Patients with chronic kidney/End-Stage Renal Disease (ESRD) often take transplant advice as a nightmare, which is absolutely wrong. Several renowned medical institutions across the globe have already proven that transplant is the far-best plan in comparison to dialysis for the patient with end level renal disease because dialysis requires strict routine trips to the hospital and if the patient fails to follow, it results in severe repercussions.
However, the transplant process of any organ is completely dependent. Sometimes it becomes a herculean task for a surgeon or the family of the patient, because it requires a donor either brain-dead or whoever is ready to donate the particular organ. These days, the kidney transplant process is being chosen by most patients worldwide because it gives relaxation from longer routine dialysis and longer treatments. In this process, the nonfunctional kidneys will be at their native place. The healthy kidney is placed at the lower abdomen on the right side.
When Body Requires Kidney Transplant?
The work of the Kidney is to purify the blood by separating the waste and fluids. This wastage and fluids drained out in the face of urine. This major function disturbs when Kidneys receive any infection or particular body is suffering from any chronic diseases like Diabetes, Chronic glomerulonephritis — an inflammation and eventual scarring of the tiny filters within the patient’s kidneys (glomeruli), high blood pressure, or severe body infection that impacts creatinine directly.
So the patient is put under the dialysis process to control the high toxin levels because of kidney failure.
In the dialysis process, the blood of the patient’s body is cleansed through the mandated process using a dialysis machine. The wastage fluid collected in the body is drained out with the help of a dialysis machine. If the patient has required the first dialysis, then it will take 3-4 hours to purify the blood. In this case, the blood level often reduces, which also requires erythropoietin and iron injections and the blood transfusion simultaneously.
This stage is also known as CKD stage 5 or End Stage Renal Disease (ESRD) patients will require lifelong dialysis or the transplantation.
Why Do Doctors Avoid Transplanting Those Patients Suffering with Serious Diseases?
If a patient has any serious underlying diseases, surgeons refuse to transplant because it might be dangerous or unsuccessful. Cancer Patients, a patient suffering from tuberculosis, bone infection, hepatitis, HIV, Liver disease, Cardiovascular or brain-related diseases. This refusal takes place because the mortality rate often increases with these patients.
On the basis of the studies, the immunity system of the cancer patient is weaker than any other normal patient. Similar conditions and circumstances have been observed in patients of tuberculosis, liver disease, cardiovascular, Hepatitis and other critical patients.
Doctors often refuse transplants to chain smokers, drugs, and alcohol addicts also.
What requires for the Kidney Transplant
There are several mandates through which the patient has to go through, including physical, psychological, anesthetic, and familial conditions to assess the certainty of the body.
The psychologist will ensure the thought process and post-treatment orders. Similarly, the anesthetic will ensure that a particular patient is not drug and alcohol addicted or a chain smoker. Though the parameter is mandated in all surgeries transplant cases, there is a high risk with the patient.
After successfully passing all parameters, the patient is put on a waiting list, either a family member is ready to donate or will be formally redirected to hospitals for cadaver kidney transplant program to receive the donated kidney.
The blood group of the patient with the donor is the most important part of this process, as it is noted that the main function of the kidney is to purify the blood. So this particular organ is directly in contact with the blood flow. So if any family member is ready to donate one kidney, it is often found that the blood group and tissues match the patient’s blood group and tissues.
After some clinical tests and counseling, a specific date is set by the surgeon for donation and later completed with the transplantation process.
Why is the Blood Group Matching Process Important? What are the risks?
There are two types of blood cells in the body. Red blood cells and white blood cells.
During the evaluation process of the patient for transplant, they have to go through the blood tests to determine the exact blood type, that is from group A, B, AB or O. Determination of Human Leukocytes Antigen (HLA) is the most important antigen. The group of this antigen surfaces on white blood cells, and it plays the most important and responsible role in the body’s immunity.
Once the HLA matches with the donor’s HLA, it is expected that the body of the patient will not reject the donated organ. A good number of antigens signals successful transplantation. There is one more important process after the blood match, which is done before the transplant process starts.
To ensure that the antibodies present in the blood of the patient won’t attack the organ of the donor, a small amount of blood is taken from both patient and donor and mixed to catch the result. If the blood of the patient forms antibodies in response, then transplant can’t be done due to the risk. If blood shows a Negative Crossmatch, then it gives a green signal to proceed with the process.
How Transplant is done?
After the result of antibodies Negative Crossmatch, the anesthesia process starts. In this process, a patient is given medication in hand to make him/her sleep well so that the surgery can be done properly.
Kidney transplant surgeon makes an incision in the abdominal part to relieve the affected kidney and place the donor’s kidney. It will be followed by the process of attaching the veins and arteries to the new kidney.
In this process, the surgeon keeps another eye on the ureter and bladder. After attaching the veins and arteries, now the ureter of the kidney will be attached to the bladder.
This is the function through which the body passes the urine and the patient can urinate normally. If the surgeon observes that the original kidney cannot harm the body later, the doctor leaves it in their position.
After completing this process, stitches are done by the team in proper care and observation, and later the patient’s body is shifted to the recovery room. This room is completely equipped with a monitoring system. Once the patient wakes up normally and feels good, the surgeon ensures proper urination, blood pressure, and other miscellaneous activities of the patient.
Later the patient shifted to ICU and from there to the private or general ward. During this time, the team of doctors properly observes the patient’s body oxygen, blood level, hemoglobin, and renal activities.
In almost all cases, the patient feels good, and later a discharge form is given to the family.
Successful kidney transplant gives a new life to patients suffering from chronic kidney disease.