Organ Donation Day: Life After Kidney Transplant For Donor And Recipient

Do you know that people undergoing transplants have a better quality of life and lower treatment costs than dialysis?

What is a kidney transplant, and who is eligible for the same: A kidney transplant is required when our kidneys cease to function; they lose their ability to remove wastes and filter excess bodily fluids. This loss of kidney function is known as end-stage chronic kidney disease/end-stage renal disease or kidney failure, which can be fatal. When a person reaches stage 5 or end-stage chronic kidney disease, they must undergo dialysis or a kidney transplant, referred to as renal replacement therapy. People undergoing transplants have a better quality of life and lower treatment costs than dialysis.

How Is Life After Kidney Transplant? Explains Dr Manish Jain, Director, Nephrology, Kidney and Urology Institute, Medanta Hospital

How Are The Donor And Recipients Decided In A Kidney Transplant Case?

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The recipient should be in good health to tolerate the surgery. As part of the protocol, we conduct an evaluation to look for medical conditions that may jeopardise the success of transplant surgery. In addition, a recipient must be mentally sound and willing to take the medications regularly.

A donor could be a living or cadaveric donor (brain-dead donors) with functioning organs. They must be related to the recipient. We use DNA analysis to confirm the donor and recipient relationship, followed by blood typing, HLA typing, and tissue matching. A donor should be in good health and be between the ages of 18 and 65. Anyone with diabetes or kidney disease in the past is not eligible for a kidney transplant because it may cause further complications in both the donor and the recipient.

What Are Some Measures They Must Take To Prepare For A Kidney Transplant?

At first, we must select a donor who should be a family donor or a related donor. Post that, adequate haemodialysis should be done before the surgery on the recipient. In some patients, a transplant takes place for a kidney patient before starting dialysis, known as a pre-emptive transplant. The donor should be infection free, should not have recent blood transfusion history, and should have a gap of at least 4-6 weeks after a blood transfusion as it may interfere with a transplant. If the renal transplant is from any deceased donor, it is essential to get evaluated every three to six months.

Typically, How Long Does It Take To Do A Transplant? And The Whole Procedure?

A kidney transplant surgery usually lasts about 3 to 4 hours. It takes 3 to 4 weeks to evaluate the donor and recipient. Therefore, we admit the patient one or two days before surgery after completing the dialysis. Unless it is an ABO incompatible kidney transplant in which a patient receives medical treatment before and after the kidney transplant to lower antibody levels in your blood and reduce the risk of antibodies rejecting the donor's kidney, the patient should be admitted seven to eight days postoperatively in the hospital. A recipient's total stay is typically ten days, while a donor's stay is approximately 4-5 days.

Often, We Hear That We Can Survive On One Kidney - Can You Elaborate On The Reason Behind The Same?

A person can live everyday life with one kidney, and the healthy kidney grows, resulting in compensatory hypertrophy and can perform up to 70% of the work of two kidneys. People with one kidney should avoid putting too much strain on it and take unnecessary medications on their own. In addition, they should manage their stress and blood pressure and avoid becoming addicted to any substance, including smoking and alcohol. A simple diet, a healthy lifestyle, and regular exercise can also help them live a healthy life with one kidney.

What Happens If The Body Tries To Reject The New Kidney?

Patients must be on immunosuppression after the transplant, suppressing the body's immune system and ability to fight infections and other diseases. Immunosuppression is purposefully induced in recipients' bodies to prevent donor tissue rejection in preparation for a new kidney. The rejection is suspected post-operation when there is an increase in renal functions like serum creatinine. Therefore, a biopsy of the transplanted kidney must be performed immediately to rule out rejection. However, because of improved and advanced immunotherapy, the chances of rejection are reduced, and overall rejection rates are around 10% in the first year of transplant.

There are two kinds of rejection: formal and informal

1) Antibody-mediated rejection- This has a 1-2% occurrence rate but can lead to severe rejection and graft dysfunction.

2) T cell-mediated rejection, which is typically around 5% and is manageable

How Long Does It Take For The Recipient To Recover From A Kidney Transplant?

Post-transplantation care is frequently required. The recipient is kept under supervision for the first month after the transplant and is advised to come in for follow-up appointments twice a week. After that, they must come once a week in the second month. After four weeks, we usually see them once or twice a month, depending on the patient's condition. If the patient experiences complications, they should consult with their nephrologist and have blood tests performed to determine the cause.

What Is The Hospital Stay Of A Kidney Donor And Recipient?

  • A donor must stay in the hospital for three to four days following surgery. After being discharged, they can return to work and live an everyday life for two weeks. They should exercise caution when lifting anything heavy.
  • A recipient must stay in the hospital for seven to eight days, for a total of ten days. For the first month, they must have blood tests every two weeks. Then we do it once a week for the next month, every 15 days for the third month, and once a month after that.

What Precautions To Take Post-Transplant To Lead A Healthy Life?

Patients should take their medications regularly and at regular intervals. Even if they cannot visit, they should maintain contact with their nephrologist. Initially, they should consume freshly prepared foods and fluids. They should avoid covering crowded areas and should wear masks. They should practise good personal hygiene and refrain from self-medicate. They should contact their nephrologist immediately if they experience nausea, fatigue, or fever.

What's The Average Wait For A Kidney Transplant?

A kidney transplant occurs much faster when one has found a potential living donor. The average wait time for a living donor kidney transplant is 3-6 months. Therefore, receiving a kidney from a living donor is significantly faster than receiving a kidney from a deceased donor.

What Are The Chances Of Donated Kidney Damage After The Transplant?

We perform a thorough evaluation of the kidney before transplant and do not accept a diabetic kidney or one from a donor with any comorbid condition. This is because there's a slim chance that the kidney will be damaged again.

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