Transplantation

Get to Know Everything Related to Kidney Transplantation

January 30th, 2018
Get to Know Everything Related to Kidney Transplantation

There could be numerous reasons behind your decision to go for a kidney transplant in India. A large number of people all across the world suffer from acute kidney disease and explore ways to make their life sustainable. Being an important organ in human body, kidneys need to function properly to keep the body functioning.

When kidney function dips to a certain level, patients have end-stage renal disease and need either dialysis or transplantation to endure their life.

Why kidneys are crucial for life?

The kidneys refer to organs that need to function to sustain life. Most people have two kidneys, located on either side of the spine, beneath the stomach organs and below the rib cage. The kidneys are known to conduct several major functions to keep the body healthy.

  • Purification of the blood to eliminate waste products from general body functions, passing the waste from the body as urine, and returning water and chemicals back to the body as necessary.
  • Ruling of the blood pressure by discharging various hormones.
  • Stimulus of production of red blood cells by discharging the hormone erythropoietin.

The standard structure of the kidneys involves two kidney bean shaped organs that are meant to produce urine. Urine is then taken to the bladder by way of the ureters. The bladder works as storage for the urine. When the body finds that the bladder is full, the urine is defecated from the bladder through the urethra.

Kidney Disorder

When the kidneys get faulty, renal failure takes place. If this renal failure continues (chronically), end-stage renal disease emerges out, with the buildup of toxic waste products in the body. In this situation, either dialysis or kidney transplant is needed.

Typical Causes of End-Stage Renal Disease

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

Treatments for End-stage Renal Disease

In most of the cases, the treatments for end-stage renal disease ends up in hemodialysis, a mechanical procedure of filtering the blood of waste products; peritoneal dialysis, under which waste products are eliminated by exposed to chemical solutions through the abdominal cavity; and kidney transplantation.

Though, none of these treatment options treat end-stage renal disease, a transplant gives the best chances of returning to a normal life because the transplanted kidney can substitute the damaged kidneys. However, it also encompasses a lasting dependence on drugs to keep the new kidney working. Some of these drugs can present extreme side effects.

Some kidney patients ponder a transplant after starting dialysis; others go for it before the start of dialysis. In some cases, dialysis patients who also have extreme medical issues such as cancer or active infections may not be appropriate candidates for a kidney transplant.

Kidney Transplantation: - There are two main roles in any case of kidney transplantation procedure – a living donor or a deceased donor and the kidney recipient

The Living Donor: - Many times family members, such as brothers, sisters, parents, children (18 years or older), aunts, cousins, or a spouse or friend may choose to donate their kidney. That person is known as a "living donor." The donor must be in good health, well knowledgeable about transplantation, and ready to provide learned consent. Any healthy person can donate a kidney to the patient.

Deceased Donor: - A deceased donor kidney is taken from an individual who has faced brain death. A law allows everyone to accord to organ donation for transplantation at the time of death and enables families to give such permission as well. After permission for donation is given, the kidneys are eliminated and stored until a recipient has been finalized.

Transplant Evaluation Procedure: - Irrespective of the type of kidney transplant-living donor or deceased donor, certain blood tests are conducted to find out the type of blood and tissue. These tests are meant to help in matching a donor kidney to the kidney recipient.

Blood Type Testing: - This test determines the blood type. There could be four blood types: A, B, AB, and O. All individuals are fitted into one of these define blood groups. The recipient and donor should have either the similar blood type or well-matched ones, except they are involved in a special program that enable donation across blood types.

The list below shows compatible types:

  • If the recipient blood type is A Donor blood type must be A or O
  • If the recipient blood type is B Donor blood type must be B or O
  • If the recipient blood type is O Donor blood type must be O
  • If the recipient blood type is AB Donor blood type can be A, B, AB, or O

The AB blood type is the most feasible to match because that person can receive all other blood types.

Blood type O is the most difficult to match. Though people with blood type O can donate to all blood types, they can only get kidneys from blood type O donors. For instance, if a patient with blood type O gets a kidney from a donor with blood type A, the body would identify the donor kidney as foreign and damage it.

Tissue Typing: - This test is also a blood test for human leukocyte antigens (HLA), and is known as tissue typing. Antigens are indicators found on various cells of the body that differentiate each person. These indicators are inborn from the parents. Both recipients and any potential donors have tissue typing test done during the examination process.

To get a kidney where recipient's markers and the donor's markers all are the same is a "best match" kidney. Best match transplants carry the heavy likelihood of working for several years. Most perfect match kidney transplants are done from siblings.

Although tissue typing is conducted notwithstanding partial or absent HLA match with some level of "mismatch" between the recipient and donor.

Crossmatch: - In one’s life, the body creates substances known as antibodies that are meant to destroy foreign materials. Individuals may build antibodies each time in case of infection, with pregnancy, have a blood transfusion, or face a kidney transplant. If there are antibodies to the donor kidney, the body may abolish the kidney. Due to this, when a donor kidney is ready, a test known as a crossmatch is performed to make sure that the recipient does not have pre-formed antibodies to the donor.

The crossmatch is performed by mixing the recipient's blood with cells from the donor. If the crossmatch results positive, it indicates that there are antibodies against the donor. The recipient must not get this specific kidney unless a special treatment is conducted before transplantation to decrease the antibody levels. If the crossmatch comes out negative, it means the recipient does not carry antibodies to the donor and that they are qualified to receive this kidney.

Crossmatches are done several times in a living donor transplant case and an eventual crossmatch is performed within 48 hours before this kind of transplant.

Serology: - This test is also conducted for viruses, such as HIV (human immunodeficiency virus), hepatitis, and CMV (cytomegalovirus) to choose the most appropriate preventive medications post-transplant. These viruses are examined in any potential donor to help avert spreading disease to the recipient.

Kidney Transplant Surgery

The transplant surgery is done while the patient is put under general anesthesia. The operation generally takes 2-4 hours. This kind of operation is a heterotopic transplant which means that the kidney is placed in another location than the previous kidneys. (Liver and heart transplants are orthotopic transplants, in which the diseased organ is eliminated and the transplanted organ is put in the same location.) The transplanted kidney is fixed in the front (anterior) part of the lower abdomen, in the pelvis.

The original kidneys are not generally eliminated unless they cause severe issues such as uncontrollable high blood pressure, repeated kidney infections, or are immensely inflated. The artery that brings to blood to the kidney and the vein that takes blood away is surgically linked to the artery and vein already existing in the pelvis of the recipient. The ureter, or tube, that takes urine from the kidney is linked to the bladder. Recovery in the hospital is typically 3-7 days.

Complications may emergein kidney transplantation surgery. The following complications do not happen often but can include:

  • Bleeding, infection, or wound healing concerns.
  • Problem with blood circulation to the kidney or problem with flow of urine from the kidney.

These complexities may demand the need of another operation for correction. The patient can find best hospitals in India offering the kidney transplant treatment in an efficient manner and the kidney transplantation cost in India is minimal to other countries.

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