Kidney Transplant – Procedure, Risks & Complications

Dr.Vikas Agarwal, 4 mins read

What is Kidney

The kidneys are a pair of bean shaped organs located just below the rib cage on each side of the spine. The size of each kidney is same as fist. It's important function is to filter and remove waste, minerals and fluid from the blood by producing urine. When your kidneys lose this filtering ability, harmful levels of fluid and waste gets accumulated in your body, which can raise your blood pressure and result in kidney failure which is known as end-stage kidney disease. It occurs when the kidneys have lost about 90% of their ability to function normally. People with the end-stage kidney disease need to have waste removed from their bloodstream through kidney transplant to stay alive. A kidney transplant is a surgical procedure to place a healthy kidney from a living or deceased donor into a patient with end stage kidney disease.

Why is it done?

A kidney transplant can treat chronic kidney disease or end-stage kidney disease to help you feel better and live longer. Kidney transplant surgery is considered safe, and is usually very successful

Compared with dialysis, kidney transplant is associated with:

• * Better quality of life
• * Lower risk of death
• * No dietary restrictions
• * Overall lower treatment cost
• * No work loss

But for certain people with kidney failure, a kidney transplant may be more risky than dialysis. Conditions that may prevent you from being eligible for a kidney transplant include:

• * Advanced age
• * Severe heart disease
• * Active or recently treated cancer
• * Poorly controlled mental illness
• * Alcohol or drug abuse*

Risks

Although rates of serious complications have fallen sharply from last many years, but still kidney transplants are not risk-free.

The risks of a kidney transplant include:

• * risks related to the procedure itself
• * risks related to the use of immunosuppressant medications (which reduce the activity of your immune system)
• * risks related to something going wrong with the transplanted kidney.

There are Short term complications as well as Long term complications

Short term complications

• Infection- Minor infections such as urinary tract infections, colds and flu, are common after kidney transplants. Some serious infection like pneumonia can occur and may require hospital treatment.
• Rejection of kidney- There can be a risk of rejection after a kidney is transplanted in the body. Before it causes any severe damage, the transplant team recognizes and treats it.  The warning symptoms of possible rejection are pains, headaches, dizziness, nausea, tenderness around the kidney, sudden weight gain.
• Narrowing of an artery- Narrowing of the artery connected to the donated  kidney can sometimes occur after a kidney transplant. In few cases, it can occur months, or even years, after the transplant. It can cause rise in Blood pressure. The artery needs to be stretched to widen it, and a small metal tube called a stent may be placed inside the affected artery to stop it narrowing again

• Blocked Ureter- The ureter can get blocked by blood clots after kidney transplant but it can be unblocked by draining it with a small tube called a catheter. But in some cases surgery may be required to unblock the ureter.
• Urine Leakage- Urine may leak from where the ureter joins the bladder after surgery. Leakage can occur after the procedure  during the first month. The fluid can leak through the surgical incision or may build up in the tummy . If you develop a urine leak, you will need to have further surgery to repair it.

Long term complications

nImmunosuppressants prevent your body's immune system from attacking the new kidney, which would cause the transplanted kidney to be rejected. A mixture of 2 or 3 different immunosuppressants is generally taken for a long term. These can cause a wide range of side effects like:

• * an increased risk of infections
• * an increased risk of diabetes
• * high blood pressure
• * weight gain
• * abdominal pain
• * diarrhoea
• * extra hair growth or hair loss
• * swollen gums
• * thinning of the bones
• * acne
• * mood swings
• * an increased risk of certain types of cancer, particularly skin cancer

What to consider before surgery?

• * Costs that will be incurred before, during and after your transplant. Costs contain tests, organ procurement, surgery, hospital stays, and transportation to and from the hospital and follow-up appointments.
• * Other services provided by the transplant center, such as support groups, travel arrangements, local housing for your recovery period and referrals to other resources.
• * The center's commitment to keeping up with the latest transplant technology and techniques

Before procedure

• * Finding a match- A kidney donor can be living or deceased, related to you. So, the transplant team will consider several factors while evaluating whether a donor kidney will be a good match for you like matching age, kidney size and infection exposure. Tests to determine whether a donated kidney may be suitable for you include:

-Blood typing

-Tissue typing

-Crossmatch

• Staying healthy- When your transplant surgery is already scheduled, work to stay healthy. It could help in speedy recovery from surgery. Work to:

-Take your medications as prescribed.

-Follow your diet and exercise guidelines.

-Don't smoke.

-Keep all appointments with your doctor.

-Stay involved in healthy activities.

During procedure

Kidney transplants are performed with general anesthesia, so you're not awake during the procedure. Throughout the procedure your heart rate, blood pressure and blood oxygen level will be monitored by your surgical team.

During the surgery:

• * The surgeon makes an incision in the lower part of one side of your abdomen and places the new kidney into your body. Unless your previous native kidneys are causing complications such as high blood pressure, kidney stones, pain or infection, they are left in place.
• * The blood vessels of the new kidney are attached to blood vessels in the lower part of your abdomen
• * The new kidney's ureter  is connected to your bladder.

After procedure

After your Kidney transplant, you can expect to:

• * Spend several days to a week in the hospital
• * Have frequent checkups as you continue recovering
• * Take medications the rest of your life

Results

After a successful kidney transplant, your new kidney will filter your blood, and you will no longer need dialysis. It is important to take all of your drugs as your physician prescribes. Your body may  reject your new kidney in case you skip your medicines even for a short period of time. Contact your transplant group immediately in case you are having side effects that prevent you  from taking your medicines. After your transplant, skin self-tests and checkups with a dermatologist to display for pores and skin cancer and maintaining your other cancer screening up to date is strongly recommended.