Transplantation is the implanting of a healthy kidney into a patient. The patient’s own kidneys are usually left in, but in some cases they might be removed before transplantation. Removal of a kidney is called a nephrectomy. A successful transplant returns renal function to near normal and frees the patient from dialysis treatment.
There are two sources of kidneys used in transplants: living donors, either blood relative or unrelated donors, and nonliving (cadaver) donors. Only one kidney is needed for transplantation since a person can maintain normal health with one well-functioning kidney.
To see how compatible a donor kidney and patient will be, a series of blood tests are performed on both the patient and possible donor to learn their blood and tissue types. This is known as tissue typing and cross matching. If the blood and tissue types aren’t compatible, the transplant will not be done because the patient will reject the transplanted kidney. In addition to tissue typing, a potential living donor has a complete medical review to make sure a good match has been made and that removing a kidney will not have any negative impact on the donor’s health. If a suitable match is made, the patient and donor are then scheduled for surgery.
To obtain a cadaver transplant, patients are put on a waiting list for a kidney at a transplant center or organ bank. The waiting period may be few months to several years. When a kidney becomes available, every patient on the list with a blood type compatible to the cadaver donor has a tissue match done from a blood sample kept on hand at the transplant center or organ bank.
There is always a risk of your body rejecting the transplanted kidney. You may need to take immunosuppressive drugs daily to help control rejection for as long as the transplant works. These medications make you prone to infection and have other side effects. You will be taught the signs of rejection and infection. Your health care provider will monitor the effects of the medication as well as the functioning of the kidney regularly.
The length of time the transplanted kidney works varies. If medications can’t control rejection of the kidney or if the kidney fails to function, you can select a form of dialysis and choose to be placed on the waiting list for another kidney transplant.
Some patients choose transplantation as a treatment option because they don’t want to dialyze and their diet is less restrictive than a dialysis diet. Also, many medical problems such as anemia, high blood pressure, heart problems, and nerve damage generally improve.