronic kidney disease

Why is kidney transplant done?

A kidney transplant is often done as a choice of treatment for kidney failure rather than being on dialysis for a whole life. Kidney transplants helps to treat chronic kidney diseases or end-stage renal disease. This helps the patient to feel better and live longer.

A kidney transplant is associated with:

• Low risk of death
• Lower cost for treatment
• Better quality of life
• Dietary restrictions

How can one prepare for the kidney transplant surgery?

Choose a transplant center

You’ll be referred to a transplant center if your doctor advises a kidney transplant. You can also choose a transplant center on your own or from a list of preferred providers provided by your insurance carrier.

Evaluation

After you’ve chosen a transplant center, you’ll be evaluated to see if you meet the center’s kidney transplant eligibility requirements.

The evaluation procedure can take many days and comprises the following steps:

• A complete physical examination 
• X-rays, MRIs, and CT scans are examples of imaging studies.
• Blood test
• Psychological assessment

When to see a doctor?

As soon as you feel a few or more of the above symptoms in your body, you must contact a doctor. If you have any of the conditions that are causes of kidney failure, it is advisable to have frequent checkups to avoid the failure.

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What can you expect from kidney transplant?

Before the procedure

Finding a match

A living or deceased kidney donor can be related or unrelated to you. When determining if a donor kidney will be a good match for you, your transplant team will take into account a number of variables.

The following are the tests to be conducted to determine if the donated kidney will be suitable for the patient:

• Blood typing – Getting a kidney from a donor whose blood type matches or is compatible with yours is preferred.
• Tissue typing – The next stage is a tissue typing test called human leukocyte antigen (HLA) typing if your blood type is compatible.
• Crossmatch – A little amount of your blood is mixed with the donor’s blood in the lab for the third and final matching test. The test determines whether antibodies in your blood react to antigens in the blood of the donor.

Staying healthy

Being as healthy and active as possible can increase your chances of being ready for transplant surgery when the time comes. It may also help you heal more quickly after surgery. Work for the following:

• To take medications as prescribed
• Follow proper diet and exercise
• Quit smoking
• Staying involved in healthy activities like relaxing and spending time with families. 

During the procedure

The procedure is performed with general anesthesia so that the patient is not awake during the procedure. During the surgery, an incision is made in the lower part of the abdomen and the new kidney is placed inside the body. The blood vessels found in the new kidney are attached to the blood vessels in the lower abdomen. The ureter is connected to the bladder. 

After the procedure

After the kidney transplant, the surgeon monitors the patients’ health at the recovery area to find any signs of complications. The new kidney has to make urine like the own kidney, only then it is found to be healthy. If it does not start immediately, a temporary dialysis is usually suggested. Most patients return to work and normal routine within 8 weeks after the kidney transplant.

Close monitoring is required after the patient goes home to check the functionality of the new kidney. Several blood tests may be required to adjust the medications based on the transplant surgery. Following your kidney transplant, you’ll need to take a number of medications. Drugs protect your replacement kidney from being attacked and rejected by your immune system. Additional medications help to lower the chance of various issues following your transplant, such as infection.

Diet and nutrition

The patient has to change the diet after a kidney transplant to keep new kidney healthy and functioning properly. Although the patient will have fewer dietary limitations than they were on dialysis prior to the transplant, they may still need to make certain changes to the diet.

Following a kidney transplant, our nutritionist may recommend:

• Each day, consume at least five servings of fruits and vegetables
• Due to its influence on a group of immunosuppressive drugs, grapefruit and grapefruit juice should be avoided (calcineurin inhibitors) 
• Getting adequate fiber in the diet on a regular basis
• It’s crucial to drink low-fat milk or consume other low-fat dairy products to keep your calcium and phosphorus levels in check.
• Including lean meats, poultry, and fish in the diet

Exercise

The patient should walk as much as possible after the transplant. Begin gradually to incorporate additional physical activity into the regular routine, with at least 30 minutes of moderate exercise five days a week. Walking, bicycling, swimming, low-impact strength training, and other physical activities that the patient enjoys can all be included into a healthy, active lifestyle after transplant. However, before beginning or changing the post-transplant exercise routine, consult with the transplant team.

Coping and support

Throughout the transplant procedure, the transplant team can also provide with other helpful tools and coping tactics, such as:

• Getting involved in a transplant support group
• Using social media to share your experiences
• Locating assistance for rehabilitation
• Setting reasonable expectations and goals
• Self-improvement

Frequent check-ups

Doctors monitor your condition at the transplant recovery area in the hospital. This is to watch for signs of any complications. Often your new kidney starts to produce urine immediately like your own kidneys did when they were fully functional.

In some cases, it may take a few days. You may need temporary dialysis. There may be soreness or pain while you heal.

Close monitoring and frequent check-ups are necessary after returning from the hospital. It is done for a few weeks to see how your new kidney is functioning and ensure that your system is not rejecting the new kidney.

You may need to have blood tests. You also have to get medication adjusted. All this is done in the weeks following the transplant.

Medication

Following a successful transplant, you will no longer need dialysis. Your new kidney will filter the blood.

You will need medications to prevent your system from rejecting the donor’s kidney. The body becomes vulnerable to infections due to anti-rejection medications called immunosuppressants. You may also need antibacterial, antiviral, and antifungal medications.

You need to take all your medicines as per the prescription. Your body may reject the donor kidney if you miss or skip your medications even for a short duration.

What are the risks associated with kidney transplant?

Risks

The risks of a kidney transplant include those immediately related to the procedure, rejection of the donor organ, and side effects from taking medications to prevent the body from rejecting the donated kidney.

Complications

Kidney transplant surgery has a high risk of serious complications, such as:

• Bleeding and blood clots
• The tube (ureter) that connects the kidney to the bladder leaks or becomes blocked.
• Infection
• The transplanted kidney fails or is rejected.
• An infection that could be passed on to the recipient of the donated kidney

Advantages of Kidney Transplant

Kidney transplant, compared to dialysis, is associated with:

• Lowering the risk of death
• Lowering the cost of treatment
• Freedom from regular dialysis
• Few restrictions in diet
• Longer life expectancy
• Better quality of life

What can be the possible results of kidney transplant?

Following a successful kidney transplant, the new kidney will start filtering the blood, so the patient will no longer need dialysis.

In order to prevent the rejection of donor kidney by the body, the patient will need medicines to suppress the immune system. The patient may have to take these drugs for the rest of his/her life. A medicine to suppress the immune system make the body more vulnerable to infection, the treating doctor may prescribe antiviral, antibacterial and antifungal medicines as well.

Conclusion

It is critical that you take all of your medications exactly as prescribed by your doctor. If you skip your meds, even for a short time, your body may reject your replacement kidney. If you’re having adverse effects that are preventing you from taking your meds, contact your transplant team right away.

Frequently asked questions

What is the average life expectancy after a kidney transplant? 

A living donor kidney lasts 12 to 20 years on average, while a deceased donor kidney lasts 8 to 12 years. Patients who receive a kidney transplant before starting dialysis live 10 to 15 years longer than those who do not.

How successful is a kidney transplant? 

After a living-donor kidney transplant, the success rate was found to be 97 percent after one year and 86 percent after five years. At one year, the success rate following a deceased-donor kidney transplant was 96 percent, and at five years, it was 79 percent.

Is kidney transplant better than dialysis? 

For many persons with severe chronic renal disease, kidney transplantation is the therapy of choice since the quality of life and survival are often superior to those who get dialysis. There is, however, a scarcity of organs accessible for donation.

What is the disadvantage of kidney transplant?

Kidney transplantation is a serious surgery with dangers both during and after the treatment. Infection, hemorrhage, and injury to the surrounding organs are all hazards associated with the surgery.