Kidney transplantation has become a lifeline for people with chronic renal sickness, allowing them a chance to live a normal life as the number of cases of end-stage renal disease (ESRD) has increased. The kidneys are two bean-shaped organs, each about the size of a fist. They are located at the back of the abdominal cavity on either side of the spine. The main function of the kidneys is to filter the blood before sending it back to the heart and remove wastes and extra fluid from the blood. They help the body pass the waste as urine.
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Steps of Kidney Transplantation
Kidney transplantation is a very complex surgery. The procedure involves several crucial steps right from finding the donor until transplanting the kidney. Here is a step-by-step procedure of kidney transplantation for those who are unaware and waiting patiently for a kidney transplant.
Finding the Donor:
Though there has been an increase in organ donation awareness in recent years, obtaining a donor can be a tedious process in case of an emergency.Once the doctor suggests a transplant procedure, they usually recommend a known transplant center which can sometimes be in-house departments in specialty hospitals or an external center, where you need to register your requirements. Then they evaluate the patient to declare the eligibility of the patient to undergo transplant surgery. If you do not find a compatible living donor, you might be put on waiting until a deceased person’s kidney is obtained.
Evaluating the compatibility:
Once a kidney is obtained, several tests like blood type and tissue matching are done to check the compatibility. These evaluations may include blood tests, imaging scans, and other investigations. The recipient will be screened for other serious conditions such as chronic infections, cancer, and cardiovascular disease. Once satisfactory results are seen the transplant surgery is arranged immediately. In case of incompatibility, the paired donation might be arranged where the same kidney is donated to another needy recipient with whom it is compatible and obtain a compatible kidney from their donor.
Once the transplantation surgery is planned, the patient and the donor (in case of living donor kidney transplantation) are admitted to the hospital. Both the donor and the recipient will receive a physical exam, blood work, a chest x-ray, EKG, and perhaps even some other investigations. This process determines whether the patient is healthy and ready for the transplantation or not.
Unfortunately, in some cases, the surgery will be postponed and the patient will be sent home. These include:
- If the patient has been diagnosed with any infections or fever. In this case, the surgery will be postponed and then if the donor is alive, the person will be reserved for later or the donated kidney can be used for another recipient who is waiting for a kidney transplant.
- If the donated kidney has any problems or is considered not suitable for any reason, the recipient will be notified and sent home to wait until the right kidney is found.
Preparing for Surgery:
To ensure the patient is ready for the surgery, several things are carried out. These include:
- Both the patients, the recipient, and the donor, if the donor is live; will have chest and abdomen shaved.
- A laxative or enema will be administered to clean out the intestines and prevent bowel blockage after the surgery.
- An IV line (Intravenous) will be inserted to supply medicine and prevent dehydration.
- A sedative will be given to reduce the stress and help the patient relax before surgery.
During surgery, the patient might need a blood transfusion. Though the donated blood is screened very carefully to minimize the chances of contracting a disease from the transfusion; at the time of waiting for a kidney, the patient should discuss with the doctors regarding the concerns about transfusions, if any.
- At first, the patient will be given a general anesthetic and will remain asleep during the surgery.
- A small incision is made over the lower abdomen through which the donated kidney will be placed.
- The recipient’s kidney is left in its position unless there is an indication of infection or cancer.
- After the kidney is placed in the right position, the blood vessels from the lower abdomen are connected to the donated kidney much like an original kidney. This ensures the blood supply to the donated kidney.
- Finally, the ureters that carry urine from the kidneys to the urinary bladder are attached to the donated kidney.
- After the procedure, the skin is sewed either with sutures or staples.
- A small drain may be inserted into the abdomen to drain any excess fluid that may have accumulated during the operation.
Frequently Asked Questions:
As a result, the average life expectancy of a dialysis patient is generally five years. On the other hand, patients who receive a kidney transplant tend to live longer than those who remain on dialysis. A living donor kidney works, on average, for 12 to 20 years, and a deceased donor kidney for 8 to 12 years.
Kidney transplant surgery carries a risk of major complications, including blood clots and bleeding. Leakage or obstruction of the tube (ureter) that connects the kidney to the bladder. Infection.
A kidney transplant is major surgery. Therefore, it carries the risk of an allergic reaction to general anesthesia.
The dialysis treatment itself is painless. However, some patients may have a drop in blood pressure that could lead to nausea, vomiting, headaches, or cramps. However, if you are careful to follow your kidney diet and fluid restrictions, you can avoid these types of side effects.
It's been suggested that the left kidney is easier to transplant than the right because the left renal vein is longer, facilitating venous anastomosis creation easier.
Laparoscopic radical nephrectomy requires patients to undergo general anesthesia. While operative times vary from person to person, the usual operative time is around 3-4 hours.
The surgery lasts one to three hours and generally requires a one to a two-night hospital stay. You should be able to resume your normal activities in a week or two.
Percutaneous nephrolithotomy is usually performed in the hospital under general anesthesia, which means that you will be asleep during the procedure and will not feel any pain.
After a kidney transplant, minor illnesses such as urinary tract infections (UTIs), colds, and the flu are frequent. Potentially more serious infections can occur, such as pneumonia and cytomegalovirus (CMV), which may require hospital treatment.
A lymphocele is caused by the accumulation of fluid around the kidney. This can be large enough to put pressure on the kidney and prevent the kidney from producing urine. You may have leg swelling on the same side as the kidney transplant.