Kidney Transplantation

RENAL (KIDNEY) TRANSPLANTATION

Kidneys are vital organs that filter harmful substances in the blood and remove them from the body with urine and maintain the acid-base balance in the blood. The functioning of one kidney is sufficient to sustain life. However, permanent impairment of the function of both kidneys is defined as chronic renal failure.

Kidney transplantation is the only treatment for chronic renal failure that provides a higher quality of life and longer lifespan. The nephrologist evaluates the patient for suitability for kidney transplantation.

The patient's first-degree relatives such as mother, father, siblings, and fourth-degree relatives such as siblings, grandchildren, uncles are investigated for suitability.

CROSS-OVER RENAL TRANSPLANTATION

Cross-over kidney transplantation is a method in which two or three donor couples share their kidneys with each other to provide a healthy transplant for a patient who is unlikely to receive a kidney from a relative.

Who Can Have a Renal Transplant?

A healthy single kidney meets all the body's needs normally. If a person decides to donate his/her kidney, the donor is screened.

In addition to physical examination, blood, bacteriological and radiological examinations, additional tests such as ultrasonography, electrocardiography, CT (computed tomography) are performed to determine the general health status of the person. Organ donation is accepted if the tests are positive.

• People over 65 years of age are not accepted as kidney donors unless it is mandatory. Those under 18 years of age are not allowed to donate live kidneys.
• As a result of the examinations, it is also an important criterion that people who are suitable for kidney donation have not had kidney disease before and do not suffer from hypertension or diabetes.
• Another important issue for kidney donation is the blood compatibility between the donor and the recipient. People with blood group 0 can give their kidneys to recipients with blood groups 0, A, B and AB. The recipient with AB blood type can receive kidneys from all blood groups.

Blood Group Compatibility Between Donor and Patient

• 0 Blood Group: 0, A, B, AB blood groups can receive kidneys from blood type 0.
• A Blood Group: Can receive kidneys from people with A and 0 blood groups. Can donate organs to A and AB blood groups.
• B and Blood Group: Can receive kidneys from people with B and 0 blood types. Can donate kidneys to B and AB blood groups.
• AB Blood Group: Can receive kidneys from people with blood group 0, A, B, AB. Can only donate to AB blood group.

Under Which Conditions Renal transplantation is performed?

• Every patient diagnosed with end-stage renal failure (filtration rate below 10%) is evaluated for kidney transplantation as they are in the life-threatening stage.
• One (1) year on dialysis causes 3-4 years of wear and tear for patients. For this reason, transplantation is recommended as soon as possible. In addition, the bodies of kidney patients wear out while under dialysis treatment and may become unable to undergo transplantation due to the development of advanced health problems over time.
• The most ideal treatment for patients who develop kidney failure is kidney transplantation from a living donor without ever starting dialysis. The importance of having a kidney that continuously filters toxic substances in the blood in the body after transplantation in terms of protecting health is more clearly understood when compared to hemodialysis treatment three times a week.

Conditions where kidney transplantation cannot be performed

• Kidney failure can be treated with another treatment if there is a possibility,
• If the patient has an active infection at the time of the kidney transplant,
• If you have a recent malignant cancer that cannot be treated,
• If the patient's heart or lungs are too weak to tolerate transplant surgery,
• If there is active drug use,
• If the patient has primary oxalosis, oxalosis occurs if you have primary hyperoxaluria and your kidneys fail. (In which case both kidney and liver need to be transplanted at the same time), transplantation cannot be performed.

All kidney failure patients who do not have these problems are transplant candidates.

What are the Risks of Renal Transplantation?

• Development of infection or hernia at the surgical incision site,
• Cessation of kidney blood supply due to problems in the renal arteries and veins,
• Urinary tract problems such as leakage or stenosis (narrowing),
• Hormonal imbalances that may be caused by immunosuppressive drugs (difficulties in controlling diabetes, etc.)

Conditions That Should be Contacted with Doctors After Renal Transplantation?

• Fever above 38 °C,
• Decreased urine volume, discoloration and burning sensation,
• Swelling of the feet and wrists,
• Sudden high or low blood pressure,
• Recurrent vomiting and diarrhea,
• Cough and shortness of breath,
• The dentist recommends antibiotics because of a dental problem,
• Any vaccination or recommendation for vaccination,
• Exposure to chickenpox, shingles (Herpes-Zoster), tuberculosis or any childhood illness.