Transplantation

What is kidney transplantation?

Many patients with chronic kidney disease are suitable candidates for transplantation, but not everyone is. So if you would like to explore transplantation as a treatment option, the first step is to discuss your personal situation with your nephrologist. He or she will evaluate a number of aspects of your overall health and kidney condition before making a recommendation for you.

If your nephrologist concludes you are a good candidate, you will need to complete the necessary examinations and tests. Then your doctor can place you on the national transplant list to receive a kidney from a deceased individual, or find a compatible live donor.

Compatibility is key

For successful transplantation, the recipient and the donor must be compatible with each other. This means that both parties have a compatible blood type and matching tissue, which lowers the risk of the recipient’s body rejecting the donor kidney. Prior to the operation, a range of laboratory tests will be done to verify compatibility.

Receiving a kidney

There are two ways to get a donor kidney: from a living person or a deceased donor. Living donors tend to be someone in your family – one of your parents or a sibling – or someone close to you like a friend or spouse.

The main advantage of receiving a kidney from a living person is the time saved. As soon as you find someone who is compatible with you and willing to donate, the transplantation process can begin.

Deciding to donate a kidney requires careful thought and consideration. The donor should be aware of the risks associated with the operation to remove the healthy kidney and know that monitoring is required post-operation to ensure that the remaining kidney is adequately filtering out the body’s wastes.

In contrast, receiving a deceased donor kidney, which usually originates from someone who died in an accident, requires patience.

After placing your name on the national transplant waiting list, there is no rule about how much time will pass before a matching donor kidney will become available.

Occasionally the wait is short. But realistically you may wait for a few years – though the average waiting times differ from country to country.

In the operating theatre

After you have a donor kidney, the next step is surgery. Because organs are very sensitive, surgery must happen as soon as possible after a kidney becomes available. If you are on the waiting list, you will have a kidney-alert when a suitable kidney arrives, so be sure you are easily reachable under your contact number at all times.

After a final check to ensure the kidney is OK, the operation can begin. As long as your own kidneys are not causing an infection, your surgeon will typically opt to leave them in. Your new healthy kidney is simply placed next to them in your abdomen and joined to your artery and vein. This allows blood to start passing through and your body can begin producing urine.

Possible complications

Part of making an informed decision about transplantation is knowing about the potential risks. Receiving a donor kidney is associated with three primary concerns: rejection, functionality, and organ lifespan.

After the transplant, you will need to take certain medications, including immunosuppressants that reduce the risk of rejection. It’s essential for you to take all medications your nephrologist prescribes you to reduce this risk to an absolute minimum. However, because these drugs suppress your immune system, it’s essential for you to really take care of yourself after the operation.

In terms of functionality, some donor kidneys begin working immediately while others take a few days. If you fall into the latter group, you may require dialysis until your new kidney functions normally. This is common and is not an immediate reason to worry about the transplant’s success.

Finally, on average a donor kidney lasts for 10-15 years. This is because the kidney function slowly decreases over time. Thereafter, you always have the option of going back on dialysis or trying to find a second donor kidney either via live donation or the national transplantation list.

While complications can happen, try not to worry about them beforehand. Your nephrologist will give you the best possible treatment before, during and after transplantation, and you should address any specific questions or concerns you have with him.

Making the right choice

Transplantation is a highly personal topic – one that you should give both time and thought to. Perhaps begin by speaking to your nephrologist about your own situation. If you both agree that transplantation is an option, you can always place yourself on the list if you don’t have a living donor, and give the decision more thought while you wait.

Speaking to others about the pros and cons of transplantation could help you reach a decision.

In the meantime, know that you have the full support of the NephroCare team. No matter what, we will always be there to provide the best quality dialysis care – if, when and where you need us. We also offer our patients assistance and advice related to transplantation.

In our patient stories section you can also read the story of a Hungarian patient who had transplantation and shares his experience with us.