Renal Transplantation

Kidney transplantation or renal transplantation is the organ transplant of a kidney into a patient with end-stage renal disease. Kidney transplantation is typically classified as deceased-donor (formerly known as cadaveric) or living-donor transplantation depending on the source of the donor organ. Living-donor renal transplants are further characterized as genetically related (living-related) or non-related (living-unrelated) transplants, depending on whether a biological relationship exists between the donor and recipient.

Sources of Kidneys

  • Living Donors
  • Organ Trade
  • Deceased Donors

Laparoscopic Live Donor Nephrectomy

Laparoscopic live donor nephrectomy is surgery to remove a kidney and transfer it to someone with serious kidney problem. The kidneys are two bean-shaped organs found under the ribs on each side of the upper abdomen (stomach). Laparoscopic live donor nephrectomy is an emerging technique that has not yet gained widespread acceptance in the transplant community due to perceived technical difficulties. However, the potential advantages of decreasing donor morbidity, decreasing hospital stay and improving convalescence while producing a functional kidney for the recipient may prove to enhance living related renal transplantation.

Complications

Problems after a transplant may include:

  • Transplant rejection (hyperacute, acute or chronic)
  • Infections and sepsis due to the immunosuppressant drugs that are required to decrease risk of rejection
  • Post-transplant lymphoproliferative disorder (a form of lymphoma due to the immune suppressants)
  • Imbalances in electrolytes including calcium and phosphate which can lead to bone problems among other things
  • Other side effects of medications including gastrointestinal inflammation and ulceration of the stomach and esophagus, hirsutism (excessive hair growth in a male-pattern distribution), hair loss, obesity, acne, diabetes mellitus type 2, hypercholesterolemia, and osteoporosis.

A patient’s age and health condition before transplantation affect the risk of complications. Different transplant centers have different success at managing complications and therefore, complication rates are different from center to center. The average lifetime for a donated kidney is ten to fifteen years. When a transplant fails, a patient may opt for a second transplant, and may have to return to dialysis for some intermediary time.