What is a kidney transplant?
Kidneys perform many vital functions in your body. When your kidneys get damaged these vital functions get affected. When you get a kidney transplant, a healthy kidney is placed inside your body to do the work your own kidneys can no longer do. It is a safe and only treatment when the kidneys get damaged.
Common Kidney problems
The kidneys are a pair of fist-sized organs located at the bottom of the rib cage. There is one kidney on each side of the spine.
The most common form of kidney disease is chronic kidney disease. Chronic kidney disease is a long-term condition that doesn’t improve over time. It’s commonly caused by high blood pressure.
High blood pressure is dangerous for the kidneys because it can increase the pressure on the glomeruli. Glomeruli are the tiny blood vessels in the kidneys where blood is cleaned. Over time, the increased pressure damages these vessels and kidney function begins to decline.
Kidney function will eventually deteriorate to the point where the kidneys can no longer perform their job properly. In this case, a person would need to go on dialysis. Dialysis filters extra fluid and waste out of the blood. Dialysis can help treat kidney disease but it can’t cure it. A kidney transplant may be another treatment option depending on your circumstances.
Available treatments for kidneys
Prevention is always the goal with kidney failure. Chronic diseases such as hypertension (high blood pressure) and diabetes are devastating because of the damage that they can do to kidneys and other organs. Lifelong diligence is important in keeping blood sugar and blood pressure within normal limits. Specific treatments depend upon the underlying diseases.
Once kidney failure is present, the goal is to prevent further deterioration of renal function. Your nephrologists must have already put you on dialysis. While dialysis will help you from the side effects of malfunctioning of kidneys, it is not a cure. Your kidneys will never become like they were before. If ignored, the kidneys will progress to complete failure, but if underlying illnesses are addressed and treated aggressively, kidney function can be preserved, though not always improved.
Steps to Get A Kidney Transplant
Kidney transplant is a serious intervention, from finding a donor to getting a pre-transplant evaluation completed and being registered with a transplant center is a very demanding process. You will have to make several trips to the transplant hospital. Be prepared to take time off from work. Depending on your health condition this may take any thing between a week to a month.
Finding the Donor with a Good Match
If you have some one in your family who is ready to donate for you, please explore that option first. A living donor transplant can be planned for well in time and relieve you of the uncertainty of waiting for a brain dead donor. It will also save you from suffering complications that may develop as your kidneys continue to deterioriate while waiting for an organ donor. If there is no suiatble living donor available, registr to get an organ without losing time. Finding a donor by itself is not good enough, the donor kidney should be a good match for you.
Conditions for Matching a Donor
Living or deceased, for a kidney transplant, matching a donor has stringent conditions.
Blood Type Testing
The first test establishes the blood type. There are four blood types: A, B, AB, and O. Everyone fits into one of these inherited groups. The recipient and donor should have either the same blood type or compatible ones, unless there is an urgency to go in for ABO incompatible donor.
The second test, which is a blood test for human leukocyte antigens (HLA), is called tissue typing. Antigens are markers found on many cells of the body that distinguish each individual as unique. These markers are inherited from the parents. Both recipients and any potential donors have tissue typing performed during the evaluation process.
To receive a kidney where recipient’s markers and the donor’s markers all are the same is a “perfect match” kidney. Perfect match transplants have the best chance of working for many years. Most perfect match kidney transplants come from siblings.
Although tissue typing is done despite partial or absent HLA match with some degree of “mismatch” between the recipient and donor.
Throughout life, the body makes substances called antibodies that act to destroy foreign materials. Individuals may make antibodies each time there is an infection, or pregnancy, or have a blood transfusion, or undergo a kidney transplant. If there are antibodies to the donor kidney, the body may destroy the kidney. For this reason, when a donor kidney is available, a test called a crossmatch is done to ensure the you, the recipient does not have pre-formed antibodies to the donor.
The crossmatch is done by mixing the recipient’s blood with cells from the donor. If the crossmatch is positive, it means that there are antibodies against the donor. The recipient should not receive this particular kidney unless a special treatment is done before transplantation to reduce the antibody levels. If the crossmatch is negative, it means the recipient does not have antibodies to the donor and that they are eligible to receive this kidney.
Crossmatches are performed several times during preparation for a living donor transplant, and a final crossmatch is performed within 48 hours before this type of transplant.
Health Checkups for Pre-transplant Evaluation
The transplant doctors want to ensure that you get a good matching donor and that you do not suffer any adverse effects during or after the transplant. So they will do many tests on you.
Testing is also done for viruses, such as HIV (human immunodeficiency virus), hepatitis, and CMV (cytomegalovirus) to select the proper preventive medications after transplant. These viruses are checked in any potential donor to help prevent spreading disease to the recipient.
You the recipient undergo testing to ensure the safety of the operation and the ability to tolerate the anti-rejection medication necessary after transplantation. The exact number and type of tests vary by age, gender, cause of renal disease, and other ailments that you may have. In general you will be screened for :-
• General Health Maintenance: general metabolic laboratory tests, coagulation studies, complete blood count, colonoscopy, pap smear and mammogram (women) and prostate (men)
• Cardiovascular Evaluation: electrocardiogram, stress test, echocardiogram, cardiac catheterization
• Pulmonary Evaluation: chest x-ray, spirometry
You will undergo ultrasound investigation and your doctors may ask you to get a CT scan or an MRI done. Please follow the instructions given by your transplant center. If they find any abnormal conditions, they will first treat you for that and only then a transplant will be performed.