Kidney Transplant

 Kidney Transplantation

Kidneys are two bean shaped organs located on each side of the body, just beneath the ribcage. Their main role is to filter waste products from the blood before converting them to urine.When kidneys lose their filtering ability, dangerous levels of fluid and waste accumulate in your body — a condition known as kidney failure or end-stage renal disease (ESRD). Various conditions can damage your kidneys, including both primary kidney diseases and other conditions that affect the kidneys.

Kidney Transplant

Kidney Transplant or Renal Transplant is a procedure in which a person with completely failed kidneys will receive a kidney from a healthy person who has both the kidneys working in good condition. Thus, after the surgery both the man can continue to lead a healthy and normal life. The person receiving the kidney is called a “recipient” & the person donating the kidney is called a “donor”. After the transplant, the healthy kidney (the “graft”) takes over the functions of nonworking kidneys in the recipient.

Reasons for Kidney Transplant

Kidney failure is most often a result of uncontrolled High Blood Pressure or High Diabetes. Untreated kidney failure can have a large impact on the person’s Heart and over all body functions.

  • Diabetes mellitus
  • High blood pressure
  • Glomerulonephritis
  • Polycystic Kidney Disease
  • Severe anatomical problems of the urinary tract

The need for a Renal Transplant arises when a person’s kidneys lost all their functions and the Kidneys function is being managed artificially by the help of Dialyzing Machines.
Kidney transplant remains the only cure for chronic kidney disease (CKD) or end-stage renal disease (ESRD).

Candidature for Kidney Transplantation

To undergo a kidney transplant, the recipient & donor both must be healthy &must NOT have:

  • Infections such as TB, hepatitis or osteomyelitis
  • Heart, lung, or liver disease
  • Cancer

In-case either the recipient or donor has any other medical issue, then they must be treated for the same first before going for the kidney transplant.

Suitable Kidney Donors

  • Living related donor- First family relatives of the person receiving the kidney, i.e. either of the parents, siblings, or children are preferred donors. Being related, there is an increased chance of kidney being a stronger biological “match” for the patient & thus increases the chances of being accepted in a foreign body.
  • Living unrelated donor – Friend or spouse can also donate. However, the recipient needs to be administered anti-rejection injections to reduce the chances of rejection of the transplanted kidney which is a foreign object in the body.

Many people worry that by donating a kidney they will become unhealthy or be in a dangerous situation. The living donor of the kidney is left with one healthy functioning kidney, which should be more than enough for the rest of the donor’s life. The donor’s activities are not usually limited.

Pre-Transplant Evaluation &Tests 

Thorough investigations &evaluations of both the donor and recipient are done to ensure that the donor is perfectly healthy at the time of donation and that he /she continues to remain normal after donation. The potential recipient undergoes evaluation, adequate dialysis and is brought to an optimal state to withstand the major surgery of renal transplant. The tests done include:

  • Blood tests or skin tests to check for infections
  • Heart tests such as an EKG, echocardiogram, or cardiac catheterization
  • Tests to look for early cancer
  • Tissue and blood typing to help make sure the body will not reject the donated kidney

Procedure for the person receiving the Kidney (Recipient)

During the procedure, the surgeon places the new kidney in the abdomen and attaches it to the artery that supplies blood to kidneys and to the vein that carries blood away from the kidney. The kidney is also attached to the ureter, which carries urine from the kidney to the bladder.

Procedure for the person donating the Kidney (Donor)

There are 3 ways by which the doctors may take out the kidney from the donor

Simple kidney removal or Open Nephrectomy

  • The surgeon will make an incision (cut) up to 12 inches long. This cut will be on the side, just below the ribs or right over the last ribs.
  • Muscle, fat, and tissue are cut and moved. The surgeon may need to remove a rib to do the procedure.
  • The tube that carries urine from the kidney to the bladder (ureter) and blood vessels are cut away from the kidney. The kidney is then removed.
  • Sometimes, just a part of the kidney may be removed
  • The cut is then closed with stitches or staples.

Radical kidney removal or Radical Nephrectomy

The surgeon will make a cut about 8 to 12 inches long. This cut will be on the front of your belly, just below your ribs. It may also be done through the side.

  • Muscle, fat, and tissue are cut and moved. The tube that carries urine from the kidney to the bladder (ureter) and blood vessels are cut away from the kidney. The kidney is then removed.
  • The surgeon will also take out the adrenal gland and some lymph nodes.
  • The cut is then closed with stitches or staples.

Laparoscopic kidney removal or Laparoscopic Nephrectomy

  • The surgeon will make 3 or 4 small cuts, usually no more than 1-inch each, in your belly and side. The surgeon will use tiny probes and a camera to do the surgery.
  • Towards the end of the procedure, the doctor will make one of the cuts larger (around 4 inches) to take out the kidney.
  • The surgeon will cut the ureter, place a bag around the kidney, and pull it through the larger cut.
  • This surgery may take longer than an open kidney removal. However, most people recover faster and feel less pain afterwards compared to open surgery.

Kidney Explained

Kidney Diagram
Kidney Transplant