Treating Kidney Failure With Kidney Transplantation
II. Kidney Transplant: An Overview
Kidney transplant is a treatment option for people whose kidneys have failed. As discussed in "An Introduction to the Kidneys and Chronic Kidney Disease" in this series, the kidneys cleanse the body of wastes and excess fluid. Your kidneys also make some important hormones, such as the one that stimulates the production of red blood cells. When your kidneys fail, treatment with hemodialysis, peritoneal dialysis or a kidney transplant is needed to replace important kidney functions. The advantage of a transplant for most people is that it offers the chance to return to a more normal life as well as an improved quality of life.
A kidney transplant is a surgical operation that involves removing a normal functioning kidney from one individual (called the donor) and placing that kidney into another individual (called the recipient) diagnosed as having kidney failure. The operation is a fairly simple one in which the donor kidney is placed in the recipient's right lower abdominal area and the blood vessels of the donor kidney are connected to major blood vessels of the recipient, so that blood can circulate through the transplanted kidney, allowing it to do its work. The ureter (the tube that takes the urine from the kidney to the bladder) of the donor kidney is connected to the recipient's bladder. The surgery usually takes two to four hours. Most people are able to be up and around later the same day or the following day, and are able to begin eating within a day or two. Although each person is different in the recovery from surgery, many people who have a kidney transplant leave the hospital within a week to 10 days.
Two types of donors can be sources of kidneys for transplantation:
- Living Donor: The kidney comes from a living person, usually someone in the recipient's family (blood relative), such as a brother, sister, aunt, uncle, mother father, or cousin. However, other individuals who have a closeemotional tie to the recipient, such as a spouse (husband or wife) or close friend can also be considered as a potential living donor. For more information, click to www.livingdonors.org.
- Non-living Donor: The kidney comes from a person who has been diagnosed as having irreversible brain death as a result of injury or illness. Either the deceased individual's family has given permission for donating the organs at the time of death, or the individual who died indicated his or her wish to be a donor by signing an organ donor card or driver's license, or by discussing it with family members.
Only one new kidney is needed to correct the kidney failure. In general, your own kidneys are not removed unless potential problems could occur if they are left in place. Your doctor will talk to you about what are your best options.
Unfortunately, one main problem, rejection, can interfere with the success of the transplant. This occurs when the body recognizes that the transplanted kidney is different from your own kidneys and tries to reject the new kidney. The tendency toward rejection is the reason why special medications are needed to prevent rejection and help the transplant to be successful in the long-term. These medications, which are called anti-rejection or immunosuppressive medications, must be taken regularly and exactly as they are prescribed. Failure to do this would put your new kidney at risk for rejection, even if it has been working well for a long time. You will also be required to have blood tests drawn at specific times and be followed closely by your doctor.
Research funded by the National Kidney Foundation and other organizations has greatly improved patient and graft outcomes in kidney transplantation. This has been achieved through the development of new anti-rejection medications, which target specific cells (lymphocytes) involved in the body's natural attempt to reject the new kidney. Teamwork between you and your transplant team is important to maintain the right balance of medications needed to keep your new kidney functioning well without contributing to significant short- or long-term complications.
A kidney transplant can fail for a number of reasons. The most common reasons are rejection, either acute and/or chronic, or recurrence of the original kidney disease in the transplant. If your kidney transplant fails, you need to be treated with dialysis. In many cases, you may be eligible to receive another transplant. This decision is made by your doctors and by you and your family.
