What is kidney transplant surgery?
The kidney transplant operation is performed when a healthy kidney is available, either from a living donor or a deceased donor. The kidney is compatible with the recipient’s blood type and tissue type. The operation takes about two hours, and the hospital stay is usually about 3 days. The most challenging part is finding a compatible kidney. The role of the transplant center is to maintain a list of patients that a healthy enough to receive a kidney transplant. Unfortunately, many patients will experience decline in their health, and we'll become too sick for kidney transplantation.
The best kidneys come from living donors as we are sure that the kidney is of very good quality, the risk of disease transmission from the donor to the recipient (cancer, infection) is very low, and this is a planned operation that can be done laparoscopically weather robotic assistance in some patients. This contrasts with the deceased donor kidney transplant which a recipient waits for on the transplant centers waiting list.
Who needs a kidney transplant?
If you have developed end stage kidney failure (GFR <20) then a kidney transplant maybe the most appropriate treatment. This requires evaluation by a multidisciplinary team before you were placed on the transplant center waiting list for a new kidney.
A kidney transplant offers many benefits:
- Treats chronic kidney diseases.
- Helps you live longer.
- Higher quality of life.
- Could be a better financial option as there won’t be a lifetime of dialysis bills.
- Not reliant on dialysis schedules.
What causes kidney failure?
The commonest causes of kidney failure are diabetes and hypertension. There are other causes such as glomerulonephritis (IgA, FSGS, Lupus), polycystic kidney disease, etc. The patient should have their kidneys evaluated by a family physician and then a nephrologist; the regular follow up allows the doctors to predict when the patient will develop end stage kidney failure requiring replacement therapy with either dialysis or, preferably, a preemptive kidney transplant.
What is dialysis?
Dialysis may be the only option if you also suffer from heart disease, or if there is a history of drug or alcohol use. The five-year survival on dialysis is 40% and the 10-year survival is 10%. Dialysis will keep patients alive for a period, but their quality of life is severely impacted by anemia, dietary restrictions, abnormal calcium and phosphorus metabolism.
What are the risks of a kidney transplant?
A successful transplant means that the patient is no longer anemic and does not have significant dietary restrictions. In contrast to the outcomes for dialysis, 7 out of 10 kidney transplant recipients will die with a functioning kidney. Only three out of 10 will experience loss of the kidney transplant end half these patience we'll be able to undergo a subsequent transplant. In summary:
Most recipients will never experience of rejection because the kidney is well matched, and the patients are selected such that they can take their medications correctly end return for follow up.
The rejection risk is 10 to 15%. These are acute rejections that are usually treated with the short course of high dose steroids or antibody formulations. The acute rejections will reverse in the in the in the majority of patients, but some patients may experience chronic rejection, and this can lead to the failure of the transplanted kidney.
If you have any questions regarding kidney transplantation, please call The Iowa Methodist Transplant Center at UnityPoint Health- Des Moines on (515) 241-4044.