Kidney Transplant

Kidney transplant (renal transplant) is a surgical procedure that involves the removal of a healthy kidney from a donor, and transplanting it to a kidney patient (recipient). (Note: A donor could be either living or deceased.)

Patients with end stage renal disease (ESRD) are normally the candidates who require a kidney transplant.

End stage renal disease is the most severe form of renal (kidney) failure. At this stage, the kidneys are not able to perform their functions.

This can result in accumulation of toxins and excess fluids in the body. Other crucial kidney functions, such as the production of red blood cells, are also affected.

Without regular dialysis or a renal transplant, this condition is fatal. Once it has been determined that a patient is in need of a transplant, a suitable donor must be located.

Pre Kidney Transplant Considerations

If a transplant is a patient's best treatment option, they should discuss the entire process with their doctor. Any questions or concerns should be raised and addressed by the patient's primary healthcare provider. If after consulting with his or her doctor a patient still has concerns, they should seek a second opinion.

A successful renal transplant is only possible if the blood and tissue profiles of the donor and recipient are compatible. The first step in the process should involve some tests to determine the blood and tissue profile of the patient (potential recipient), which must be used to compare with that of any potential donor or donors. This will help to ensure that both donor and recipient have similar blood and tissue profiles, and thus minimize the risk of rejection of the transplanted kidney, by the recipient's immune system.

The next step is to locate a kidney donor or a donated kidney. The search for a kidney donor or a donated kidney can be extremely frustrating and time consuming. First, once a patient has been recommended for a kidney transplant, his or her name should be placed on the renal transplant waiting list. This list can be extremely long, since the demand for kidneys far outweighs the supply. In some places it may be possible to be placed on more than one waiting list, at different institutions. Patients should discuss this possibility with their doctor.

The kidney is the most sought after organ in the entire world. Statistics from the World Health Organization (WHO) indicate that there are just over 100,000 solid organ transplants performed every year, worldwide. Of this figure, approximately 69,400 are renal transplants, 20,200 are liver transplants, 5,400 are heart transplants, 3,400 are lung transplants and 2,400 are pancreas transplants.

Globally, kidney transplants account for almost 69% of all solid organ transplants.

Unbelievably, the current annual number of renal transplants only represents a mere 10% of the estimated global need. In other words, the estimated annual global need for kidney transplants is close to 690,000!

Finding a donor is not always easy. The first challenge is to find a willing donor. In most cases, a patient's family members or their close friends are the best prospects for finding a donor.

But simply finding a willing donor is no guarantee that a kidney transplant will be possible. The blood and tissue profiles of both donor and recipient must be compatible. Once a family member or close friend is willing to become a donor, they should be examined to determine if they are a suitable candidate.

The problem of incompatibility can sometimes be overcome by swapping donors. If for example, a patient in the United States finds a willing donor whose blood and tissue profile is not compatible with their own, and another patient in Canada has a willing donor with incompatible blood and tissue profile; the donor in Canada can donate a kidney to the American patient and the American donor can donate to the Canadian patient, if their respective profiles match. In other words, donors can switch or exchange recipients. As you can imagine, this will take some coordination and searching. That is why it is important for patients in need of a transplant to register with their local health institution(s), who can help to coordinate such exchanges.

An additional challenge of matching recipient and donor involves the health status of the donor and recipient. Apart from analyzing their respective blood and tissue profiles for compatibility, their health status must also be analyzed. It is not only important for the donor and recipient to have similar blood and tissue profiles, but they must also be healthy enough for a renal transplant surgery.

In order to maximize the chances of a successful kidney transplant, both recipient and donor must fulfill these kidney-transplant criteria.

Once a suitable donor is found and there are no other hindrances, the transplant surgery can proceed.

Both donor and recipient should feel confident about the institution and surgeons, who will be performing the transplant surgery. Patients should do some research to locate a reputable institution, where the transplant surgery can be performed. Be sure to find out about the institution's track record with transplants. Ask about the surgeon or surgeons and their experience in performing transplants. Once a suitable institution is located, discuss the entire procedure with them to ensure that all is in place to minimize delays and misunderstandings.

Post Kidney Transplant Considerations

The greatest concern after a transplant is rejection of the new kidney, by the recipient's immune system. There is always the risk that the recipient's immune system might attack the new kidney. Hence the reason it is important for the donor and the recipient to possess similar blood type and tissues, among other things. This is absolutely vital before a kidney transplant surgery can be performed.

The risk of rejection can be further reduced by the use of medications that suppress the recipient's immune system. This, however, has to be properly managed and monitored, since a depleted immune system poses a risk to the recipient. During the period when the immune system is suppressed, the chances of contracting infections and other diseases are increased. Thankfully, advances in modern medicine have produced medications to minimize these risks.

Patients who are fortunate enough to receive a kidney transplant have an excellent chance of, not only extending their life but also, enjoying a much better quality of life.

Recent studies have indicated that the typical patient will live 10-15 years longer with a kidney transplant than if they stayed on dialysis. Patients tend to have more energy, a less restricted diet, and fewer complications with a transplant, than if they stayed on dialysis. Even professional athletes have made a comeback to their sport after receiving a transplant.

The cases of kidney disease continue to increase, worldwide. The demand for donated kidneys continues to increase. In fact, kidneys top the list of organs in demand by patients awaiting transplants.

Patients who are awaiting a kidney transplant could experience great anxiety, since there is no guarantee they would receive a donated kidney. The demand for kidneys, for transplant purposes, far exceeds the supply.

In spite of the challenges associated with finding a donor, a patient should not lose hope. A patient, who has end stage renal disease and meets the criteria for a renal transplant, should discuss their prognosis with their health care provider.

The keys to help maximize the chances of a successful kidney transplant are planning and perseverance. It is important for the patient to find out as much as possible about the entire process and understand their role and responsibility, as well as the roles and responsibilities of all parties involved.