For the successful evaluation of kidney transplantation, the follow-up period after kidney transplantation is as important as the operation process.
What is Kidney Transplantation?
Kidneys are vital organs that filter harmful substances in the blood and remove them from the body with urine, and maintain the acid-base balance in the blood. One kidney is sufficient to sustain life. However, permanent deterioration of the function of both kidneys is defined as chronic renal failure. Chronic kidney failure requires regular dialysis in order to maintain the vital activities of the person.
Dialysis can only meet a part of the function of the kidneys. Since patients have to undergo dialysis 2 or 3 times a week depending on the degree of kidney failure, their quality of life decreases and they have to make restrictions on their diets. In addition to dialysis, they need to use regular medication and to compensate for the deficiencies due to insufficiency of kidney functions.
Kidney transplantation is the only chronic kidney failure treatment method that provides a higher quality of life and longevity. Individuals diagnosed with end-stage renal disease are referred to the organ transplant center by a nephrologist. Here, the nephrologist evaluates the patient in terms of eligibility for kidney transplantation.
The physician first questions the patient in terms of the living donor. Compliance is investigated from the patient's first-degree relatives such as mother, father and child to fourth-degree relatives such as siblings, grandchildren, and uncles.
Patients who do not have the chance to have a living donor kidney transplant are started on dialysis and are immediately put on the cadaveric list. Cadaver describes people who have been brain dead. Patients who have irreversibly lost their brain and brain stem functions are considered to be medically dead because they have no chance of recovery and reincarnation.
Vital organs of people with brain death also lose their functions over time, despite all medical support. Therefore, it is extremely important for the families of people with brain death to make a quick decision on organ donation for the recovery and survival of other people. Donation of organs such as kidneys taken from people who have brain death, body whole it doesn't spoil your coat. The procedure is performed meticulously like the operations performed on living individuals, and after the operation, the body is stitched closed by the surgeon.
What is Cross Kidney Transplantation?
When two or three desperate couples who do not have the chance to receive a kidney from their own family share their mutual kidneys, they have the chance to have a healthy transplant. It is called a cross kidney transplant. Cross kidney transplantation is also known as “kidney fraternity”.
Main reasons for failure of transplantation despite being a living kidney donor:
- Blood group incompatibility between donor and recipient: For kidney transplantation from living donor, donor and recipient blood group must match. For example, if the recipient has A blood group and the donor has B blood group, the transplant cannot take place. The blood group of the donor must be either A or O for the transplantation to take place.
- Inability to obtain a kidney from a relative due to the antigen in his blood (inconsistent cross-match tests): Incompatible cross-match tests is a condition that causes severe rejection (organ rejection). Couples registered in our cross transplant program can be matched according to blood type, age and gender. If the tissue and cross examinations of the couples are suitable, the couples are introduced.
For example, let's consider a couple who cannot receive kidneys from their relatives, although the donor has blood group A and the donor has O blood type and the donor's blood type matches due to the high level of antibodies in the recipient. This couple can be a kidney sibling with a couple with blood group 0 in the cross list and donor blood group A. In this way, matching can be achieved for recipients with 0 blood group, which is the most difficult match on the cross transplant list.
Who Can Be a Kidney Donor (Donor)?
First of all, a healthy single kidney must meet all the needs of the body. should be known to be able to meet normally. In case the person decides to donate his kidney, detailed scans are performed on the donor (donor/donor).
Physical examination, blood, bakt In addition to the eriological and radiological examinations, additional tests such as ultrasonography, electrocardiography and CT can be performed to determine the general health status of the person. If the evaluations meet the criteria, organ donation is accepted.
Although there is no upper age limit for donating a kidney, people aged 65 and over may experience dysfunction as their kidneys get older, like all other organs. For this reason, kidney donation is not accepted from donors over the age of 65 unless it is necessary. People under the age of 18 are not allowed to donate living kidneys.
As a result of the examinations, donations are not accepted if people who are eligible for kidney donation have previously had kidney disease, hypertension or diabetes.
In the case of kidney failure in the family of the donor, the kidney can only be taken from people over 30 years of age and who do not show any signs of the disease. Another important factor for kidney donation is the blood compatibility between the donor and the recipient. People with 0 blood group can donate their kidney to recipients with 0, A, B and AB blood groups. The recipient with AB blood group can receive kidneys from all blood groups. Can donate organs to 0, A, B AB blood groups.
The kidney taken from the patient's mother or father is Its acceptance by cudu is partially realized. In kidney transplants between siblings, full or moderate agreement can be seen. In addition to all these, kidney transplantation can be performed among people with tissue incompatibility. However, in transplantation types with tissue incompatibility, the recipient's body has a higher risk of rejecting the new kidney in the following years. Every patient diagnosed with ) is evaluated for kidney transplantation, because at this stage, the kidney functions of the patient are permanently impaired and it has begun to endanger the patient's life.
1 year spent on dialysis can wear out patients in 3-4 years. For this reason, it is recommended to be transplanted as soon as possible. The importance of having a kidney that constantly filters toxic substances from the blood after transplantation can be easily understood in terms of maintaining health when compared to having hemodialysis treatment three times a week. may be the subject.
In Which Situations Kidney Transplantation Cannot Be Performed?
- If kidney failure can be treated with any other treatment method,
- In the period when kidney transplantation will be performed, the patient If there is an active infection
- If there is a malignant cancer that has emerged recently and cannot be cured,
- If the patient has a short life expectancy,
- The patient's heart or lungs are transplanted If the patient is too weak to survive the surgery,
- There is active drug use,
- Primary oxalosis (In this case, both kidney and liver must be transplanted to the patient at the same time), transplantation cannot be performed.
How is Kidney Transplantation Performed? What are the Stages?
After confirmation of the patient's eligibility for transplantation, the patient's fourth-degree It is necessary to obtain a compatible kidney from one of his relatives or from a person who has brain death. In kidney transplantation, the new kidney is placed in the right or left inguinal region and the old kidneys are usually left where they are. Kidney transplant operations usually take 2-3 hours.
Because there is no contact with the intestines during the kidney transplant operation, the patient can start eating very soon after the operation. If the kidney is to be taken from a living person, the donor's left kidney is checked first. If this kidney is suitable, it is preferred for transplantation. The kidney that performs its functions more smoothly is left in the donor. After a successful kidney transplant surgery, the patient can be discharged on the fifth day if the kidney has been removed from a living donor.
If the kidney is taken from a cadaver, it will take a few days for the kidney to start working and the discharge time will increase by this amount. There is no harm in getting pregnant and having a child 1-2 years after kidney transplantation.
What Should Be Considered After Kidney Transplantation?
The first biochemistry check is done two days after leaving our hospital. After the first control, it is necessary to come to our hospital twice a week for biochemistry tests. The frequency of coming to our hospital and getting an examination later changes to once a week, once every 15 days, or once a month. The doses of immunosuppressant drugs (immunosuppressor drugs) used are adjusted according to the blood level. That's why it's so important to have regular blood tests. The blood donation time is adjusted according to the drugs used. Patients receiving insulin therapy are followed up by the diabetes polyclinic after discharge. Skin clips are removed one month after surgery. If redness, swelling or fluid formation is observed at the wound site, seek immediate medical attention. Drinking at least 2000-3000 cc (2-3 liters) of fluid per day is important for urine output. Medicines should be taken in accordance with your doctor's advice and at the same time. It is necessary to inform the transplant team and your doctor about the situations where additional medication should be used.
What are the Risks of Kidney Transplantation?
In all surgeries
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