A Guide to the Kidney Transplant Procedure Used to Relieve the Symptoms of End-Stage Renal Disease

Indications

Surgeons perform kidney transplants on people who have end-stage kidney disease, also known as renal failure or kidney failure. When the kidneys do not function properly, excess fluid and wastes build up in the blood. They also stop producing necessary hormones and fail to regulate the amounts of sodium, potassium and other minerals in the blood.

Contraindications

Some people are not good candidates for this extensive procedure. People who have tuberculosis, liver disease, heart disease, lung disease, hepatitis and a history of cancer may not be able to undergo the kidney transplant procedure. Those with a history of drug and alcohol abuse do not meet the criteria for kidney transplant set by individual transplant units. Those who have morbid obesity may need to lose weight before undergoing a kidney transplant, as obesity increases the risks associated with receiving general anesthesia.

Benefits

Receiving a healthy donor kidney has several benefits for those who have end-stage kidney disease. After a successful recovery, transplant patients have more energy, fewer dietary restrictions and improved quality of life. After transplant, patients no longer need to undergo hemodialysis or peritoneal dialysis.

Risks and Disadvantages

Because this procedure is so physically and emotionally demanding, there are some risks and disadvantages. Any surgical procedure has risks, especially long procedures that involve general anesthesia. These risks include infection, blood clots, pulmonary embolism, heart attack and stroke. One of the major disadvantages of undergoing a kidney transplant procedure is that transplant recipients have to take immune suppressants after the surgery. These drugs reduce the risk of organ rejection, but they also reduce the body’s ability to fight infection. Immune suppressant use also increases the risk of some types of cancers. The side effects of these medications are also bothersome, which is another disadvantage of the procedure.

Organ Matching

Transplant teams use HLA typing, a form of tissue typing, to determine if a donor is match for a transplant recipient. This process involves identifying genetic markers that reside on the white blood cells of potential donors. Scientists refer to these genetic markers as antigens. Children inherit one-half of their antigens from their mother and the other half from their father. University of Texas Medical Branch explains that there is a 25 percent chance of an identical antigen match between sisters and brothers. There is a 50 percent chance that brothers and sisters will have a three-antigen match. The best match for a kidney transplant is a six-antigen match, but surgeons can use kidneys from lesser matches in some cases. Laboratory tests to determine blood type also play a role in donor selection. Donors should have a blood type compatible with the blood type of the recipient.

Surgical Procedure

This procedure takes approximately three hours to complete, according to MedlinePlus. During the surgery, the surgeon places the new kidney inside the lower abdomen. After the kidney is in place, the surgeon connects the veins and arteries of the donor kidney to the veins and arteries of the recipient’s pelvis. The surgeon also has to connect the ureter, or tube that carries urine, from the kidney to the bladder. Unless the recipient’s kidneys are causing high blood pressure or other problems, removal is not necessary.

Recovery Period

After the transplant, the recipient has to take immune suppressants to reduce the risk of transplant rejection. This makes it necessary to restrict physical activity and travel during the first several months of recovery. While transplant recipients can walk and do other low-intensity exercise, they should not lift weights or perform strenuous exercises. Most transplant patients can return to work approximately two months after their surgeries.

References

MedlinePlus: Kidney Transplant

University of Texas Medical Branch: The Kidney Transplant Process