Kidney transplant
Around 40 per cent of patients with end-stage renal failure (ESRF) need a transplant which frees people from the need for dialysis treatments.A successful kidney transplant has ten times the function of dialysis (for example ten times the ability to remove toxins and extra water from the blood). It means that transplant patients have a better quality of life, with more energy than they did on dialysis.
But transplant patients must take their medication (to prevent rejection) for life, or for as long as the transplant continues to function. On average, kidneys from deceased donors last ten years and from living donors, about 15 years.
How transplants work
An assessment is necessary to determine whether your body will accept an available kidney. This may require several visits over four to six months, and all potential recipients must be healthy enough for surgery.Although there is no age limit, few units will transplant patients over 70 years - unless very fit.
If a family member, partner or friend wants to donate a kidney, they will need to be evaluated for general health too.
If there is no potential living donor, you will need to register with UK Transplant and be put on a national waiting list to receive a kidney from a deceased donor. The average wait in the UK is three years, but this varies considerably around the country. Kidneys can also be donated by strangers.
If there is a suitable living donor, the operation can be scheduled in advance, when it suits both sides. If you’re on a waiting list for a deceased donor kidney, as soon as it becomes available, you must go to the hospital quickly - where a test is carried out to check the kidney won’t be rejected. If it’s suitable, the transplant can proceed. The operation usually takes three to four hours.
During the operation, the transplant kidney is inserted into the lower abdomen and connected to an artery and vein (to the leg). The blood flows through the new kidney, which makes urine, just like the old kidneys did when they were healthy. The old kidneys are usually left in place.
Often the new kidney will start making urine as soon as blood starts flowing through it, but about one third of patients will require dialysis for around a week. Most patients leave hospital two weeks after the operation.
To prevent the immune system from seeing the new kidney as foreign and rejecting it, you’ll have to take drugs that turn off (or suppress) your immune response (immunosupressants). It’s important to understand the instructions for taking these medicines before leaving hospital, as missing the tablets for just 24 hours can cause rejection and the loss of the kidney.
Care after your transplant
Within reason, you can eat and drink what you want after a transplant, but it’s important not to gain weight too quickly and avoid salty foods that can lead to high blood pressure.Rejection of the kidney normally causes no symptoms, so regular blood tests are essential.
Immunosuppressant drugs can cause several problems, increasing the likelihood of:
Even if tablets are taken carefully, and outpatient appointments attended, your body may still reject the new kidney. If this happens, you can go back on dialysis and back on the waiting list for another kidney. Some patients have two, three or more kidney transplants in their lives.
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