THIRUVANANTHAPURAM: Kidney transplantation is the most-opted treatment for patients diagnosed with complete loss of function of both kidneys. Usually, they have to go through dialysis or kidney transplant for survival. Basically, a kidney transplant is a surgery where a kidney from one person is donated to another person. Usually, the original kidneys won't be removed, instead the new kidney will be placed in the lower part of the abdomen.
There are two types of donors namely deceased and live donors. A deceased donation is absolutely legal and has been justified by the Transplantation of Human Organs Act. Besides which a properly diagnosed brain death is absolutely morally and ethically justifiable as diagnosing death.
For the proper diagnosis of brain death, the Act has laid down guidelines and which should be strictly followed. A live donor is usually a close relative of the patient who voluntarily comes forward to donate her organ whether kidney or part of the liver.
The donor and recipient are operated on simultaneously. The donor's kidney is removed by laparoscopic techniques usually open technique is used only in complicated anatomy. The recipient abdomen is opened and a place created to put in the kidney in the lower part of the abdomen.
The blood vessels in this part are also identified to attach to the kidney. After the kidney is removed, a special fluid is allowed to flow into the kidney to remove all the blood and blood cells from the organ.
The fluid is also cooled so that the kidney is now cooled to a very low temperature so that it can withstand a long time outside the body. After this, the kidney is taken to the recipient for attaching it to the blood vessels of the recipient.
Once the artery and vein are attached, blood is allowed to flow into the organ and usually, on blood flowing, the kidney will function at once and produce urine. In the end, the tube carrying the urine from the kidney is attached to the urinary bladder of the recipient. The abdomen wound is now closed and the patient is shifted from the theatre to the transplant ICU.
Life after transplant
In the initial days, a daily blood test is needed to ensure adequate kidney function. There can be a large number of potential problems including damage to the blood vessels, urine tubes, development of fluid collections.
The rejection or infection may complicate the issue and might result in prolongation of hospital stay. In the long term, the transplant recipient should ensure regular medicine intake at the proper time. The patient should also avoid attending crowds or travel which might result in infection. Still, the long term outcomes are quite good nowadays.
Dr Satish Balan is the Senior Consultant Nephrologist Kerala Institute of Medical Sciences, Thiruvananthapuram (The views expressed by the author are his own)