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Kidney transplant

Surgical procedure to implant a healthy kidney into a patient with kidney disease or kidney failure. The kidney transplant may be taken from a living donor or a recently deceased donor.
Alternative names
renal transplant; transplant of the kidney
Kidney transplants are the second (corneal transplant is number 1) most common transplant operation in the United States (over 9,000 cases per year). The operation is easier than all other major organ transplants. The patient can be treated with dialysis (to filter the blood and remove fluid and waste products) until a kidney donor can be found.

The healthy kidney is obtained from a living donor (usually a blood relative) or from a donor that has recently died but has not suffered kidney injury. Transportation of the healthy kidney is done in a cooled saline solution that preserves the organ up to 48 hours, permitting the necessary analyses to determine blood and tissue donor-recipient matching (this matching, in some cases, is done before the operation).

Living donors: (donates kidney):
While the patient is deep asleep and pain-free (general anesthesia), an incision is made in the side of the abdomen (flank). The kidney is removed and the incision is closed.

Kidney recipient (receives kidney):
While the patient is deep asleep and pain-free (general anesthesia), an incision is made in the lower abdomen. The new kidney is stitched into place within the pelvis and the incision is closed.
Kidney transplant may be recommended for patients with kidney failure caused by:
  • severe, uncontrollable high blood pressure (hypertension)
  • infections
  • diabetes mellitus

Kidney transplant is not recommended for patients who have:

  • heart, lung, or liver disease
  • other life-threatening diseases
  • an infection (such as TB or osteomyelitis)
  • difficulty taking medications several times each day for the rest of their lives
Expectations after surgery
Kidney transplants require life-long treatment with medications that suppress the immune response (immunosuppressive therapy). Transplants from a blood-related living donor are considered a slightly better risk (in terms of avoiding rejection) than from a cadaver (nonliving donor). Between 80% and 90% of transplanted kidneys are functioning two years after the operation. The main problem (as with other transplants) is graft rejection.

The patient is encouraged to resume normal activities as soon as possible after surgery.(In my hospital the opposite was encouraged,to do as little as possible for 3 to 4 months)

The major obstacle for kidney transplants is the problem in finding a donor, fighting the rejection effect, and cost.
The recovery period averages 1 month. The average hospital stay is 1 week(in Belgium it's minimum 10 days). The sutures or clips are removed about one week after surgery.(again here only after 4 weeks)Move the legs often to reduce the risk of deep venous thrombosis.
Risks for any anesthesia are:
  • reactions to medications
  • problems breathing

Risks for any surgery are:

  • bleeding
  • infection

Additional risks include:

  • infection due to the immunosuppressive medications that must be taken to prevent transplant rejections



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