Renal transplant is a surgical procedure that involves the replacement of the diseased or dysfunctional kidney with a healthy kidney.
Kidney failure is a condition in which the kidneys are not able to remove toxins and waste from the blood. In such a condition, renal transplant is advised by the doctor.
Renal transplant is required mainly in the case of kidney failure. Symptoms of kidney failure are:
High blood pressure
Nausea and vomiting
The other indications that suggest that a patient might need a kidney transplant include:
Severe metabolic imbalance leading to diseases like Gout, Diabetes mellitus
Presence of tumors, such as renal cell carcinoma and Wilm’s tumor
Kidneys have become unresponsive to medical or surgical treatments
Trauma resulting in permanent damage to the kidney
The doctor commonly advises to
Avoid consumption of tobacco, alcohol or any other harmful substance
Follow a balanced diet and regular exercise regime to keep the weight in check
Maintain oral health through sound dental care
Renal transplant procedure is performed by an experienced Renal Transplantation specialist. The procedure is performed under general anesthesia and lasts about 3 to 4 hours.
The doctor will
Make an incision in the lower abdomen to gain access to the kidneys.
If existing kidneys are causing complications, they are removed else they are left in place.
New kidney will be placed and blood vessels will be to it.
Ureter of the new kidney will be connected to the urinary bladder.
The incision is sutured.
The doctor generally recommends the following post procedure
Limit the intake of salts, proteins and sugar
Avoid lifting heavy objects for a few weeks until your incisions are healed completely.
Bath in a bathtub, jacuzzi or swimming in a pool is forbidden for 15 days after the operation as it can cause infection.
Recovery time depends on the patient’s health and the method of surgery used. Open surgery causing a large incision generally takes about 8 weeks to recover. In case of a laparoscopic surgery involving small incisions, the recovery period is about 4 weeks.
Life after surgery
The patient can lead a normal and healthy life even after surgery. However, patients need to take care of their transplanted kidney and the following points need to be kept in mind:
No smoking - Smoking doubles the risk of a kidney failure.
Stop alcohol and drug abuse - Alcohol being high in calories causes weight gain. Drugs, on the other hand lead to a drastic increase in the blood pressure. Both cause serious damage to the kidney.
Although the dietary restrictions are not much, a few changes in the diet are advised. In order to control your weight and blood sugar level, avoid foods high in sugar and fat content.
Intake of salt should be limited, as high levels of sodium can increase your blood pressure.
Taking 5-6 small meal servings unlike the conventional heavy 3 meals is also advised.
Low-fat dairy products should be consumed to maintain the desired calcium and phosphorus levels.
The diet should be rich in fiber content.
The intake of water should be kept more than 7-8 glasses in a day to keep the body hydrated.
Regular kidney function tests should be performed to make sure that the transplanted kidney is functioning properly in the body.
Risk and Complications
Complications of renal transplant:
Rejection - in this case the immunity system of the body identifies the new transplanted kidney as a foreign object or an invader and hence rejects it. This can cause serious damage to the kidney. Immuno-suppressive medications prevent the risk and rate of rejection.
Infection - Post operation, bacterial infections involving the urinary tract are very common. The immuno-suppressive medications prevent rejection, but leave you at an increased risk for infections. To prevent infection, antibiotics should be taken for the first 3-6 months after your transplant.
Urine Leak - If the bladder becomes full before the incision in the bladder gets healed, the ureter can pull away from the bladder causing the urine to leak out.
High blood pressure - The immuno-suppressive medications might lead to an increase in the blood pressure which in turn may damage your heart and other organs. Additional medicines might have to be taken to control the blood pressure.
Diabetes - Some immuno-suppressive medications can also increase the blood sugar level in the body. Proper diet and adequate exercise can help in maintaining optimum blood sugar level.
Kidney stones - Sometimes kidney stones get transplanted along with the donor kidney. This calls for kidney stone treatment.
The donor source for a kidney can be either living or dead.
1. Living Donor
Any individual between 18-60 years of age can be a donor. Donors don’t need to be genetically related. All that is required is a perfect match between the kidneys of the donor and the recipient.
Besides this, the blood group and the tissue type of the donor and the recipient should be compatible and all cross match tests should be negative.
In case the blood group and the tissue type are incompatible, then kidney exchange, also known as Paired Donation is done where in the donor and the recipient are paired with another donor and recipient who too are incompatible with each other.
2. Deceased Donor
Deceased Donors can be classified into two categories:
1. Brain-dead Donors and
2. Donation after Cardiac Death donors
A Brain-dead/Beating-heart donor’s heart pumps blood to maintain the circulation. This helps surgeons to operate while blood is being delivered to the rest of the body. “Donation after Cardiac Death” donors are operated immediately after death to recover the organ.
Legal documentation is required for both the donor and recipient.
If a recipient is unable to find or get a donor, he/she must seek immediate help from the authorized organizations that collect and curate data about potential donors by registering himself/herself with the respective organization. Such organizations can help the recipient find a suitable donor within the stipulated time frame.
Though in a majority of cases the donor might go on to lead a healthy life, there can be a few complications in some circumstances. The living donor might suffer from side effects, which include internal bleeding, chronic pain, hernia, hypertension, cardiac problems, infections, obesity, nerve damage and pancreatitis.
The cost of a kidney transplant surgery ranges from INR 5,00,000 to 7,00,000 in Indian hospitals, depending on the procedure to be carried out and the availability of kidney donor.
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