What Are the Functions of the Kidneys?
Kidneys are a pair of organs present on either side of the abdomen below the rib cage. They are present in pairs and carry out many vital functions, such as;
-
Purification of the blood to produce urine.
-
Regulates blood pressure through hormones.
Chronic conditions like end-stage renal disease (ESRD) or chronic kidney disease (CKD) can lead to kidney failure to filter the blood. This results in waste product accumulation inside the body, causing kidney failure, which requires dialysis (artificial filtering of the blood outside the body) or kidney transplant as a treatment.
When Is a Kidney Transplant Required?
When the kidneys stop performing their regular functions, kidney failure occurs. This is called end-stage renal disease. To purify the blood, dialysis is required, which is not a sustainable source for filtration. In such cases, where there is a need for continuous dialysis permanently, a kidney transplant can be a healthier option. Some of the criteria where a kidney transplant is required include
-
Pre-dialysis: Some of the studies show that patients who underwent dialysis after a kidney transplant live for a longer time when compared to patients who had dialysis first and then a kidney transplant. So, a kidney transplant is effective and can be indicated before the dialysis procedures.
-
Glomerular Filtration Rate (GFR) Reaches 25: When the patient's glomerular filtration rate reaches 25 and above, it may be the right time for the patient to undergo a kidney transplant. In some cases, people with high GFR may wait for the treatment only to learn about the progression of the disease; in such cases, filtration or dialysis may be indicated.
-
Decline: If the patients observe a progressive decline in their kidney functions and health, they may be indicated with immediate transplant surgery.
-
Before Comorbid Conditions: A kidney transplant can be indicated before the patient may get effects from comorbid conditions like malignancy, uncontrolled infections, or coronary artery disease.
What Is Kidney Transplant Surgery?
A kidney transplant is a surgery in which the donated kidney is placed in the lower abdomen, where it is connected to the urinary bladder. This procedure does not involve removing patients' kidneys; rather, a donated kidney is placed in a new position lower than the position of the original kidneys near the urinary bladder. The new kidney function depends upon the source of the donation. If the donated kidney is from a living donor, it starts working quickly. If it is from a deceased donor, it may require two to four weeks for the kidney to work, and if that happens, dialysis is required till it functions.
Blood matching is required in such a way that there is no mismatch between the donor and recipient.
-
If the recipient's blood type is A, the donor's blood type should be A or O.
-
If the recipient's blood type is B, the donor's blood type should be B or O.
-
If the recipient's blood type is O, the donor's blood type should be O.
-
If the recipient's blood type is AB, the donor's blood type may be A, B, AB, or O.
The AB blood type accepts kidneys from all other blood types, whereas blood type O is the hardest to match since blood type O can donate to all other blood groups and can receive kidneys only from blood type O. And if a patient with blood type O receives a kidney from a donor with blood type A, the body recognizes the donor kidney as foreign and destroys it.
What Is the Procedure for Kidney Transplant Surgery?
-
A kidney transplant surgery is performed under general anesthesia. It is a condition in which a medication is given intravenously to induce sleep during the surgery.
-
After the anesthesia is acquired, an incision is made in the abdomen of the recipient and the donor's kidney.
-
Then a connection is made from the arteries and veins of the body to the arteries and veins of the new kidney.
-
Further, the transplanted kidney’s ureter is attached to the bladder, so urination occurs normally. The urinary bladder is a hollow organ where urine is stored temporarily, and the ureters are a pair of tubes that connect each kidney to the bladder.
-
The original kidneys in the body are removed only when they cause problems, such as high blood pressure or infection.
What Are the Measures to Be Taken After the Kidney Transplant Surgery?
-
Staying in the Hospital: Healthcare professionals may monitor the patient in the kidney transplant recovery area to observe complications after kidney transplant surgery. The individuals may experience pain in the incision site. The patient should avoid lifting heavy loads. It makes kidney transplant recovery faster.
-
Routine Check-Up: The patient should closely observe kidney function after leaving the hospital for a few weeks by attaining routine checkups. Routine follow-up is one of the kidney transplant requirements.
-
Immunosuppressants: These medications help the patient to improve their immune system.
-
Anti-rejection Medications: These medications are prescribed after the surgery to lessen the risk of rejection of the kidney transplant. Daily laboratory findings of urine production are monitored for adjusting anti-rejection transplant medications. Anti-rejection medications include;
-
Anti-inflammatory drugs- Prednisolone.
-
Cytokine inhibitors.
-
Antiproliferative drugs.
-
Antilymphocyte drugs.
-
These medications may have certain side effects like high cholesterol, increased hair loss or growth, weight gain, puffiness, high blood pressure, bone damage, acne, and more.
What Are the Risk Factors Associated With Kidney Transplants?
Rejection of the Transplanted Kidney - There are a few chances of rejection of the transplanted kidney. Still, if it happens even after taking the anti-rejection drugs, the transplanted kidneys need to be removed and should be replaced by a new one.
Other risks include:
-
Bleeding.
-
Blood clots.
-
Infection.
-
Blocked ureter.
-
Urine leakage (urine may leak from the point where the ureter is attached to the kidney).
-
Heart attack.
-
Failure of the donated kidney.
-
Risks with anti-rejection drugs such as the increased risk of infection, cancer, diabetes mellitus, hypertension, weight gain, bone thinning, increased hair growth, acne, and diarrhea.
-
Risks associated with the procedure of surgery.
-
Common infections like colds and urinary tract infections can occur after the transplant surgery, whereas pneumonia is found to be a serious infection and needs medical attention.
Conclusion:
Kidney transplantation serves as a life-saving procedure for many individuals requiring dialysis daily. It is a healthier and more convenient way to have healthy kidneys. Certain anti-rejection drugs and regular checkups after the surgery can enhance the transplanted kidney function. Dietary changes, weight management, and a healthy lifestyle can help the betterment and continuity of the new kidney. Smoking and alcohol consumption should be stopped since it reduces the chances of infection. Medical advice should be taken sooner in case of fever, diarrhea, vomiting, headache, or in case of infection.
