Urologic Diseases
Kidney Transplant
 

Introduction

A kidney transplant is a surgical procedure involving removing a functioning kidney from a living or dead donor, and placing it into the body of a patient with severe renal failure (recipient), no matter whether that patient has started dialysis therapy. Kidney transplantation (also known as renal transplantation) is considered the most effective treatment for renal failure, compared to dialysis.

Types of kidney transplants
  • Living-donor transplant:
Removal of a healthy kidney from the living donor, and placing it in the renal failure patient. The living donor can donate only one kidney to replace one of the patient’s failed kidneys.
  • Deceased-donor transplant:
A deceased-donor kidney transplant is when a kidney from someone who has recently died is removed with consent of the family or from a donor card and placed in a recipient whose kidneys have failed.

Kidney transplantation surgery:
The kidney transplantation surgery is carried out by placing the new kidney on the lower right or left side of the patient's abdomen, as decided by the surgeon. Once placed in its position, the kidney is connected to the nearby abdominal blood vessels, making sure that blood flows through those vessels to the new kidney. Then, the surgeons connect the kidney to the patient's ureter and bladder. As for the old, filed kidney, it should not be removed unless so decided by the physician.

Contraindications to kidney transplantation:
For certain people with kidney failure, a kidney transplant may be more risky than dialysis. Conditions that may prevent the patient from being eligible for a kidney transplant include:
  • Chronic, incurable cardiac diseases, such as: severe cardiomyopathy, and acute arterial occlusion;
  • Bacterial or viral infection, until cured;
  • Active or recently treated cancer: patients with recently-treated cancer will need to wait for a period of time, specified by the transplanting physician, before undergoing a kidney transplantation surgery, owing to the risk of recurrence of the disease after transplantation, because of immunodeficiency;
  • Incurable and uncontrollable psychiatric conditions or mental diseases;
  • Drug abuse; and
  • Some immunodeficiency diseases that may cause the transplanted kidney to fail.

Kidney transplantation risks:
  • Immediate risks: i.e., those risks normally associated with surgeries, including bleeding, clots, and infection (such as urinary tract infection, flu and influenza). 
  • Long-run risks: including the risk of suffering diabetes, high blood pressure (hypertension), in addition to an elevated risk of developing infections and malignant tumors, owing to the immunosuppressant administered to the kidney recipients, with the aim to mitigate the risk of transplant rejection.

General tips to be followed after kidney transplantation:
  • Make sure to undergo checkups and medical screenings on a regular basis;
  • Take the prescribed medications regularly, to help prevent the immune system from attacking or rejecting the transplanted kidney;
  • Stop smoking: it may result in shortening the life of the transplanted kidney, aw well as elevating the risk of some cancers; 
  • Follow a specific diet, avoid the foods high in salt, fat and sugar, and pay close attention to the cleanliness of food; 
  • Exercise regularly after healing of the surgery;
  • Avoid contact with persons who have infections (e.g., influenza);
  • Pay close attention to personal hygiene (for example, by washing hands with soap, especially after toilet use, before cooking and before eating); and
  • Consult your doctor once you feel pain in the transplanted kidney, or suffer urine retention.

FAQ 
o How long does a transplanted kidney work?
Living-donor transplants usually work for 15–20 years, and deceased donor-transplants usually work for 10–15 years. 
o Is it safe for a kidney recipient to exercise?
Exercising is necessary for patients who have undergone kidney transplants. However, they must begin with mild exercises, such as waling and running. Patients can practice other sports three months after the transplantation surgery. It is advisable, though, to avoid vigorous physical activity and violent sports.
o What causes kidney rejection?
The probability of kidney rejection during the first year ranges from 8 to 10 percent. This percentage can go higher in case of failure to take the prescribed medications regularly, or taking less doses than required. The probability of rejection becomes higher in such cases as: incompatible blood-groups of the donor and recipient, or existence of antibodies to the transplanted kidney.
o How soon can a kidney recipient resume sexual activity after transplantation?
A kidney recipient can resume sexual activity after healing of the surgery and removal of the ureteral stent.
o Can a female kidney-recipient get pregnant?
Yes. Women are recommended to keep on the pill for no less than one year after transplantation. The kidney-transplanting physician should be kept aware of any pregnancy plans, so as to provide guidance based on the kidney functions, or replace medications that can affect pregnancy with safer medications.


Myths & Realities:
o Kidney recipients should be isolated.
Reality: A kidney recipient should be isolated for a few days after undergoing the transplantation surgery. After that, however, isolation will be undesirable; as it can cause psychiatric problems, such as depression. The patient will have to have to take preventive precautions, such as:
Hand-washing every now and then, and
Keeping away from crowded places, and the persons suffering respiratory or infectious diseases.
Taking seasonal vaccinations regularly.

o A kidney-recipient cannot fast.
Reality: A patient who has undergone a kidney transplantation surgery is advised not to fast in the first year after the surgery. After that, however, he or she can fast upon obtaining the transplanting physician’s approval.

o There are age restrictions on kidney transplantation.
Reality: There are no age restrictions. What matters the most is the patient's general health, and the transplanting physician’s complete assessment of the patient's condition, so as to ensure positive outcomes of the kidney transplantation.








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Last Update 27 October 2019 03:33 PM
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