What is kidney transplant?
Kidney transplantation is the process wherein a kidney is surgically removed from a donor and placed in a recipient. Transplantation is required because the recipient’s organ has failed or damaged by disease or injury.
What are the organs that can be transplanted?
Organs and Tissues that can be transplanted are:
Which are the most commonly transplanted organs and tissues?
Worldwide Kidney is the most commonly transplanted organ followed by liver and heart.
How is the kidney transplant done?
Kidney transplantation is done from two different sources: a living donor or a deceased donor.
The Living Donor
Family members, including brothers, sisters, parents, children (18 years or older), uncles, aunts, cousins, or a spouse or close friend may pledge/register to donate a kidney. The person is called a "living donor." The donor must be in good health & well informed about transplantation.
A deceased donor kidney is donated by a person who has suffered brain death.
Transplant Evaluation Process
Regardless of the type of kidney transplant living or deceased some blood tests are needed to find out what type of blood and tissues are present which help to match a donor kidney to the recipient.
Blood Type Testing
There are four blood types: A, B, AB, and O. Everyone fits into one of these groups. The donor & the recipient must have either the same blood type or should be compatible, unless they are participating in a program that allows donation across blood types. The list below shows compatible types:
The second test, is a blood test for human leukocyte antigens (HLA) called as tissue typing. Antigens are markers found on the cells of the body and are unique for each individual. These markers are inherited from the parents. Both recipients and donors undergo the the evaluation process.
The body produces antibodies that act to destroy foreign materials. Individuals may generate antibodies each time there is an infection, during pregnancy, blood transfusion, or a kidney transplant. If there is production of antibodies to the donor kidney, the body may destroy the kidney. For the same reason, a crossmatch test is done to ensure the recipient does not have pre-formed antibodies against the donor.
The positive crossmatch denotes presence of antibodies against the donor & the recipient should not receive this particular kidney unless a special antibody reducing treatment is done before transplantation. If the crossmatch is negative, it means the recipient does not have antibodies against the donor and are eligible to receive this kidney.
Crossmatches are performed several times in preparing for a living donor transplant, and a final crossmatch is performed 48 hours before the transplant.
Several tests of donors are done for viruses, such as HIV (human immunodeficiency virus), hepatitis, and CMV (cytomegalovirus) to opt for the proper preventive medications after transplant to help prevent spreading disease to the recipient.
The transplant surgery is usually takes 2-4 hours performed under anesthesia. This type of operation is a heterotopic transplant which means the kidney is placed in a different location than the existing kidneys in the body. The original kidneys are not usually removed unless they are causing severe problems in the body. Recovery in the hospital is usually takes 3-7 days.
Complications can occur with any surgery, mentioned below is the list of complications that do not occur often but may occur:
These complications may require operation to correct them.
How long can a transplanted organ last?
Transplanted organs don't last forever.
However transplanting a healthy organ to replace a diseased or failed organ can prolong life but transplants have limits too. According to the Scientific Registry of Transplant recipients, a transplanted pancreas works for more than five years in only 57 percent of patients, which means nearly half of patients will require a second transplant. A transplanted liver will function for five years or more in 70% of recipients, it may also function longer if the organ came from a living donor. The five-year survival rate for the transplanted heart is about 76%. However, a transplanted lung can work for 5 years or more in about 52% of patients only.
Do’s for the kidney transplant patient:-
Don’ts for the kidney transplant patient:-