What is a Kidney Transplant? How is Kidney Transplant Surgery Performed?

What is a Kidney Transplant?

Kidney transplantation is the surgical procedure of transplanting a healthy kidney from a donor or cadaver to patients with chronic kidney failure, instead of a kidney that has lost its function. It can also be referred to as kidney transplant surgery.

A healthy kidney is usually taken from a donor and placed in the patient's body, where it takes on the task of filtering blood and removing waste products from the body. A successful transplant can improve a patient's quality of life and longevity.

Kidney transplantation is one of the most effective methods of treating kidney failure and is performed in specialized kidney transplant centers. In these centers, patients undergo detailed medical examinations to assess their suitability and transplantation is performed with kidneys taken from living or cadaver donors. Preoperative preparation, surgical process and postoperative follow-up are meticulously managed by a multidisciplinary team in these centers. This ensures that patients can continue their lives with a healthy kidney.

Why is a Kidney Transplant Performed?

Kidney transplantation is usually performed to restore kidney function in people with chronic kidney failure or end-stage renal disease (ESRD). Kidney transplantation is a surgery performed after complete loss of kidney function due to reasons such as diabetes, hypertension, polycystic kidney disease, glomerulonephritis, chronic infections and urinary tract obstruction. Transplantation is the most effective treatment method, especially for patients for whom dialysis treatment is inadequate.

Who is Eligible for Kidney Transplantation?

Kidney transplantation is suitable for patients with chronic kidney failure who do not have serious diseases of other organs. Candidates for transplantation are generally individuals between the ages of 18 and 70 who do not have risks such as infection, active cancer, or serious cardiovascular disease. Additionally, successful results from blood and tissue compatibility tests are required for immune system compatibility.

Recipient Eligibility Criteria

To be eligible for a kidney transplant, a diagnosis of chronic renal failure or end-stage renal disease is required. The candidate's general health must be at a level that allows him/her to endure the post-transplant period and should not have risk factors such as active infection, cancer, or serious cardiovascular disease. They should not have any conditions that would prevent treatment, such as alcohol or substance abuse, and should be compatible with regular use of immunosuppressive medications. In addition, ensuring blood group and immunological compatibility is a basic requirement for transplantation.

• The eligibility criteria for a kidney transplant recipient can be listed as follows:
• A diagnosis of chronic renal failure or end-stage renal disease.
• A general health condition sufficient to tolerate the post-transplant period.
• A lack of health problems that would make the transplant risky, such as active infection, cancer, or serious cardiovascular disease.
• A lack of habits that would interfere with treatment, such as alcohol or substance abuse.
• Achieving blood type and immunological compatibility for kidney transplantation.
• Agreeing to regularly take immunosuppressive medications after transplantation.

Donor Eligibility Criteria

To be a kidney transplant donor, the individual must be 18 years of age or older and in good health. The donor's kidney function must be normal and he or she must be able to survive with only one kidney. There must be no serious health problems such as active infection, cancer or cardiovascular disease, and no conditions that would interfere with the transplant process such as alcohol or substance abuse. The donor must meet blood type compatibility and immunological compatibility criteria, and must be approved by physicians as being physically and psychologically suitable for transplantation.

The eligibility criteria for a donor in kidney transplant surgery can be listed as follows:

• Must be a healthy individual aged 18 years or older.
• Must have normal kidney function and be able to survive with a single kidney.
• Must not have any health problems such as active infection, cancer, or cardiovascular disease.
• Must not have any conditions that could interfere with the transplant process, such as alcohol or substance abuse.
• Must meet blood type compatibility and other immunological compatibility criteria.
• Must be physically and psychologically suitable for transplantation and confirmed by a physician.

Who is Not Suitable for Kidney Transplantation?

Kidney transplantation is not suitable for individuals with serious health problems such as serious heart, lung or liver diseases. An active cancer diagnosis or ongoing cancer treatment, untreated active infections, and mental or psychological conditions that prevent regular use of post-transplant medications constitute obstacles to the transplant process. Additionally, life-threatening bad habits such as substance abuse are also among the conditions that make kidney transplantation unsuitable.

Kidney transplantation is not considered suitable for the following conditions:

• Presence of serious health problems such as serious heart, lung, or liver disease,
• An active cancer diagnosis or ongoing cancer treatment,
• Presence of untreated active infections,
• Presence of mental or psychological conditions that prevent regular use of post-transplant medications,
• Presence of life-threatening bad habits (e.g., substance abuse).

What are the Benefits of Kidney Transplant?

Kidney transplant surgery allows patients with kidney failure to live a normal life by improving their quality of life and eliminating the limitations of dialysis treatment. Thanks to kidney transplant surgery, patients can easily return to their work and social lives.

The benefits of kidney transplantation include:

• A significant increase in the patient's quality of life,
• The opportunity to avoid dialysis treatment,
• Increased energy levels and reduced overall fatigue,
• Most patients can return to their work and social lives,
• Longer life expectancy compared to dialysis,
• Less fluid and nutritional restrictions,
• Improvement in bone health and blood counts,
• Reduced risk of anemia,
• Reduced risk of cardiovascular disease,
• Increased ability to perform daily activities.

Kidney transplantation is a vital treatment option for patients with kidney failure and, when performed under the right conditions, can save a patient's life and greatly improve their daily life.

How is Kidney Transplant Surgery Performed?

Kidney transplantation is performed by surgically transplanting a healthy kidney, usually taken from a living or cadaver donor, to patients with chronic kidney failure. The surgery is performed by reaching the inguinal vessels from outside the abdominal membrane, and the transplanted kidney is placed in the right or left inguinal region. For kidneys taken from living donors, the closed (laparoscopic) method is generally preferred and this method shortens the patient's recovery time. After the transplant, the patient is closely monitored, and medication and regular check-ups are performed to prevent infection or immune problems.

Preparation before kidney transplant surgery

Pre-kidney transplant preparation involves a careful evaluation process for both the recipient and the donor. In this process, factors such as blood type and tissue compatibility are vital, as these compatibility is critical for a successful kidney transplant.

One of the most important steps in kidney transplantation is ensuring blood type compatibility and tissue compatibility between the recipient and donor. Kidney transplant blood type compatibility is necessary for the immune system to accept the transplanted kidney. Otherwise, the recipient's body may view the kidney as a foreign substance and reject it, which could lead to transplant failure. Blood type compatibility occurs between "A, B, AB and O" blood types, and recipients and donors with the same blood type are generally considered the most suitable candidates.

Tissue compatibility is evaluated through genetic markers called HLA (human leukocyte antigens). These markers are part of the immune system's defense mechanism, and in kidney transplantation, HLA compatibility between the donor and recipient increases the likelihood of kidney acceptance after transplantation. Higher tissue compatibility reduces the risk of kidney rejection, increasing the success of the transplant in the long term.

What is cross-transplantation?

Cross-transplantation is based on the principle of matching a donor and recipient whose blood type or tissue compatibility is not suitable for kidney transplantation with another donor-recipient pair. For example, if the donor in the first pair is not compatible with his/her recipient, he/she can donate his/her kidney to a recipient in another pair, and his/her recipient can receive a compatible kidney from that pair. This method provides a vital alternative for patients whose chances of transplantation are low due to incompatibilities.

Cross-transplantation allows more patients to receive kidney transplants and ensures efficient use of organ donations. During this process, all compatibility tests between donors and recipients are carefully performed and the transfer is carried out safely for all parties.

These preparations before kidney transplantation increase the likelihood of a successful transplant and help patients maintain a healthy life in the long term. For a complex surgical intervention such as kidney transplantation to be successful, both accurate medical evaluations and complete compatibility between the donor and recipient must be ensured. Therefore, it is crucial that everyone involved in the kidney transplant process works diligently during this preparation phase.

Things to Do After Kidney Transplant Surgery

Following certain guidelines after kidney transplant surgery will both speed up the recovery process and prevent potential complications. First of all, regular doctor check-ups are very important. During these check-ups, kidney functions, blood pressure and other health parameters are monitored. Nutrition after kidney transplantation is one of the most important issues to consider. Patients need to follow certain dietary guidelines to maintain kidney health. Attention should be paid to salt and protein intake, and healthy and balanced eating habits should be maintained.

In addition, medications that suppress the immune system should be used regularly and in the doses recommended by the doctor. These medications prevent kidney rejection, but they can also have side effects, so if you experience any side effects, you should consult a doctor immediately. During the post-operative recovery period, heavy physical activities should be avoided, but the body should be strengthened by doing light exercises.

Post-operative hygiene and precautions against infection risk are also very important. In particular, the cleaning and care of the surgical area should be done carefully, and if any signs of infection are seen, a doctor should be consulted immediately. The quality of life after kidney transplantation depends on the correct and complete implementation of the steps that patients must pay attention to during this process. In this process, patients should be aware of their health, follow their doctor's recommendations, and not neglect their regular check-ups, which will contribute to a healthy life in the long term.

What are the methods used in kidney transplant surgery?

Kidney transplantation is a treatment method used to improve the quality of life of patients with kidney failure and to help them sustain their lives. The main methods used in kidney transplantation are living donor transplantation and cadaver transplantation.

Living donor kidney transplantation

A living donor kidney transplant is performed when a healthy individual, usually a family member or relative related to the patient, donates a kidney. This method:

• The success rate is high because the kidney is transplanted immediately after removal.
• The waiting period is shorter than with a cadaver transplant.
• Laparoscopic surgery can be a less traumatic procedure.
• The donor usually stays in the hospital for a few days, and full recovery can take several weeks.
• Regular checkups are recommended to ensure the donor can live a healthy life with a single kidney.

Cadaver transplantation

A cadaveric transplant is the transplantation of a kidney from a brain-dead person to a suitable patient on the organ waiting list. In this method:

• Waiting periods are longer.
• The transplant must be performed quickly after the kidney is collected from the donor.
• Blood type compatibility and immunological factors are crucial.
• The risk of kidney rejection is slightly higher than with living donor transplants.
• The use of immunosuppressive medications is mandatory in the postoperative period.

Living donor transplants and cadaveric transplants are vital for patients with kidney failure. Which method is preferred depends on the patient's health status, availability of a suitable donor and other medical conditions.

Possible Side Effects of Kidney Transplant Surgery

One of the most common risks after kidney transplantation is the body's rejection of the transplanted kidney. Symptoms of kidney rejection after a kidney transplant include high blood pressure, decreased urine output, weight gain, swelling and weakness. Immunosuppressant medications are used to prevent rejection, but these medications can also cause some side effects. Signs of infection after kidney transplantation should also be carefully monitored because these medications can weaken the body's defense mechanism against infections. It is also important to monitor kidney function long-term, as high creatinine levels after a kidney transplant may be a sign that the kidney is not functioning properly.

Kidney transplant risks include surgical, medical, and immune-related problems. Surgical risks include bleeding, vascular occlusion, infection, and organ loss, while medical risks include the side effects of steroids and immunosuppressant drugs on the digestive system, nervous system, and small vessels. Infections are common, especially in the first six months after surgery, and if left uncontrolled, can trigger kidney rejection. Additionally, risks related to the immune system include the body rejecting the transplanted kidney and the chronicity of this process, which can impair kidney function. Therefore, patients should be kept under close follow-up for a long time after transplantation.

Possible risks and side effects of a kidney transplant may include:

• The body's rejection of the transplanted kidney
• Surgical risks such as bleeding, vascular occlusion, and infection
• Organ loss (uncommon)
• Immune problems

Frequently Asked Questions About Kidney Transplantation

What are the benefits of a kidney transplant?

A kidney transplant is surgery to replace a diseased or damaged kidney with a healthy kidney from a donor or cadaver. A kidney can be taken from a deceased organ donor or a living donor. Family members or other compatible individuals may also donate one of their kidneys.

Who can be a living donor for kidney transplantation?

In kidney transplantation, the living donor can be a relative up to the 4th degree or the patient's spouse. The donor's health condition is evaluated in detail and if he/she has no medical problems that prevent him/her from donating, he/she is considered suitable for transplantation.

How does the cadaver kidney transplantation process work?

For cadaveric kidney transplantation, patients are placed on a waiting list until a suitable kidney is found. If suitable tissue and blood compatibility is determined, patients are taken into surgery and the transplant is performed within an average of 14-18 hours.

What are the advantages of laparoscopic kidney donor surgery?

In kidney donor surgeries performed using the closed method, the recovery period is short and the donor can quickly return to his/her normal life. After the surgery, there will only be a 4-5 cm scar in the groin area and loss of work capacity is minimal.

How long does it take for the patient to be discharged after transplant surgery?

In living donor kidney transplants, the kidney usually starts working immediately, so the patient is discharged within 5 days. In cadaveric transplants, it may take a few days for the kidney to start working, and patients are usually discharged within 8-9 days.

What follow-up is done after kidney transplantation?

In the first weeks after surgery, patients are called to the center twice a week for blood tests and general check-ups. Over time, the frequency of check-ups is reduced, but the patient is kept under regular follow-up for a long time.

What is the risk of post-operative infection?

The risk of infection is high in the first six months after kidney transplantation. Urinary infections are particularly common, and failure to control infections can lead to kidney rejection. Therefore, it is important to fight infections effectively.

Does living with one kidney negatively affect health?

It has been scientifically proven that living with one kidney does not cause any serious harm to health. Transplant donors can generally live healthy lives.

What preparations are made before transplant surgery?

Before surgery, patients undergo detailed medical examinations. After cardiac examinations, blood and tissue compatibility tests are completed, the patient is prepared for transplantation. The process is usually completed within 5 days.

How long should immunosuppressant medications be used?

After kidney transplantation, patients must take immunosuppressive medications for life to prevent their immune systems from rejecting the transplanted kidney. Regular use of these medications and check-ups are critical for the healthy functioning of the kidney.