Kidney transplant is a treatment option for individuals who for whom chronic kidney disease (CKD) has progressed to stage 5, also known as end-stage renal disease or kidney failure. At this stage of the disease, the kidneys have lost the majority of their function, making dialysis, and eventually, kidney transplant necessary for survival.
Here we'll go over the basics of the kidney transplant, including when it may be recommended as a treatment option, what factors are involved in deciding whether an individual is a good candidate for this surgery, and what is involved in the transplant process.
When Kidney Transplant Becomes An Option
Kidney transplant is a surgical procedure that replaces a diseased kidney with a healthy donor kidney. It is considered as a treatment option in individuals who are in stage 5 kidney disease, which means that the glomerular filtration rate (GFR) -- the best measure of kidney function -- has deteriorated to 15 ml/min or less, and other treatments to improve kidney function have failed. At this advanced stage of kidney disease, patients generally have two treatment options -- dialysis or transplant. While dialysis can be very effective at maintaining health, kidney transplant can often offer patients a better quality of life and may help them live longer than dialysis alone.
Who Is A Good Candidate For Kidney Transplant
This surgery is not for everyone. To determine whether you're a good candidate for a kidney transplant, you will go through an evaluation process. That process typically starts with your regular doctor, who will be able to tell you whether you have any medical conditions that make transplantation dangerous or unlikely to succeed, such as significant heart or lung disease, cancer, HIV, hepatitis C or other serious infections, among others. If such issues are ruled out, you'll be referred to a transplant center for further evaluation, which may require several visits over a period of several weeks or months. During this process, you'll be tested for blood type and other matching factors and your overall health will be evaluated to determine whether or not you will benefit from kidney transplant.
The Kidney Transplant Process
If you are a good candidate for transplant surgery, the first step in the process is the search for a suitable donor kidney. Donor organs may be obtained from living donors, typically a relative or friend who is willing to donate a kidney and has, after testing, been deemed compatible in terms of blood type and other matching factors, and healthy enough to undergo surgery and make do with one kidney. The other option is a compatible kidney from a person who has died -- a cadaver kidney. If a cadaver kidney is to be used, you'll be placed on a national waiting list for a donor organ. Both, with today's advanced anti-rejection medications, have good success rates, although some studies have shown that transplant patients with living donors may have slightly higher success rates.
Once a donor organ has been located, surgery will be performed. Typically, the new kidney will be placed in the lower abdomen, and connected to veins, arteries and the ureter (the tube that carries urine to the bladder). Your own kidneys, in most cases, will be left in place. Surgery takes about 3 to 4 hours on average, and you'll likely have to remain in the hospital for 7 to 10 days after surgery. You will have to take medications to suppress your immune system for the rest of your life to aid in preventing your body from rejecting your donor organ, and undergo careful and regular medical monitoring and care to maintain kidney and overall health.