Kidney Transplant

The options of kidney failure are –

• Hemodialysis
• Peritoneal Dialysis
• Kidney Transplant

Of all these, kidney transplant provides a better long-term survival for kidney failure.

There are two main types of Kidney transplant depending on the kidney donor

• Living Donor Kidney Transplant: When a family member volunteers to be a kidney donor
• Deceased Donor Kidney Transplant: When a kidney comes from a Brain dead or Donation after cardiac death donor.

After Kidney transplant one feels healthier and experience

• More energy, Live almost normal life
• No dialysis
• Normal reproductive life
• Normal Physical activities
• Able to work full time

Studies show that patients who have successful kidney transplant live longer than patients treated with dialysis

Kidney Transplant process comprises of following stages

• Assessment / Pre-operative work up
• Multi-disciplinary team Evaluation
• Optimization of Health, Frequent monitoring of health.

The Team comprises specialists and nurses and support staff from various fields who participate in the patient management for transplant. They Include

• Transplant Surgeon
• Transplant Nephrologist
• Transplant Anesthesiologist
• Intensivists
• Cardiology & Pulmonary team
• Transplant Infectious Disease consultant
• Nutritionist
• Physiotherapy
• Psychology Counsellor/ Psychiatrist
• Transplant Coordinator
• Transplant Social Worker

The Kidney Transplant takes about 3-5 hours. During surgery the new kidney is placed in the lower belly and connected to the main blood vessels of the body. The kidney is also connected to the urinary bladder to allow for free passage of urine.

The original kidneys are not removed if they are not causing any problems.

Your new kidney needs to match your tissue and blood type to increase the chances that your body will accept it.

The new kidney usually starts working right away. If the kidney is from a living donor, it should start to work very quickly. A kidney from a deceased donor may take longer to start working.

Regardless of the type of kidney transplant-living donor or deceased donor-special blood tests are needed before the kidney transplant.

• Blood group: The recipient and donor should have either the same blood type or compatible ones –
  If the recipient blood type is A Donor blood type must be A or O
  If the recipient blood type is B Donor blood type must be B or O
  If the recipient blood type is O Donor blood type must be O
  If the recipient blood type is AB Donor blood type can be A, B, AB, or O
• Tissue Typing: Tissue typing is a blood test for human leukocyte antigens (HLA). Antigens are markers found on many cells of the body that distinguish each individual as unique. These markers are inherited from the parents. Both recipients and any potential donors have tissue typing performed during the evaluation process.
• Crossmatch: We all have special proteins called antibodies in our blood. The crossmatch is done by mixing the recipient’s blood with cells from the donor. If the crossmatch is negative, it means the recipient does not have antibodies to the donor and that they are eligible to receive this kidney.

If there are antibodies to the donor kidney, the body may destroy the kidney. For this reason, when a donor kidney is available, crossmatch is done to ensure the recipient does not have pre-formed antibodies to the donor.

After your transplant, you’ll spend about a day in the intensive care unit and 4 to 5 more days in the hospital. Most patients can return to a regular lifestyle within a month after Kidney Transplant.

The biggest worry after kidney transplant is rejection. This occurs when the immune system attacks the new kidney as a foreign “invader,” damaging or destroying it. Rejection can happen in the first few weeks or months of surgery. Immunosuppressant medicines usually prevent or treat rejection.

About 80 out of 100 kidney transplants from deceased donors will still be working five years after transplantation. For kidneys from live donors, about 90 out of 100 kidney transplants will still be working five years after transplantation.

You will have regular blood tests to check your kidney function and levels of anti rejection medication.

An ABO (blood group) incompatible transplant takes place between a living donor and a recipient with a different blood group.

Getting a transplant before you need to start dialysis is called a preemptive transplant. It allows you to avoid dialysis altogether. Getting a transplant after a short time after kidneys fail (but with some time on dialysis) is referred to as an early transplant. Both have benefits. Some research shows that a pre-emptive or early transplant, with little or no time spent on dialysis, can lead to better long-term health.