Everything about kidney transplants

For a lot of people with a renal disease, it is of vital interest to receive a new kidney. The moment a donor kidney has been found, the kidney transplant will take place. In this article you can read everything about kidney transplantations.

Indications for a kidney transplant

There are several indications for a person to be put on a waiting list for kidney transplantation. Shown by figures from 2010, most common on the waiting list is terminal kidney insufficiency. Terminal kidney insufficiency can be the result of chronic glomerulonephritis, but several other causes are possible. Every year, more and more people end up on a waiting list for a new kidney. Humans do need a kidney to survive! If both kidneys stop functioning, the person will eventually die.

Today, kidney patients' lives can be extended through kidney dialysis. With this dialysis, the function of the kidney is taken over by an external device.

How to find a donor kidney

Doctors will try to find a kidney with the least chance of rejection from the patients body. Because this process is very slow, it's understandable that there are so many patients on the waiting list for a new kidney. It's preferred to use a kidney from an identical twin brother or sister, but even the patients' parents and regular brothers or sisters will be examined. When one of the relatives (usually still alive) has a suitable kidney, this can cause a lot of problems. These problems will mainly present themselves in ethical and emotional fields.

Yet, only a few transplants are done with kidneys from relatives. Most kidneys are obtained from people who are not related. The majority of these donors died in a traffic accident.

A kidney, once it's been taken out of a human body, can be preserved in two ways.

• The kidney is flushed with an electrolyte sollution of 4 degrees celcius. It can be stored for 24 hours.
• If one needs to store it for more than 24 hours, another technique must be applied.

In the second case, a perfusion device will be used. This device guarantees the bloodflow through the kidney out of the body, to keep it intact. However, because of it's high costs, this method is not used very often. Another reason not to use this method is because of the deficit of donor kidneys. Every deceased person can donate his kidney to anyone on the waiting list. Because of the high amount of waiting patients, it's not hard to find a suitable new body for every donor kidney.

Transplantation of the kidney in a new body

To transplant a donor kidney in a new body, two operations are needed. At first, the kidney has to be removed from the donor's body. One of the receiving patients from the waiting list will undergo the second operation. At this moment the kidney will be planted into the body of its new owner.

During this surgery, the kidney will be installed in the pelvic area, behind the peritoneum. Arteries and veins are linked to the pelvic vessels, to provide the kidney with oxygen and nutrients. The donor kidney's ureter is connected to the ureter from the receiving patient. As soon as everything is correctly attached, the operation can be rounded off and the patient can be taken to the intensive care unit.

Follw-up treatment

Treatment doesn't end after the transplant is done. The patient needs after-care. Since his body will see this new kidney as an intruder, it will try to reject it. This rejection will be caused by the immune response, started by the patient's body. Immunosuppressants, including corticosteroids, will be administered to the patient, to reduce the chances of rejection. Because of these drugs, the patient suffers from an impaired immunity, which makes him a lot more sensitive for infections. Even an existing, but hidden infection before surgery, can be an enormous risk.

In spite of all the medical efforts, every patient will have an acute rejection reaction about two months after the transplantation. Mostly, this reaction can be suppressed by a temorary increase of the immunosuppressants. In some cases, the rejection persists and the kidney dies. In that case, the patient again needs to be connected to the dialysis device and added to the waiting list for another transplantation.

Surveys have shown that after a period of five years, 50% of the patients still has their donated kidney. These five years are a relief for them: five years without dialysis, which is both physically and mentally a burden.

Sources: www.todio.nl