Kidney_Transplant_Understanding_the_Risks_Complications_and_Recovery_Process

Kidney Transplant: Understanding The Risks, Complications And Recovery Process

An Overview

High blood pressure, diabetes, kidney stones and other health issues along with advancing age can aggravate kidney failure. When a person’s kidneys cannot function properly anymore, doctors may recommend a kidney transplant. This is a surgery to replace a non-functional organ with a healthy one. A healthy kidney may be obtained from a living or deceased donor.

The main function of the kidneys is to filter and eliminate waste, fluid and minerals from the blood via the production of urine. When a person’s kidneys lose their filtration ability, harmful levels of waste, fluid and other toxins accumulate in the body. This can raise blood pressure and lead to kidney failure or end-stage renal disease (ESRD), which happens when the kidneys lose around 90% of their normal functioning ability.

Some common causes of ESRD include diabetes, chronic, uncontrolled high BP and polycystic kidney disease. To stay alive, people with ESRD must have waste removed from their bloodstream through dialysis (by using a machine) or via a kidney transplant. Against a lifetime on dialysis, many people prefer a kidney transplant to treat ESRD, which makes them feel better and live longer. Unlike dialysis, it also has a lower risk of death, lower cost of treatment and fewer dietary restrictions.

Living-donor kidney transplantation is an option since only one donated kidney is necessary to replace two failed organs. If no compatible living donor is available, the prospective recipient’s name will be placed on a waiting list for a kidney from a deceased donor. The wait time could vary from several months to years, depending on how soon a suitable match is found.

 

Some Attendant Risks

Do note that this surgery is not a cure and some types of kidney disease could return after the transplant. Also, health risks related to kidney transplants include those directly linked with the surgery and donor organ rejection. The other risks are the side effects of anti-rejection drugs (immunosuppressants) required to prevent the body from rejecting the donor kidney. Therefore, the potential recipient needs to carefully consider all these aspects before opting for a kidney transplant.

 

Possibility of Complications

There are also risks of significant complications such as blood clots and bleeding; infection; blockage of or leakage from the tube that links the kidney to the ureter or bladder; rejection or failure of the donated kidney; cancer or infection that could be transmitted by the donated kidney; stroke, heart attack and death; and the side effects of anti-rejection medications.

 

After a kidney transplant, one needs to take medications to help prevent the body from rejecting the donated kidney. These immunosuppressant medications could cause various side effects such as bone damage and blood thinning; diabetes; high cholesterol; high blood pressure; and excessive hair loss or hair growth. 

 

Evaluation of Eligibility and General Criteria

Once a person has decided on a kidney surgery and selected the transplant centre or hospital, he/she will be evaluated to determine whether the eligibility criteria for a transplant have been met. The transplant centre’s medical team will assess if the person:

• Is healthy enough to undergo the surgery and tolerate lifelong medications after transplant
• Has no medical condition(s) that can interfere with the success of the transplant

 

The evaluation process could take several days. It may include a thorough physical examination; blood tests; imaging studies, such as an X-ray, CT scans or MRI; psychological evaluation; and any other tests deemed necessary by the doctor in charge.

 

The general criteria for accepting a person as a kidney transplant recipient could be:

• Having end-stage renal failure and being on dialysis
• Late-stage chronic kidney disease that is approaching the need for dialysis
• A life expectancy of a minimum of five years
• A proper understanding of post-operative care and instructions

 

However, a kidney transplant may be risky for certain people with kidney failure. Kidney transplant eligibility can be denied due to advancing age, severe heart disease, recently treated or active cancer, dementia or inadequately controlled mental illness, alcohol or drug abuse, recurring infection and other factors that may affect a person’s ability to undergo the procedure safely and take the required medications to prevent organ rejection.

 

Potential Kidney Donors

Although most kidney transplant recipients may be between 45 and 65 years old, there is no upper age limit. To ensure the best results, the hospital will most likely seek a donor who falls in an age group closer to that of the patient.

A recipient’s immediate family members, spouse and friends could qualify as kidney donors. The kidneys of deceased donors are from those people who had elected to donate their organs after death. To ensure a proper match, potential kidney donors will be screened carefully. In this way, unnecessary complications are prevented.

 

Understanding the Procedure and Allied Issues

During the kidney transplant, a donor kidney will be placed in the recipient’s lower abdomen. The recipient’s own kidneys won’t be removed unless they are causing problems.

Kidney transplant surgery could, on average, take between two to four hours. Thereafter, the recipient may need to spend around three days in the hospital. This helps the medical team keep a close eye on the person to make certain he/she is recovering well.

The transplanted kidney may begin working immediately. Or the recipient may need to take dialysis temporarily until it begins working, which could sometimes take several days or even weeks. During this period, the recipient will keep taking immunosuppressant medications to ascertain the immune system does not reject the newly transplanted kidney.

 

Kidney Transplant Benefits

Typically, kidneys taken from a living person last longer than those from a deceased individual. A transplanted kidney from a living donor could last between 12 and 20 years while that from a deceased donor around eight to 12 years. Note that a person could receive more than one kidney transplant during his/her lifetime.

A successful kidney transplant recipient will feel increased energy, strength and stamina. Once the person returns to a normal routine, he/she can enjoy an unrestricted diet and fluid intake. Those with hypertension could need fewer blood pressure medications after the transplant.

 

A Few Precautions

To facilitate faster recovery, some general guidelines must be followed after surgery:

• Avoid any strenuous physical work or lifting heavy objects for at least six to eight weeks.
• Shun driving for at least six weeks. Always use a seat belt when moving in a car.
• Exercise such as stretching and walking is recommended. Jogging, cycling and swimming or playing tennis and golf will help one regain strength once the incision has healed.
• Contact sports must be avoided since this can injure the transplanted kidney. In case of doubt regarding any specific activity, please check with the doctor.
• Stay well-hydrated by drinking at least two litres of water daily.
• Limit caffeine as it’s a weak diuretic that increases dehydration.
• Don’t consume raw or undercooked items as a weakened immune system increases the risk of severe illness.
• Avoid certain herbal supplements and vitamins that can interact with transplant medications. The doctor will guide the recipient about what is safe to use.

 

Most kidney transplant recipients may return to work within a few months after a successful surgery. However, varied aspects of the recovery process may affect this timing.