Transplant FAQs

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:

• Kidney
• Liver
• Lungs
• Heart
• Pancreas
• Intestine
• Thymus
• Veins
• Nerves
• Tendons
• Bones
• Heart Valves
• Skin
• Cornea

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.

Deceased Donor

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:

•             If the recipient is A blood type Donor must be A or O blood type
•             If the recipient is B blood type Donor must be B or O blood type
•             If the recipient is O blood type Donor must be O blood type
•             If the recipient is AB Donor can be A, B, AB, or O blood type

Tissue Typing

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.

Crossmatch

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.

Serology

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.

Transplant Surgery

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:

•             Bleeding, infection, or wound healing problems.
•             Disturbance with blood circulation to the kidney or hampered flow of urine from the kidney.

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:-

1. Enjoy your new freedom
2. Take your medications regularly- Failure to do so may cause rejection and loss of Kidney.
3. Have a complete list of your tablets ready and up-to-date.
4. A folder with copies of all letters who you may have seen as well as copies of laboratory values will help a lot.
5. When you have blood test to check the levels of the immunosuppressive drugs make sure the blood is taken before the morning dose.
6. If you forget/ miss the dose of your medicine seek advice.
7. Attend your clinic appointments. Your transplant function should be checked on a regular basis. Ask your doctor about the intervals.
8. If you feel unwell or you think something is wrong, seek advice as soon as possible. Inform your Doctor.

Don’ts for the kidney transplant patient:-

1. Do not stop your medication.
2. Your immune system is impaired  by the immunosuppressive medication. Do not ignore the signs of infection. A fever, cough, urinary symptoms or abdominal pain should be informed to the doctor straight away.
3. Do not take any other medication (this includes over the counter drugs) unless advice from the kidney/ transplant doctor is taken.
4. Do not make mistakes with your immunosuppression. If uncertain about the dose ask for advice.
5. Do not change the schedule of your immunosuppression.
6. Avoid the company of people with infections (eg. people with runny nose or cough) particularly early after transplantation.
7. It is important that you do not miss appointments. Even if you feel well it is important to attend clinic because it is very rare that you get symptoms with transplant rejections.Similarly, it is just as important to attend clinic if you are unwell.
8. Do not ignore advice from the transplant team. If they strongly advise investigations they have good reasons.
9. Do not smoke.
10. Do not go on holiday without appropriate precautions.