When does one need a kidney transplant?
All healthy individuals have two functioning kidneys. The kidneys main function is to remove the waste material from the body in the urine. If due to any condition, the kidneys fail and cannot remove waste from the body, which is of permanent nature (also called as End Stage Kidney Disease - ESKD), a kidney transplant is warranted. Dialysis can be offered as a stopgap measure while arrangements for transplant are being made.

Who can donate for a kidney transplant?
Kidneys can be obtained from a living donor or a non-living donor (Cadaveric transplant). For a living donor transplant, the person should be in good health, should have the same blood group as the person receiving the kidney and should not suffer from severe heart, lung or liver disease. Preferably both donor and receipt should also have same HLA matching. In cadaveric transplant, a healthy kidney is obtained from someone who has "died" suddenly (usually following head injury or accidents). These donors are "brain dead".

What is the transplant surgery?
The surgery usually takes about 4 hours. In case of living donor transplant, the surgery on the donor and the patient is done simultaneously in adjoining theatres. The donor's kidney is removed with its blood vessels and put in the recipient and donor's blood vessels are connected to that of the patient. (The patient's original kidneys may be left as they are). Once the transplanted kidney begins to function adequately, the ureter (tube connecting kidney to urinary bladder) of the new kidney is connected to bladder.
      In cadaveric transplant, the kidney is retrieved soon after the patient is pronounced brain dead. The kidneys are preserved in ice upto 48 hours and suitable recipients are identified and called to the hospital for transplant. The surgery is the same as that for a living donor transplant. However, the kidney may not function immediately as the kidney is not transplanted immediately. In these recipients, dialysis may be required for a few days till the kidney starts functioning properly.

What are complications of kidney transplant?
There are 2 major complications that can occur:
1. Rejection of transplanted kidney: The patient's body immune system may recognize the transplanted kidney as a foreign material and reject is leading to failure of transplanted kidney. To prevent it, certain drugs such as cyclosporin, azathioprine, steroids that suppress the immune system are commonly administered. The drugs have to be taken as long as the transplanted kidney functions.
2. Infection: Immunosuppressive drugs lower the patient's body immune function making it prone to infection. These infections must be recognized early are treated promptly.

What is the success rate of kidney transplant?
At 10 years following transplant, 80% to 85% would still have a functioning kidney. It is difficult to state how long a transplanted kidney will last but there are instances where transplanted kidneys have lasted even more than 25 years after transplants.

Last updated on 01-02-2005