A kidney transplant is a surgical procedure where a failing kidney is removed and replaced with a healthy kidney from another person. Kidney transplants are usually recommended for people with permanent kidney failure or End Stage Renal Disease (ESRD), when dialysis is no longer enough for the body. The kidney that is donated can come from a deceased donor or a living donor depending on the availability. A kidney transplant provides a longer and better quality of life compared to dialysis.
Reasons for Kidney Failure and Transplant
The most common causes of kidney failure leading to a transplant are diabetes, high blood pressure, glomerulonephritis (inflammation of the glomeruli in the kidneys), polycystic kidney disease and other genetic defects. As kidneys fail, they can no longer filter waste and excess fluid from the blood effectively. This puts a tremendous strain on the body and leads to various other health issues if left untreated. When kidneys fail completely, dialysis or transplantation are the only options to artificially filter the blood until a donor kidney can be found.
Finding a Matching Donor Kidney
When a patient’s kidneys fail permanently, they are put on the National Transplant Waiting List. The Kidney Transplant team then works to find the best matched donor kidney based on blood type, tissue type and crossmatch results. The best match is usually a deceased donor through organ procurement organizations. Living donor transplants from a family member or friend allow for better matching and faster recovery times compared to deceased donors. Extensive tests are done on both donor and recipient to minimize risks of donor organ rejection after transplantation.
The Transplant Surgery
On the day of surgery, both the recipient and living donor (if applicable) are prepped in the operating room. The recipient’s failing kidneys are removed through an abdominal incision. The donor kidney is then implanted in the lower abdomen and attached to blood vessels to allow blood flow. It is also connected to the bladder to allow urine drainage. The surgery usually takes 3-4 hours. After transplant, the patient is monitored closely in the ICU for any early complications. Immunosuppressant drugs are also started right away to prevent organ rejection.
Post-Transplant Care and Monitoring
After being discharged from the hospital, kidney transplant recipients require lifelong follow up with their transplant team. Daily immunosuppressive medications must be taken to prevent rejection of the donor organ by the recipient’s immune system. Complementary therapies such as steroids and antilymphocyte globulin are also used. Recipients must undergo regular medical exams and lab tests to monitor kidney function and check for any signs of organ rejection. Changes to lifestyle like a healthy diet, exercise and stress management also play a key role in long term transplant success. Recipients need to be very careful about infections due to immunosuppression and get recommended vaccinations. Even with excellent care, there is always a possibility of late organ rejection or other post-transplant complications that require close medical management.
Living Donor Transplant Program
A living donor transplant can take place when a loved one chooses to donate one of their kidneys willingly while alive. Extensive evaluation of the physical and mental health of potential living donors is done prior to approval. This includes medical history review, lab tests, CT scans, psychiatric clearance and physician evaluation to assess compatibility and risks. If approved as a suitable candidate, the healthy living donor undergoes minor surgery to remove one of their two kidneys through small incisions in their abdomen. This donor kidney is then transplanted into the recipient during their surgery. The remaining kidney of the donor is typically enough to support their needs long term. Living donor transplants are growing rapidly due to wait list challenges and provide recipients with superior outcomes versus deceased donor transplants. However, donors should carefully consider risks and only proceed with full informed consent. The benefits to recipients can be lifesaving.
Continuous Advancements in Transplant Medicine
While kidney transplantation is a complex procedure requiring ongoing management, it remains the best long term treatment available for permanent kidney failure compared to dialysis. It allows recipients to regain independence and better quality of life. Continuous progress is being made to optimize surgical techniques, minimize toxicity of lifelong medication regimens, screen for better donor-recipient matches, and research organ preservation solutions that prolong deceased donor kidney viability. Clinical trials are also evaluating use of stem cells and 3D printed organs to potentially heal or even grow new transplantable kidneys in future. As treatments advance, more lives could be saved through transplantation or avoid lifelong dialysis dependency. Kidney failures continues to rise especially among minorities in many countries like the USA due to increased risk factors like diabetes and hypertension. Expanding access to screening, prevention programmes and transplant resources will remain crucial to support those suffering from the costly burden of chronic kidney disease. With ongoing research providing hope for new solutions, transplantation empowers patients with renewed health and a chance to live their lives to the fullest again.
Kidney transplant offers permanent treatment for kidney failure by replacing failing kidneys with a healthy donor organ. Though requiring lifelong medical management, transplant recipients gain improved physical functioning and longevity versus dialysis alone. Living donors can provide a lifesaving gift to loved ones battling renal disease. Continuous advancements in transplantation surgery, immunosuppression protocols and organ preservation hold promise to benefit even more individuals suffering from kidney failure worldwide in need of a second chance at life.
*Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it