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Kidney Transplantation

Introduction:

A kidney transplant is a surgical procedure aimed at placing a healthy kidney from a deceased or living donor into a person with severe renal impairment who has or has not started dialysis. It is often the best treatment for kidney failure compared to dialysis.

 

Types of Kidney Transplants:

  • Living-donor Kidney Transplant:

A kidney is removed from a living donor and placed into the body of a recipient who has renal failure. One kidney should be obtained from the donor to replace the two failed kidneys.

  • Deceased-donor Kidney Transplant:

It is when a kidney from someone who has recently died is removed with consent of the family or from a donor card and placed into a recipient whose kidneys have failed.

 

Kidney Transplant:

The surgery is done by placing the new kidney in the lower part of the abdomen either on the right or left side as per the decision of the treatment team. The new kidney is then attached to the blood vessels in the abdomen, making sure the blood flow reaches the new kidney. After that, the kidney is attached to the ureter and the bladder. The original kidneys are not removed.

 

Contraindications to Kidney Transplant:

For some people with kidney failure, kidney transplant may be more serious than dialysis. Ineligible cases include:

  • Untreatable heart disease, such as severe heart failure and severe occlusion of heart arteries.
  • Bacterial or viral infections, until treated.
  • Cancer. A patient who has recovered from cancer needs to wait for a period of time to be decided by the transplant physician, given the risk of cancer recurrence after the transplant due to immunodepression.
  • Mental illnesses that are difficult to treat and control.
  • Drug addiction.

 

Risks of Kidney Transplant:

  • In the Short Term: Similar risks to any other surgery, such as bleeding, clots and infection (such as: urinary tract infections, colds and flu).
  • In the Long Term: Increased likelihood of developing diabetes and hypertension as well as an increased risk of infectious diseases and tumors due to immunosuppressive drugs needed to reduce the chance of rejection of the new kidney.

 

Instructions after Kidney Transplant:

  • Make sure to have periodic tests and follow-ups.
  • Drugs should be taken to help prevent the immune system from attacking and rejecting the new kidney, as well as to reduce the risk of complications (such as: infections).
  • Stop smoking, as it can reduce the lifespan of the new kidney and increase the risk of some cancers. 
  • Follow a healthy diet by avoiding foods that contain salts, fats and high sugars and making sure to get food from clean and sterile places. 
  • Maintain regular physical activity after recovery from surgery.
  • Avoid contact with people with contagious diseases (such as: influenza patients).
  • Pay attention to personal hygiene by washing your hands regularly with soap and water, especially after going to the toilet and before preparing food and eating meals.
  • Consult the doctor when you feel any pain in the transplanted kidney or stop urinating.

Note:

New kidneys should generate urine as the original kidneys used to when they were healthy, often immediately. In other cases, this may take several days. 

 

Frequently Asked Questions: 

    • For how long does the transplanted kidney function?
      The average lifespan is 15 to 20 years for a kidney removed from a living donor and 10 to 15 years from a deceased donor.
    • Is it possible to practice all kinds of sports after a kidney transplant?
      Exercise is important and required from the recipient. Patients should start with easy sports, such as walking and running. Patients can also do other sports three months after the surgery. They are advised to avoid sports that require physical violence or include strong blows. 
    • What causes the body to reject the new kidney?
      Kidney rejection can occur by 8 to 10% in the first year. The rate of rejection increases when drugs are not taken regularly or are taken at lower doses. Some implants carry a higher risk of rejection (such as transplants from an incompatible blood group or in the presence of antibodies specific for the donor tissue).
    • When can the patient have sexual intercourse?
      The patient can engage in sexual intercourse once the wound is healed and the stent is removed from the ureter.
    • Is it possible for women who have undergone kidney transplant to conceive and give birth?
      Yes. Women are advised to take contraceptives and postpone pregnancy for at least one year after the transplant. You should tell your doctor about any planned pregnancy in order for them to be able to give advice based on your kidney function and change the drugs that may be harmful to the fetus to safer ones.

 

Misconceptions:

  • The patient should be isolated after kidney transplant.
    Fact: Isolation of patients from the community after transplants is undesirable and can lead to mental and psychological problems (such as: depression). The patient only needs prevention by:
    • Washing hands.
    • Staying away from crowded places and close contact with people with respiratory or infectious diseases.
    • Taking seasonal vaccinations. 
  • Patients cannot fast after kidney transplant.
    Fact: It is preferable that the patient does not fast in the first year after the transplant, but they can do it the following years if the doctor who performed the transplant approves it.
  • There is a specific age to get a kidney transplant.
    Fact: There is no specific age. The most important factor is the health status of the patient and the transplant physician's full evaluation of the condition to ensure greater benefit from the transplant.

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