Kidney Transplantation – things I should know !!

Living donor kidney transplantation is a surgical procedure. During the surgery a healthy kidney is donated by a living person to someone with end-stage renal disease or kidney failure. This type of transplantation has several advantages, including better outcomes and shorter waiting times compared to deceased donor transplants. Here is some basic information about living donor kidney transplants:

Position of the Transplanted kidney in the recipient.

1. Advantages:
   • Better Outcomes: Living donor kidneys usually function better and last longer than deceased donor kidneys.
   • Shorter Waiting Times: Living donor transplants can be scheduled in advance. This reducing the time the recipient spends on the transplant waiting list.
2. Donor Eligibility:
   • Donors must be in good overall health.
   • They undergo a thorough medical evaluation to ensure compatibility and assess any potential risks.
   • Age – should be an adult, to understand and volunteer for the donation.
3. Recipient Evaluation:
   • The recipient also undergoes a comprehensive evaluation to assess their suitability for a transplant.
   • Blood typing establishes compatibility between donor and recipient.
4. Types of Living Donors:
   • Biologically Related: Family members such as parents, siblings, children, or other blood relatives.
   • Unrelated, but with a Close Relationship: Friends, co-workers, or in-laws after approval from the authorized commitee.
   • Altruistic or Non-Directed Donors: Individuals who choose to donate without a specific recipient in mind after approval from the authorized commitee.
5. Surgery:
   • Living donor kidney transplantation involves a surgical procedure for both the donor and the recipient.
   • The donated kidney is attached at the recipient’s lower abdomen.
   • The remaining kidney in the donor typically compensates for the loss of the donated kidney.
6. Post-Transplant Care:
   • Both the donor and recipient will undergo a period of recovery following the surgery.
   • Regular follow-up appointments are essential to monitor the health of both individuals.
7. Psychosocial Support:
   • Living donor transplantation involves emotional and psychological aspects for both the donor and recipient.
   • Transplant centers often provide counseling and support services.
8. Paired Exchange and Advanced Donation Programs:
   • Paired exchange programs allow incompatible donor-recipient pairs to exchange kidneys with another pair to find compatible matches.
   • Advanced donation programs involve a person donating a kidney in advance without a specific recipient in mind.

The Procedure :

The surgery typically lasts 3-4 hours. The donor kidney is placed in the lower abdomen, and the existing kidneys are usually left in place unless they pose a threat due to infection or high blood pressure. Once connected to the blood vessels and bladder, the transplanted kidney should start functioning soon after the surgery.

Post-Surgery Care and Medications :

After surgery, monitoring and medications become a key part of life. Anti-rejection medications, known as immunosuppressants, help prevent your immune system from attacking the new kidney. Regular follow-ups with your healthcare team are crucial to monitor kidney function, medication side effects, and any signs of infection or rejection.

Risks and Complications :

As with any major surgery, kidney transplantation comes with risks:

• Rejection: Your immune system might see the new kidney as foreign and attack it.
• Infection: Immunosuppressive drugs can make you more vulnerable to infections.
• Other Complications: Blood clots, bleeding, or problems with the connection between blood vessels are also potential risks

Living donor kidney transplantation is a life-saving and transformative procedure. Kidney transplant offer a better quality of life for recipients and the opportunity for donors to make a significant and positive impact on someone else’s life. It’s important for both donors and recipients to have a thorough understanding of the process, including potential risks and benefits.

Dr. Suhas Mondhe, MBBS, DNB Medicine, DNB Nephrology, DRCPSC, is a consultant nephrologist and transplant physician in Baner, Pune.

He specializes in treating complex kidney issues, including hemodialysis, catheter placements, and kidney biopsies, with a caring and patient-centered approach.