9 things you need to know about Renal Transplantation

Renal transplantation is the process of transplanting the healthy kidney from donor to the recipient who had renal failure by surgery. In this article, we discuss about 9 things that you need to know about kidney or renal transplantation in general and in Nepal.
✍️ Dr. Sumit Acharya, Consultant Nephrologist and Renal transplant Physician, Shahid Dharmabhakta National Transplant Center and Norvic International Hospital

Who needs renal transplantation?

The person who have chronic kidney disease and there kidneys doesn’t do 80 to 85 % of their works then they need renal replacement therapy and renal transplantation is one of them.
What are the alternatives of renal transplantation?
The patients need to do other form of renal replacement therapy in the form of hemodialysis or peritoneal dialysis to sustain their life.
Which is better- dialysis or renal transplantation?
No doubt renal transplantation is better form of renal replacement.
It is naturally made organ from other body so it can do work as of normal kidney unlike artificial dialyzer in hemodialysis.
  • Quality of life will be better
  • Better maintenance of fluid and electrolyte
  • Better freedom in dietary habits
  • No need to go to dialysis center and waste time
  • Better life span
  • Can do his job and earn for living efficiently
Who can’t do kidney transplantation?
Who have:
  • Severe infection
  • Untreatable cancer
  • Not controlled psychiatric illness
  • High level of antibodies in body
Who can donate kidney?
  • Age more than 18 years
  • Relatives according to Nepalese transplant act
  • According to will of family after death and person who had given consent before his death to donate  in case of brain death donation
  • Pair exchange- in case when blood group of relative doesn’t match  then exchange between two family donor whose blood group match can be done.
What are the difficulties in kidney transplantation?
  • Need of surgery
  • Risk of rejection- the body treat donor kidney as foreign object or try to damage it
  • Need to take medicine regularly for life long
  • Chance of infection because medicine which are used will compromise the immune system. Infections are like urinary tract infection, chest infection and causative organisms are viral, bacterial and fungus
What will be the risk to the kidney donor?
  • All the required investigation are done to make sure that donor is healthy and he/she would not have any effect after donation
  • As he or she will be always screened after transplantation for any abnormalities and that will be detected early.
  • Donor can do regular job after 3 months post transplantation
  • In case of female donor there is no contraindication of pregnancy
Advice to kidney post transplant patients
  • Need to take medicine regularly
  • Needs to check blood urine and drugs level regular
  • Regular exercise, maintain optimal weight
  • Low fat, carbohydrate diet
  • Don’t use over the counter drugs
  • Maintain good hygiene
  • Regular check up
  • Be away from infected persons and crowds
Do person need second kidney transplantation?
There is always life span of person as well as the kidney. If first transplanted kidney fails then the person again needs renal replacement therapy in the form of transplantation or dialysis. But the second transplantation is high risk because antibodies are developed against the previous kidney that may harm this new kidney as well.
In second transplantation do we need to take out previously kept kidney?
We don’t need to take out previously transplanted kidney regular because it is difficult to do surgery in previously transplanted kidney as it is adhere to underlining structure and it may cause unwanted bleeding more over previously transplanted kidney may increase tolerance. We need to remove it if it is infected and causing problem and there is no space for kidney  in case of 3rd or 4th transplant.
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