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Understanding kidney transplantation

Dr. Sishir Gang, MD, DM, DNB Chairman, Department of Nephrology, Muljibhai Patel Urological Hospital, Nadiad, Gujarat

BRAND CONNECT
Published: Dec 29, 2022 06:52:52 PM IST
Updated: Dec 30, 2022 12:07:08 AM IST

Understanding kidney transplantationA kidney transplant is a surgery that involves taking a healthy kidney from a donor and placing it into a person whose kidneys are no longer working properly. A kidney transplant is a treatment for kidney failure; it’s not a cure. The patient will need to take medicines every day to make sure the immune system doesn't reject the new kidney. The patient is advised to consult the health care professional regularly. A working transplanted kidney does a better job of filtering wastes and keeping the healthy than dialysis. However, a kidney transplant isn’t for everyone. The doctor may tell the person that he/she is not healthy enough for transplant surgery.  

Who Might Need a Kidney Transplant?
A kidney transplant may be an option if the kidneys have stopped working entirely. This condition is called end-stage renal disease (ESRD) or end-stage kidney disease (ESKD). If anyone reach this point, the doctor is likely to recommend dialysis. The patient need to be healthy enough to have major surgery and tolerate a strict, lifelong medication regimen after surgery to be a good candidate for a transplant.

If the patient have a serious underlying medical condition, a kidney transplant might be dangerous or unlikely to be successful. These serious conditions include:
•    Cancer, or a recent history of cancer
•    Serious infection, such as tuberculosis, bone infections, or hepatitis
•    Severe cardiovascular disease
•    Liver disease

Who Donates the Kidney?
Kidney donors may be either living or deceased.

Living Donors
Because the body can function perfectly well with just one healthy kidney, a family member with two healthy kidneys may choose to donate one of them to patient. Receiving a kidney from a family member is a good option. It reduces the risk that body will reject the kidney, and it enables you to bypass the multiyear waiting list for a deceased donor.

Deceased Donors
Deceased donors are also called cadaver donors. These are people who have died, usually as the result of an accident rather than a disease. Either the donor or their family has chosen to donate their organs and tissues. Patient’s body more likely to reject a kidney from an unrelated donor.

How is Kidney Transplant Performed?
Doctor schedule the transplant in advance if the person receiving a kidney from a living donor. However, if the patient is waiting for a deceased donor who’s a close match for person’s tissue type, you’ll have to be available to rush to the hospital at a moment’s notice when a donor is identified. A kidney transplant is done under general anesthesia. This involves giving the patient a medication that puts to sleep during the surgery.
Once the patient is asleep, the doctor makes an incision in the abdomen and places the donor kidney inside. They then connect the arteries and veins from the kidney to the arteries and veins. This will cause blood to start flowing through the new kidney. The doctor will also attach the new kidney’s ureter to the bladder so that patient able to urinate normally.

Aftercare
•    Hospital staff will monitor the vital signs until they are sure the patient is awake and stable. Then, they’ll transfer the patient to a hospital room.
•    The new kidney may start to clear waste from the body immediately, or it may take up to a few weeks before it starts functioning. Kidneys donated by family members usually start working more quickly than those from unrelated or deceased donors.
•    Patient can expect a good deal of pain and soreness near the incision site. Doctors also put patient on a strict schedule of immunosuppressant drugs to stop rejection.
•    The patients are advised to keep regular appointments with the transplant team after discharge so that they can evaluate how well new kidney is functioning.
•    Take immunosuppressant drugs as directed. The doctor will also prescribe additional drugs to reduce the risk of infection.
•    Finally, it is advised to monitor yourself for warning signs that the body has rejected the kidney. These include pain, swelling, and flu-like symptoms.

Medical Care in Emergency
When patient is taking anti-rejection medicines, there is a greater risk for infection. Anti-rejection medicines can dull symptoms of problems such as infection. Call the transplant center right away if feeling unwell or have
•    A fever of more than 100 degrees
•    Drainage from your surgical scar
•    Burning when you pass urine
•    A cold or cough that won’t go away

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