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Kidney Transplantation

Specialization: Transplantology

Kidney Transplantation: Who Needs This Operation and How Successful It Is 

Kidneys perform a filtering function, consisting in removing harmful substances – waste and excess liquid. Kidney transplantation is needed if they lose their ability to function properly, provoking increased blood tension, organs swelling, harmful substances ingress into the blood, etc. The final stage of kidney dysfunction is their inability to cleanse the body – about 90% of the kidney tissue doesn’t respond to body signals.

Kidney dysfunction causes are:

  • diabetes;
  • high blood pressure as a chronic pathology, uncontrolled by a person;
  • glomerulonephritis – inflammatory processes of the filtration system in the kidneys provoke scarring;
  • polycystic kidney disease.

Renal failure treatment 

Basic care methods of renal faiure are:

  • hemodialysis – blood purification by removing accumulated waste substances;
  • peritoneal dialysis – waste removal from organism by introducing chemicals into the stomach;
  • organ transplant.

The above clinical methods are not 100% effective in the fight against the end-stage renal disease, nevertheless, A kidney transplant will most likely return a person to a normal lifestyle. A donor kidney replaces a damaged organ but means a lifelong dependence on drugs and various tests.

Kidney transplant resources

Organs for transplantation can be obtained from a living kidney donor or deceased person.

Living donors

A kidney is taken from close relatives: brother or sister, parents, children and other family members. Friends or spouses can give an organ, nevertheless, it requires complete biological compatibility of patient material and the donor. Additionally, donors must be completely healthy, have no physical abnormalities, be fully aware of surgery consequences and give written consent to transplantation.

Deceased persons

Kidney transplant from deceased donors is possible only in death of the latter from cerebrum dysfunction. Person himself/herself or his/her relatives give consent to transplantation. Such permission is kept until required.

Graft evaluation in renal failure

Regardless of whether a deceased or living person becomes a donor, a test series must be carried out before operation. Results will help determine the tissue type and patient’s blood quality. Based on it, a donor is selected.

Blood group and tissue structures type determination

Donor and patient must have the same group or be compatible. Some blood groups don’t accept others, although they are used on their own. In case of donor organ incompatibility with biological recipient environment, the organism defines it as foreign and stops its functioning.

Patient needs to donate leukocytes for a clinical study – tissue typing. This analysis determines the antigen’s nature – individual cell markers.  For kidney transplantation, donor and recipient markers must match completely or partially.

Cross compatibility

In its life cycle, organisms produce specific antibodies: in pregnancy, when infected, after organ transplantation, etc. If an organism contains antibodies, it doesn’t adopt donor kidney, reducing its functionality to zero level. Therefore, before operation, cross-compatibility analysis of donor and recipient is mandatory.

Serology

Among others, donors pass tests for HIV, hepatitis and severe viral pathologies. It’s necessary to exclude the virus spreading in recipient’s organism.

Kidney transplantation stages

  1. Period before surgery.

At this stage, the transplantation possibility from a living donor is assessed or the human death with a suitable organ is expected. Recipient undergoes a clinical examination, passes necessary tests and other things required to ensure the operation safety.

Patients may be contraindicated for kidney transplantation in the following cases:

    1. incurable vascular pathologies;
    2. end-stage cancer; 
    3. ongoing chemotherapy;
    4. systemic organism infections;
    5. mental illnesses that cannot be treated;
    6. psychotropic substances consumption;
    7. irreversible neurological pathology. 
  1. Transplantation.

Operation lasts about 2-4 hours. Donor kidney is placed in the lower front abdomen – above the pelvic bone. Simultaneously, the natural recipient organ isn’t removed – removal is required if the kidney continues provoking serious problems: increased unregulated pressure, inflammation, etc.

     3.Period after transplantation. Meds for recovery and maintenance.

After the operation, the patient spends about a week in hospital. During the further recovery period, constant medical monitoring is required, aimed at identifying kidney rejection signs. Additionally, by carefully monitoring the patient, doctors timely determine infection progress, problems with immune functions, etc.

Meds preventing kidney rejection

After the operation, patients take immunosuppressants needed to prevent organism from kidney rejection. Meds course doesn’t stop until the full fusion of the transplanted kidney and its natural environment. This therapy is mandatory.

How successful are kidney transplants?

Surgery success is affected by whether the kidney was obtained from a living or dead donor, general physical condition, etc. Mostly, unsuccessful transplants occur because of kidney rejection. Below is the recipients survival rate for 5-year period.

  1. Transplanted kidney obtained from living person – 95%.
  2. Organ of a deceased donor – 88%.

Grafts are successfully inserted immediately in 88% and 79%, respectively.