Kidney Transplant: A New Lease on Life

When an individual's kidneys fail, three treatment options are available: hemodialysis, peritoneal dialysis, and kidney transplantation. Many patients feel that a successful kidney transplant provides a better quality of life because it allows greater freedom and often is associated with increased energy levels and less restricted diet. . this brochure proved information on the kidney transplantation to help you in making a decision about whether this the the best treatment for you. You may find it helpful to talk to patient who already have had a kidney transplant. You also need to speak to your doctor, nurse and family members.

The following questions and answers will help you understand the issues involved with transplants.

 

What is a kidney transplant?

A kidney transplant is an operation in which a person whose own kidneys have failed receives a new kidney to take over the work of cleaning the blood.

 

Are there different types of kidney transplants?

Yes. There are two types of kidney transplants: those that come from living donors and those that come form unrelated donors who have died ("cadaver" donors). A living donor usually is someone in your immediate or extended family or maybe your spouse or close friend.

 

What are the advantages and disadvantages of living donation?

One advantage of receiving a kidney transplant from a living donor is that the average long-term success rates tend to be somewhat higher than transplants from cadaver donors. Another advantage is that the operation can be scheduled to suit the patient's needs because it is not necessary to wait for a kidney to become available from a cadaver donor.

The disadvantage is that donor must be perfectly healthy and must undergo major surgery to remove a kidney to transplant into you, the recipient. Usually, the operation involves no serious risk for a healthy donor. In addition, studies have shown that one remaining healthy kidney is enough to keep the body healthy by removing wastes and excess fluid from the blood. Living donors usually experience positive feelings about their courageous gift.

 

What are the advantages and disadvantages of deceased donation?

Technical advances have resulted in very good success rates for kidney transplants for deceased donors. However, due to the shortage in the supply of cadaver kidneys for transplantation, you must remain on a waiting list until a suitably matched kidney becomes available.

 

How do I start the process of getting a kidney transplant?

Your doctor can discuss the transplant process with you. He or she also can refer you to a transplant center for further evaluation. 

 

How can I afford the cost of the transplant and the medicines I will need?

Medicare and private insurance cover most transplant and medication costs. Medicare covers 80 percent of the costs of the drugs you need to prevent transplant rejection and you pay 20 percent of the cost. At  present, Medicare covers these drugs for three years. However, Medicare does not pay for all of the drugs you may need to take. Other sources for assistance include your state-supported medical programs and veterans' programs. You may also qualify for different patient assistance programs offered by the drug companies. The social worker of financial coordinator at your transplant center is available to answer your specific questions.

 

What does the transplant operation involve?

The kidney transplant operation involves an incision or cut on the lower part of the abdomen to connect your blood vessels to the new kidney and the ureter (urine tube) of the new kidney to your bladder. The operation usually takes about three hours. Expect to feel groggy and sore as you would after any type of surgery. You will find a tube (catheter) in your bladder to collect and measure the urine. There will be an intravenous (IV) tube in your arm to supply you with nutrients and fluids. The IV and catheter will be removed in several days. Often, the recipient can be out of bed within a day or two. Many times, the new kidney begins to work right away.

 

When can I expect to go home?

Most patients can leave the hospital in one to three weeks. Once you are home, the most important part of your transplant begins: the follow up. to be successful, you will have to be monitored carefully and your medications adjusted. This involves blood tests several times a week just after the transplant. Before long, it will not be necessary for blood tests or doctor visits to be so frequent. However, you always will need to have your kidney function and medicines checked from time to time.

 

Do my kidneys have to be removed?

No. Removal of your old kidneys is usually not necessary before a kidney transplant.

 

How long before I can return to work?

The main goal of transplantation is rehabilitation. How soon a patient is able to return to work depends on factors such as age, the type of job, and other medical problems. Many patients can return to work in three to eight weeks after their transplant.

 

What is rejection?

The most important complication that may occur after transplant is rejection of the kidney. The body's immune system guards against attack by all foreign matter, such as bacteria. This defense system may recognize tissue transplanted form someone else as "foreign" and act to combat this "foreign invader." anti-rejection medications, such as steroids, azathioprine and cyclosporine, help to prevent this, but when it does occur, additional treatment often can reverse rejection episodes. Frequent checkups according to your doctor's recommendation will ensure early diagnosis of rejection.

 

What are the side effects of the anti-rejection medicines?

Anti-rejection medicines have a large number of possible side effects because the body's immune defenses are suppressed. Fortunately, these side effects usually are manageable for most patients. If side effects do occur, changing the dose or type of the medicines will usually take care of them. Some of the most common side effects include: high blood pressure, weight and susceptibility to infections and tumors.

 

What other types of medicines will I need to take?

In addition to anti-rejection medicines, many patients also need t take blood pressure medicine and medicines to prevent ulcers and infection.

 

What are the chances that a transplanted kidney will continue to function normally?

A variety of factors influence the success of kidney transplantation. The chances that a transplanted kidney will continue to function are between 80 and 90 percent one year after the operation. Results of transplantation are improving steadily with research advances. For instances research has led to improvements in surgical techniques, preservation of donated kidneys and drugs used to prevent rejection of transplanted kidneys. In the event that a transplanted kidney fails, retransplantation is a good option for many patients.

 

Can people who are older or who have other health problems have a transplant?

Yes. In many cases, older people and people with diseases such as diabetes, heart trouble and other health problems can have successful kidney transplants. Careful evaluation is needed to understand and modify any specials risks.

 

If I have diabetes, can I have pancreas transplant?

Sometimes it is possible to do a pancreas transplant along with your kidney transplantation. Your doctor can advise you about this possibility.

 

What about my sex life?

In people who have had satisfactory sexual function, there may be a steady improvement in sexual function as they begin to feel better after a transplant. In addition, fertility (the ability to have children) tends to increase. Women should avoid becoming pregnant too soon after a transplant. Birth control counseling can be helpful at this time. (See National Kidney Foundation brochure: Sexuality and Chronic Kidney Failure.)

 

Will I need to follow a special diet?

Usually. Kidney transplants, like other treatments for kidney failure, often require following special diet guidelines. If you were on dialysis before, you may find this new diet less restricted. The length time you must follow the special diet varies. Your progress will be followed closely, and your doctor and dietitian will change your diet as needed. (For further details, see National Kidney Foundation brochure: Nutrition and Transplantation.)

 

What else can I do?

You should inform yourself fully by reading and talking to doctors, nurses and patients who have kidney transplants. You also can get more information by contacting your local National Kidney Foundation Affiliate.

 

General note:

More than 20 million Americans have some form of kidney or urologic disease. Millions more at risk. The National Kidney Foundation, Inc., a major voluntary health organization, is working to find the answers through prevention, treatment and cure. Through it's 51 Affiliates nationwide, the Foundation conducts programs in research, professional education, patient and community services, public education and organ donation. The work of the National Kidney Foundation is funded by public donations.