KIDNEY TRANSPLANTATION

General Information

DEFINITION--Replacement of a diseased kidney with a healthy kidney obtained from a healthy donor with compatible immunological characteristics. The donated kidney may come from a living relative or deceased donor.

BODY PARTS INVOLVED--Diseased kidney; healthy donor kidney; blood vessels to and from the kidney; ureters.

REASONS FOR SURGERY--Restoration of normal kidney function.

SURGICAL RISK INCREASES WITH

• Adults over 60.
• Obesity.
• Smoking.
• Poor nutrition.
• Recent illness.
• Alcoholism or chronic illness.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.
• Note: Risks are same for donor and recipient.

What To Expect

WHO OPERATES--General surgeon or urologist with transplant experience and training.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; x-rays of kidneys.
• After surgery: Blood studies.

ANESTHESIA--General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• The diseased kidney from the recipient may be removed several weeks in advance. During this time, dialysis (See Glossary) provides artificial kidney function.
• A kidney is removed from the donor, then chilled and preserved for up to 12 hours.
• An incision is made in the abdomen of the recipient. The abdominal cavity is examined. The new kidney is placed and sewn in position.
• The blood vessels and ureters are connected to the new kidney.
• The peritoneum and abdominal muscles are closed.
• The skin is closed with sutures or clips, which usually can be removed about 1 week after surgery.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Ureter leak.
• Rejection of transplant.

AVERAGE HOSPITAL STAY--24 to 25 days.

PROBABLE OUTCOME

• A successful transplant restores almost normal life expectancy in patients who might otherwise have died. Transplants are successful in 70-80% of cases. Allow about 4 weeks for recovery from surgery.
• A living donor continues with good kidney function and no ill effects from the procedure.

Postoperative Care

† Move and elevate legs often while resting in bed to decrease the likelihood of deep--vein blood clots.

MEDICATION---

Your doctor may prescribe:

• Pain relievers. Don't take prescription pain medication longer than 4 to 7 days. Use only as much as you need. > Stool softeners to prevent constipation. > Antibiotics to fight infection. > Immunosuppressants to reduce the likelihood of tissue rejection.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Avoid vigorous exercise for 6 weeks after surgery. Resume sexual relations when you feel able. > Resume driving 2 weeks after returning home.

DIET---Your doctor will prescribe a diet.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• You experience nausea, vomiting.