Keeping Your New Kidney Healthy
To keep yourself healthy, and to make sure your new kidney works well, the following are extremely important:
- Take your immunosuppressants and other medicines exactly how your doctor told you.
- Know the signs of infection or possible kidney rejection, then contact your transplant team right away if this ever happens.
- Avoid being around people who are sick.
- Drink plenty of water to stay hydrated.
- Eat foods low in salt, fat, and cholesterol.
- After you are cleared by your doctor, start an exercise routine such as walking, or biking.
What Addition Information Should Women Know About The Recovery Process
Although fertility is not a problem, rejection or high blood pressure are both complications a woman might experience for at least one year after transplant surgery. Therefore, it is important to prevent a pregnancy during this time by using birth control.
Women who have a kidney transplant can have a healthy pregnancy later. Talk to the Transplant Team about the timing of your pregnancy after your transplant. Also, know the risks and make sure your obstetric provider is experienced in dealing with transplant patients.
A female transplant patient who becomes a new mother should not breastfeed her baby. The immunosuppressive medicines prescribed after transplantation can be passed through the mothers breast milk and can cause harm to the baby.
Female transplant patients should be sure to have a yearly Pap test and a mammogram. Immunosuppressive medicines could cause increased susceptibility to various types of cancer. Pap tests and mammograms are preventive measures that can help your healthcare providers detect any problems.
Positive Crossmatch And Sensitized Patient Kidney Transplant
This program makes it possible to perform kidney transplants in patients who have developed antibodies against their kidney donor, a situation known as “positive crossmatch.”
The process is similar to that for blood type incompatible kidney transplants. Patients receive medications to decrease their antibody levels or they undergo plasmapheresis treatments to remove the harmful antibodies from their blood. If their antibody levels are successfully reduced, they can then go ahead with the transplant.
Blood type incompatible kidney transplants and positive crossmatch/sensitized patient kidney transplants have been very successful in the United States and internationally. Success rates are close to those for transplants from compatible living donors and are better than success rates for deceased donor transplants.
UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
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What Are The Risks Of Kidney Transplantation
The risks of kidney transplantation are the same as those of any surgery. There is the risk of bleeding, infection or breathing problems. You also might experience some side effects from the medications, and you could be more prone to infections, since the medicine you will take after transplantation lowers your body’s ability to fight infection.
There is also the risk of rejection. Since the body recognizes the new kidney as a foreign object, it will normally try to get rid of it or “reject” it. However, you are given medicine to prevent rejection.
Because of years of experience, research, and improved medicines that prevent rejection, kidney transplants are very successful with few complications after transplantation.
Statistical Analysis And Outcome
The primary endpoint was 5-year death censored graft survival. Categorical variables were assessed using Fisher’s exact test or chi-squared test. For continuous variables, the median with interquartile range as well as the mean with standard deviation are shown. MannWhitneyU-test was used for statistical analysis of continuous variables. Survival rates were illustrated using the KaplanMeier method. Hazard ratios of the influence of the donor age categories with 95% confidence intervals were calculated with multivariable Cox regression. Analyses were stratified by country to eliminate confounding by different country-based allocation strategies. Other parameters such as donor/recipient comorbidities, cold ischemia time, duration of dialysis, induction therapy, sensitization status, or race were deliberately not considered for Cox regression analysis as the primary goal was to show the real-life changes in 5-year death censored graft survival between the two transplant periods for the different donor age groups. To exclude the influence of age-matched allocation strategies, separate analyses in the subgroups of 1864 and 65-year-old recipients were also performed. The survival rate of the 1849-year-old donors in the period 19972006 served as reference.
Two tailed P-values of < 0.05 were considered statistically significant. Statistical analysis was conducted using the software IBM® SPSS® Statistics version 25.0 .
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Blood Type Incompatible Kidney Transplant
This program allows patients to receive a kidney from a living donor with an incompatible blood type. To be able to receive such a kidney, patients must undergo several rounds of plasmapheresis, which is similar to dialysis, before and after the transplant. Plasmapharesis removes antibodies from the patient’s blood that can lead to rejection of the transplanted kidney.
Patients require multiple treatments with plasmapheresis before transplant, and may need several more after transplant to keep their antibody levels down.
Some patients also need to have their spleens removed at the time of transplant surgery to lower the number of cells that produce antibodies. The spleen, a spongy organ about the size of a person’s fist, produces blood cells. Located in the upper left part of the abdomen under the rib cage, the spleen can be removed using laparascopic surgery.
What Is A Kidney Transplant
A kidney transplant is a surgery done to replace a diseased kidney with ahealthy kidney from a donor. The kidney may come from a deceased organdonor or from a living donor. Family members or others who are a good matchmay be able to donate one of their kidneys. This type of transplant iscalled a living transplant. People who donate a kidney can live healthylives with one healthy kidney.
A person getting a transplant most often gets just 1 kidney. In raresituations, he or she may get 2 kidneys from a deceased donor. The diseasedkidneys are usually left in place. The transplanted kidney is placed in thelower belly on the front side of the body.
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Who Is On My Transplant Team
A successful transplant involves working closely with your transplant team. Members of the team include:
- Youyou are an important part of your transplant team.
- Your family membersthis may include your spouse, parents, children or any other family member you would like to involve.
- Transplant surgeonthe doctor who places the kidney in your body.
- Nephrologista doctor who specializes in kidney health and may work closely with a nurse practitioner or a physicians assistant.
- Transplant coordinatora specially trained nurse who will be your point of contact, arrange your appointments, and teach you what to do before and after the transplant.
- Pharmacista person who tells you about all your medicines, fills your prescriptions, and helps you avoid unsafe medicine combinations and side effects.
- Social workera person trained to help you solve problems in your daily life and coordinate care needs after your transplant.
- Dietitianan expert in food and nutrition who teaches you about the foods you should eat and avoid, and how to plan healthy meals.
Your transplant team will be able to provide the support and encouragement you need throughout the transplant process.
Why Are Transplanted Kidneys Placed In The Front
The kidney transplant is placed in the front part of the lower abdomen, in the pelvis. The original kidneys are not usually removed unless they are causing severe problems such as uncontrollable high blood pressure, frequent kidney infections, or are greatly enlarged.
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Anxiety Depression And Mental Health
Getting a transplant is usually an exciting event, but because it is also a major life change, its normal to have all kinds of emotions afterward. If youre experiencing feelings of anxiety, depression or guilt, please know that you are not alone; many transplant patients experience these feelings at first, for many reasons.
- Mood changes may be a side effect of the immunosuppressant medicines you are taking.
- You may feel stressed or anxious about your new lifestyle.
- You may feel guilty about getting a kidney from a living or deceased donor.
- If you have been on dialysis for a long time, you may feel guilty about leaving other dialysis patients behind once you get your transplant.
- Your family members may also have emotional changes as they adjust to your new lifestyle.
You do not have to deal with these feelings alone. Getting a kidney transplant is a major life change, and it is normal to feel stressed and anxious about big life changes.
Reach out to your family and friends for support. Also, let your transplant team know about your emotional changes; so they can help support you and adjust your medicines if needed. Your transplant team can also refer you to a mental health specialist.
Have Your Kidney Transplant
During kidney transplant surgery, a surgeon places a healthy kidney into your body. Youll receive general anesthesia before the surgery. The surgery usually takes 3 or 4 hours. Unless your damaged kidneys cause infections or high blood pressure or are cancerous, they can stay in your body. Surgeons usually transplant a kidney into the lower abdomen near the groin.
If youre on a waiting list for a donor kidney, you must go to the hospital to have your transplant surgery as soon as you learn that a kidney is available.
If a family member or friend is donating the kidney, youll schedule the surgery in advance. Your surgical team will operate on you and your donor at the same time, usually in side-by-side rooms. One surgeon will remove the kidney from the donor, while another prepares you to receive the donated kidney.
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Why Might I Need A Kidney Transplant
You may need a kidney transplant if you have end stage renal disease. This is a permanent condition of kidney failure. It often needsdialysis. This is a process used to remove wastes and other substances fromthe blood.
Remove urea and liquid waste from the blood in the form of urine. Urea is made when foods containing protein, such as meat, poultry, and certain vegetables, are broken down in the body. Urea is carried in the blood to the kidneys.
Balance salts, electrolytes, such as potassium and sodium, and other substances in the blood
Produce erythropoietin, a hormone that aids the formation of red blood cells
Regulate blood pressure
Regulate fluid and acid-base balance in the body to keep it neutral. This is needed for normal function of many processes within the body
Some conditions of the kidneys that may result in ESRD include:
Repeated urinary infections
Polycystic kidney disease or other inherited disorders
Glomerulonephritis, which is inflammation of the kidney’s filtering units
Hemolytic uremic syndrome, a rare disorder that causes kidney failure
Lupus and other diseases of the immune system
Other conditions, such as congenital defects of the kidneys, may result inthe need for a kidney transplant.
There may be other reasons for your healthcare provider to recommend akidney transplant.
Special Programs For Living Donor Kidney Transplantation
Many patients have family members or friends who wish to donate a kidney but are not able to because their blood type or tissue type doesn’t match the recipient. In such cases, the donor and recipient are said to be “incompatible.” UCSF offers several programs to help these patients receive a kidney.
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How Will I Pay For A Transplant
Medicare covers about 80% of the costs associated with an evaluation, transplant operation, follow-up care, and anti-rejection medicines.; Private insurers and state programs may cover some costs as well. However, your post-transplant expenses may only be covered for a limited number of years. Its important to discuss coverage with your social worker, who can answer your questions or direct you to others who can help.;
What Is Done To Prevent Rejection
To allow the transplanted kidney to survive in your body, you will be givenmedicines for the rest of your life to fight rejection. Each person mayreact differently to medicines.
New antirejection medicines are continually being developed and approved.Your healthcare team will tailor medicine regimes to meet your needs.
Usually several antirejection medicines are given at first. The doses ofthese medicines may change often, depending on your response. Becauseantirejection medicines affect the immune system you will be at higher riskfor infections. A balance must be maintained between preventing rejectionand making you very susceptible to infection.
Some of the infections you will be especially at risk for include oralyeast infection ,herpes, and respiratory viruses. Avoid contact with crowds and anyone who has aninfection for the first few months after your surgery.
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Is Kidney Transplantation Better Than Dialysis
Kidney transplantation is the best renal replacement for ADPKD patients with kidney failure.
Having a kidney transplant before needing dialysis known as pre-emptive kidney transplantation has advantages over having a transplant after starting dialysis. These include: avoiding needing surgery to prepare for dialysis, having a better transplant and a longer survival time. It also reduces costs for the NHS.
In the UK, pre-emptive kidney transplantation is offered when your estimated glomerular filtration rate or eGFR has fallen below 15 ml/min.
When I dropped below eGFR 20, it was suggested that I start thinking about live transplant. My great niece volunteered and was a really good match. From the time she agreed to donate to transplant was about 2¾ years. I had the transplant at eGFR 9, in October 2016.
The transplant team told me that mine was a textbook pre-emptive live donation. My niece sailed through it she wanted food as soon as she came back from theatre! The transplant was on the Thursday and she went home on the Monday. I was in the full week. Once out, I was very well looked after by my wife.
Nicki needed a transplant after having her own diseased kidneys removed
*Creatinine is used to measure kidney function. High levels indicate poor function.
What Happens Before A Kidney Transplant
If your child needs a kidney transplant, your first step is to visit a transplant center. The health care team will check to make sure that your child is healthy enough to have surgery and take the medicines needed after the transplant. This will include blood tests, X-rays, and other tests, and can take a few weeks or months.
If the transplant team decides your child is a good candidate, the next step is to find a kidney. In most cases for living donor transplants, a kidney comes from a close relative or friend who has a compatible blood type.
If a living donor isn’t found, your child’s name will go on a waiting list until a kidney from a deceased donor is matched to your child. The need for new kidneys is far greater than the number donated, so this can take a long time.
You’ll stay in close touch with the doctors and the rest of the health care team. Make sure they know how to reach you at all times. When a kidney is located, you’ll need to go to the transplant center at a moment’s notice.
While you wait for a transplant, keep your child as healthy as possible. That way, he or she will be ready for transplant surgery when the time comes. Help your child:
- eat healthy foods and follow any special diet recommendations from the doctor, nurse, or dietitian
- take all medicines as directed
- keep all medical appointments
Tell your doctor and the transplant center right away if is any change in your child’s health.
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What Are The Alternatives To Having A Kidney Transplant
Although kidney transplantation is the best type of renal replacement therapy for ADPKD patients with kidney failure, not all patients are suitable and some may choose not to have the operation.
The alternatives to having a kidney transplant are:
- dialysis using a machine to filter your blood
- dialysis using fluid placed in your abdomen
- changes to diet and lifestyle and supportive medicines only, to ease your symptoms .
Potential Complications With New Kidney
- BK Virus Most people get BK virus, or polyomavirus, in early childhood and see no symptoms. The virus stays present in the kidneys and can be detected by a kidney biopsy. Most illnesses caused by BK virus occur in those receiving immunosuppression after an organ transplant. Kidney injury develops late in the course of BK virus disease, and reducing the amount of immunosuppressive medication can help decrease the virus.
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What Disqualifies A Kidney Transplant
There are some medical conditions that could prevent you from being a living donor. These include having uncontrolled high blood pressure, diabetes, cancer, HIV, hepatitis, or acute infections. Having a serious mental health condition that requires treatment may also prevent you from being a donor.
How Do I Know My New Kidney Is Working
Blood tests help you know your donor kidney is working. Before you leave the hospital, youll schedule an appointment at the transplant center to test your blood. The tests show how well your kidneys are removing wastes from your blood.
At first, youll need regular checkups and blood tests at the transplant center or from your doctor. As time goes on, youll have fewer checkups.
Your blood tests may show that your kidney is not removing wastes from your blood as well as it should. You also may have other symptoms that your body is rejecting your donor kidney. If you have these problems, your transplant surgeon or nephrologist may order a kidney biopsy.
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