Kidney transplant

Kidney transplant

Definition

A kidney transplant is a surgical procedure to implant a healthy kidney into a patient with kidney failure.

Alternative Names

Renal transplant; Transplant - kidney

Indications

A kidney transplant may be recommended for patients with kidney failure caused by:

• Severe, uncontrollable high blood pressure
• Infections
• Diabetes
• Glomerulonephritis

A kidney transplant alone may NOT be recommended for patients who have:

• Heart, lung, or liver disease
• Other life-threatening diseases
• Certain infections, such as TB or osteomyelitis
• Difficulty taking medications several times each day for the rest of their lives

Convalescence

For a living donor, the recovery period is 4-6 weeks. The patient should avoid heavy activity during this time. The sutures are removed after a week or so.

The kidney recipient is usually observed in the hospital for about a week. After that, he or she requires close followup in the transplant clinic and frequent monitoring of labwork.

Expectations after surgery

Kidney transplants generally offer the best outlook for patients with end-stage kidney disease. Most centers have patient and organ survivals of over 90% at one year, and more than 80% at three years. By 10 to 15 years, about 50% of transplanted kidneys are still functional. Kidneys from living related donors do better than from deceased donors.

However, this success is not without its costs. The patient's immune system identifies the transplanted kidney as a foreign organ and tries to destroy it. This is called rejection. In order to avoid rejection, almost all kidney transplant recipients require life-long treatment with medications that suppress their immune response (immunosuppressive therapy).

This has several unwanted consequences. Because the immune system is suppressed, the patient has a higher risk of infection and cancer. This requires aggressive cancer screening.

The immunosuppressive medicines themselves have side effects, which may include high blood pressure and high cholesterol, increased risk of diabetes, and other problems.

The success of a kidney transplant depends in part on close followup and meticulous adherence to the medicine regimen.

For the donor, studies show that living with one kidney following surgery is relatively safe, with few physical and psychologic complications.

Risks

The risks for any anesthesia are:

• Reactions to medications
• Problems breathing

• Bleeding
• Infection

• Infection due to the immunosuppressive medications that must be taken to prevent transplant rejections

Kidney anatomy

Kidney - blood and urine flow

Kidneys

Kidney transplant - series

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