HAVING A KIDNEY TRANSPLANT
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What is a live donor kidney transplant?
A living donor kidney transplant is when a healthy relative (a donor) volunteers to donate one of their two healthy kidneys to a relative with kidney failure (the recipient), so that the patient with kidney failure can go back to living a normal life. A kidney transplant does not cure kidney failure, however a successful transplant means the person with kidney failure doesn’t have to have dialysis anymore, and it helps them enjoy a life filled with more freedom and energy. It gives a patient a better quality of life and is a much better treatment.
Who can I ask to give me a kidney?
Anybody can be a kidney donor, as long as they are a friend or relative and they are fit and healthy. There are some medical tests that they will need to take to make sure that their kidney is compatible with the patient with kidney failure, which ensures that the new kidney will work as well as possible. It can be difficult to approach a family member or friend to ask if they would consider being a kidney donor. Your doctor will advise you on this.
An ethics committee at the hospital will look at each individual case to make sure that the transplant is being done ethically. A kidney cannot, for example, be taken from anyone who is being bribed or paid in any way, as this is illegal.
Will I need lots of tests before a kidney transplant?
If it is decided that a patient with kidney failure can have a living-donor kidney transplant from a relative, they will need lots of tests to know that they are well enough to have the operation. People with kidney failure can get a number of other problems as they develop their kidney failure including problems with the heart and blood vessels, high blood pressure, bone problems and diabetes. Doctors need to know that each of these things are as well as they possibly can be before the transplant happens. A transplant is a big operation, so it comes with some risks, which is why it’s important that they are as healthy as possible.
Will I still need dialysis just before a transplant?
If a patient is already receiving dialysis treatment then the dialysis will carry on up until the day of transplant. In most cases, the dialysis treatment just before the transplant is the last dialysis the patient will need. In a few cases there is a short period of time after the kidney transplant where the patient will need a little support from dialysis before the new kidney is working properly.
What happens in a transplant operation?
In a living-donor kidney transplant, a healthy relative with two working kidneys will have an operation to remove one of their kidneys. This kidney will then be put into the patient with kidney failure. The operation is carried out by a transplant surgeon and a transplant team.
Will I feel anything during the operation?
Before the operation, the transplant team will make sure that the patient is as comfortable as possible. They will then use general anaesthetic so that the patient is asleep through the surgery and cannot feel pain, and use antibiotics to stop infection. Once the patient is asleep, they will be taken into the operating theatre where the transplant surgeon will put the new kidney, which has been taken out of the donor, into the recipient. The kidney can start to work straight away and will produce urine.
The wound is closed up and the original kidneys are left where they are. The patient is usually fitted with a small tube, which goes from the bladder into a bag outside the body called a ‘urinary catheter’. This means that after the operation the doctors can check that the patient is producing the right amount of urine. The patient is taken to the recovery room where they will wake up. The surgery usually takes a couple of hours.
When will the new kidney start working?
In most cases, a kidney that has been taken from a healthy donor will start to work in the recipient straight away. In a few cases there will be some time where the kidney doesn’t start working straight away, and the patient may need dialysis for a few days before the new kidney recovers and starts to work. The patient is looked after carefully in hospital to make sure the new kidney is working, and to make sure the medication is doing it’s job.
When will I feel better after the operation?
Most recipients are out of bed the day after the operation, and are walking around the ward within 2 days. They are kept in hospital for a little bit longer to check that the kidney is working, and to check that they are taking their medications properly. Most recipients will be home within 7 to 10 days. After the operation, the recipient’s pain will be well controlled, which is something that a doctor will have talked to the recipient about before the operation. If the recipient is in any more pain than they expected, the medicine can be changed so that they are more comfortable. Most recipients are nearly pain free within 2 days of the operation. The recipient will have a curved shaped scar that will be about 20cm long in the lower corner of the tummy.
If the kidney transplant is successful, most recipients will feel better by the time they go home from hospital. Within 2 to 3 weeks most people feel a lot better because they are not on dialysis. Some recipients even say that within 24 hours they feel very different.
Will I have to take lots of medication?
The recipient’s immune system, which helps protect the body against disease, will be able to tell that there is something unfamiliar in the body, and will try to get rid of it, or ‘reject’ it. A transplant recipient will have to take medicine before the operation and after the transplant (for the rest of their life) called ‘immunosuppressants’ and they stop the recipient’s body from trying to get rid of the new kidney.
The number of these medicines will reduce over time. There are big doses immediately after the transplant because the immune response is most likely to be active at that point. The transplant doctors will aim to reduce the doses of medicine, but without them the transplant will stop working.
How long will my new kidney last?
With careful after-care and regularly taking anti-rejection medication, it would not be unusual for a new kidney to last more than 10 years. There are some kidney transplants that are still working at 40 years. It’s important to remember that a kidney transplant will not last forever, however, even if the transplant only lasted for 5 years, the transplant will have given the recipient 5 years of a better quality of life and 5 years off dialysis. Just 5 years of a working transplant will mean a stronger, healthier patient than one on dialysis.
Can I still play sports, drive, have sex and do normal things after my transplant?
The whole point of a kidney transplant is to get a patient’s quality of life back to as near normal as possible. The benefit of a transplant, or the opportunity it gives, is for the recipient to do what they want in their life.
If the recipient feels that they are doing something that is particularly ‘risky’, then their transplant team will be happy to discuss it with them before they make a decision. With alcohol, they must first ask the question “will this interfere with the specific medication that I am on?” While drinking lots of alcohol is always dangerous, a kidney donor can consume alcohol in moderation as normal.
Will I be able to have a baby after my transplant?
Women with kidney failure who receive a kidney transplant are more likely to have successful pregnancies and start families than if they stay on dialysis. Men are also more likely to be more fertile following a kidney transplant and therefore father children.