What is a Kidney?
The Kidneys are pear shaped digestive organs located in the upper abdomen which play a key role in bodily functions. Their main functions are blood filtering and getting rid of bodily waste thereby balancing the electrolyte levels in the body. The kidneys are also vital for controlling blood pressure and stimulating the production of red blood cells. The kidneys are located in the abdomen, one on each side of the spine. Kidneys get their blood supply through the renal arteries directly from the aorta and send blood back to the heart via the renal veins to the vena cava.
The transplant itself is a surgical process where the surgeon places the new kidney in your abdomen and attaches it to the artery that supplied blood to one of your kidneys and to the vein carrying blood away from the kidney. The ureter is attached to the kidney, which carries urine from the kidney to the bladder.
What is a Kidney Transplant ?
Replacement of diseased or non-working kidneys with a healthy kidney from a living or brain dead donor. One can live long with one kidney also if it is functioning properly. It is for the patients who has end stage renal disease. The Kidney transplant surgeries are of two types :
- Living Donor Kidney Transplant Surgery : The kidney is taken from a close family member or spouse who is compatible and willing to donate. Thorough examination of the donor is done before accepting a candidate.
- Cadaveric or Deceased Donor Kidney Transplant Surgery : In this the kidney is taken from a brain-dead person and the family members have consented to donate their organs. Extensive blood tests are done on both donor and recipient.
Types of Kidney Diseases
The process which reduces the functioning of the kidneys is called as ‘kidney disease’. There are two types of kidney diseases- acute kidney disease where damage is sudden revealing the symptoms quickly and the other is chronic kidney disease where the decline in the kidney function is slow and progressive. The different types of kidney diseases are :
- Kidney cancer
- Early kidney failure
- Chronic renal insufficiency
- Hyperfiltration (Stage 1)
- Mild microalbuminuria ( Stage 2 )
- Clinical albuminuria ( Stage 3)
- Advanced clinical nephropathy (Stage 4)
- Kidney failure (Stage 5)
- Diabetic nephropathy
Causes of Kidney Diseases
- Diabetes mellitus, which damages small blood vessels in your body and makes it difficult for the kidneys to function properly
- High blood pressure or hypertension if left untreated will damage the glomeruli which filters waste from the body.
- Glomerulonephritis causes your kidneys to leak red blood cells into your urine.
- Polycystic Kidney disease caused by clusters of fluid-filled cysts and develops in the kidneys.
- Renovascular disease which causes decreased blood flow to the kidneys.
- Chronic Pyelonephritis causes by repeated episodes of urinary tract infections.
- Systemic Lupus erythematosus where body mistakenly attacks own kidney tissues.
- Obstructive Nephropathy is a blockage of urine causing damage to kidneys.
- Analgesic Nephropathy and Drugs cause kidney damage when over medications quantities are taken.
Diagnostic tests for kidney disease are blood tests, urine tests, measuring kidney function, imaging tests and kidney biopsy.
Types of Kidney Treatments
- Acute Kidney Diseases Treatment : Treatment depends partly on the causes and extent of the failure. The first major goal is to know the exact cause of kidney failure and the other one is the degree to which the accumulating wastes and water are affecting the body. These two points will decide the treatments required.
- Chronic Kidney Diseases Treatment : The goal is to prevent or slow down additional damage to the kidneys. The most important point is to control the disease that is causing it. For a diabetic patient, the doctor will plan to treat and manage the condition to help and slow down additional damage of the kidneys. The doctor will also check for other conditions that may cause kidney damage including a blockage in the urinary tract or overdose of medicines.
Kidney Transplant’s Pre-conditions:
- It is preferable that the donor should a first degree family member with the same or compatible blood group. Other relatives can also be considered but with proper documents and DNA typing to support their relationship.
- The donor should be mentally and physically fit
- He/She should be between the age group of 18 and 60 years
- The donot should not be suffering from chronic diseases such as HIV, Severe Hypertension, Hbs Ag, Diabetes etc
- The donor and the attendant should be near relatives.
Necessary Formalities to be completed in India:
Step1: Obtaining No Objection Certificate from the respective embassy in Delhi. Furnish the following documents at the Nigerian Embassy:
- A letter on the hospital’s letter head telling that the patient is undergoing the treatment
- Old medical reports and health records
- A small summary of the case or medical history of the patient (if referred)
- An affidavit from the local government authority stating that the patient and the donor are relatives (mandatory for all Foreign Patients).
- 10 photographs each (patient and donor)
- Salary slip or bank statement of both patient and donor as the Income proof
- The consent from the next of kin of donor on a stamp paper that should carry donor’s and kin’s photograph, duly pasted. In case the donor is a cousin, it is necessary for the next of kin to be present at the Transplant Authorization Committee.
- Birth certificate or marriage certificate etc as proof of relation
Step 2: The patient is required to go to the SDM office along with the donor and the relative for getting the affidavit of donor, attested by him. Following documents are needed at the SDM office:
- A letter on the hospital’s letter head telling that the patient is undergoing the treatment.
- NOC from the Embassy
- Affidavit patient
- Affidavit donor
- Affidavit relative
Step 3: Notary attests the affidavits of the patient and the relative. This takes a time of a day or two.
Step 4: After the affidavits get attested, these documents are taken to the Authorization Committee of the hospital for approval. At the same time, the concerned doctors conduct some important tests on the patient and the donor. All this takes around 2 week’s time.
Kidney transplantation is a procedure that places a healthy kidney from another person into your body. This one new kidney takes over the work of your two failed kidneys.
A surgeon places the new kidney inside your lower abdomen and connects the artery and vein of the new kidney to your artery and vein. Your blood flows through the new kidney, which makes urine, just like your own kidneys did when they were healthy. Unless they are causing infection or high blood pressure, your own kidneys are left in place.
Benefits of Kidney Transplant
A successful kidney transplant can benefit the patient drastically. The patient will be able to get back to its normal lifestyle after the surgery and can go for a normal diet and opt for more fluid intake. After transplant the patient need not to depend on dialysis. Anemia which is a common problem with kidney failure might also be corrected. The success rate depends on the type of organ transplanted, by the number of organs transplanted and the type of disease that caused the organ to fail. For single organ transplants the success rate is 80 % to 90 % of and a 5-10 year survival rate.
Post Transplant Care
Your body's immune system is designed to keep you healthy by sensing "foreign invaders," such as bacteria, and rejecting them. But your immune system will also sense that your new kidney is foreign. To keep your body from rejecting it, you'll have to take drugs that turn off, or suppress, your immune response. You may have to take two or more of these immunosuppressant medicines, as well as medications to treat other health problems. Your health care team will help you learn what each pill is for and when to take it. Be sure that you understand the instructions for taking your medicines before you leave the hospital.
If you've been on hemodialysis, you'll find that your post transplant diet is much less restrictive. You can drink more fluids and eat many of the fruits and vegetables you were previously told to avoid. You may even need to gain a little weight, but be careful not to gain weight too quickly and avoid salty foods that can lead to high blood pressure
You can help prevent rejection by taking your medicines and following your diet, but watching for signs of rejection-like fever or soreness in the area of the new kidney or a change in the amount of urine you make-is important. Report any such changes to your health care team.
Even if you do everything you're supposed to do, your body may still reject the new kidney and you may need to go back on dialysis. Unless your health care team determines that you're no longer a good candidate for transplantation, you can go back on the waiting list for another kidney.
Side Effects of Immunosuppressants
Immunosuppressants can weaken your immune system, which can lead to infections. Some drugs may also change your appearance. Your face may get fuller; you may gain weight or develop acne or facial hair. Not all patients have these problems, though, and diet and makeup can help.
Immunosuppressants work by diminishing the ability of immune cells to function. In some patients, over long periods of time, this diminished immunity can increase the risk of developing cancer. Some immunosuppressants cause cataracts, diabetes, extra stomach acid, high blood pressure, and bone disease. When used over time, these drugs may also cause liver or kidney damage in a few patients.