Kidney Transplant

Kidney transplantation is defined as one of the most important surgical procedures that may be the cause of saving the life of the patient, and may be used by urologists due to a malfunction of the kidney of the patient, which led to the inability to perform normal functions or what is known as kidney failure.

The importance of the kidneys in the body through their function in filtering of toxins and rid the body of excess fluids and salts in the form of urine, so the incidence of a disease affects the kidneys and thus result in the accumulation of fluids and toxins in the body causing high blood pressure until the kidneys reach the final stages in their ability to work then they completely fail.

Urologist surgeons depend on kidney transplantation from a living donor or deceased in order to solve kidney problems for a patient who suffers from kidney failure. However, the matching stage preceding kidney transplantation is the most important and difficult step that determines the timing of the kidney transplant.

Treatment takes approximately "19 days".

Before starting the patient preparation procedure for kidney transplantation, the appropriate donor should be found and perform all tests to check for matching and avoid complications of the patient's rejection of the new kidney, the tests include: 

• Donor tests:
• Blood tests.
• Urine test.
• Comprehensive tests include assurance of the safety of the donor from other diseases.
• Tissue typing to verify tissue matching between the donor and the patient. 
• Echocardiogram (Echo.).
• Electrocardiogram (ECG).
• Different imaging tests, such as: X-ray, MRI, CT tests.

• Patient tests (the recipient):
• Comprehensive tests include assurance of the patient's safety from other diseases.
• Blood tests.

• Matching tests: tissue typing, verification of patient and donor blood type matching, cross-match test; mixing of donor and patient blood sample to monitor antibody reaction in patient's blood.

Kidney transplant complications may include:

• Bleeding.
• Infection.
• A leakage from the ureter that connects the kidney and bladder and may be clogged.
• Failure of kidney transplant from the donor.
• Rejection of the patient's body to the new kidney.
• Cancer or infection due to new kidney.
• Death because of a heart attack or stroke.

Kidney transplant surgery consists of:

After all the patient and donor tests are performed, and the desired match is reached, both the patient and the donor are prepared for the surgery, and the steps begin by general anesthesia for both. 

The first stage involves the removal of the healthy kidney from the donor by making 3 small incisions on the skin and inserting the laparoscope through it and the rest of the special surgical tools, then the adrenal gland is separated from the kidney as well as the ureter, and then all adherent tissues in the kidney are removed, after that making an incision in the lower abdomen to remove the kidney, but before that surgeon cut the arteries and veins connected to the kidney to release and remove it from the body and place it in an ice container to maintain it.

The second stage involves the transfer of the donor kidney to the patient's body by connecting the arteries and veins of the new kidney with certain arteries and veins in the patient's body, and then connecting the ureter to the bladder, the new kidney is placed in the pelvic area without the need to compromise the existing kidneys, even if they are in complete failure. Kidney transplantation takes 4 to 10 hours, depending on the skills of the surgeon.

*The patient may have to wait until it is his turn (waiting list); to obtain the appropriate kidney, with the need for monthly blood tests.

*Jordan adopts a law requiring the patient to obtain a kidney from first- or second-degree donors for the patient, or if only the donor is the spouse of the patient.

The patient is moved to the intensive care unit and remains under the supervision of the urologist until the new kidney is able to perform its function and how well the body responds to it. The kidneys often start working a few days after the transplant, and the patient can leave the hospital after about a week.

Success rate of the kidney transplant depends on several factors, including the skill of the urologist, and depends on the patient himself, as the patient must take care of his health very well by strict adherence to the dosage times of the drug, in addition to the application of all recommendations by the surgeon and medical staff in general.

It should be noted that the patient who underwent kidney transplantation is given anti-rejection drugs (immunosuppressive drugs) to facilitate the body's response to the new kidney, and despite the complications that may be experienced by the patient due to these drugs, but it must continue to be taken to reduce the chances of rejection of the body to the transplanted kidney.

The period following kidney transplantation is one of the important and sensitive periods in the patient's life, he has had the opportunity to start a new life without the need to adhere to the dialysis sessions in the hospital, therefore, following medical advice and the necessity of adhering to the dosages of medicine is one of the most important reasons for the success of the transplanted kidney in the performance of its functions. 

Normally, the patient spends about three to eight weeks at home depending on his or her health, after which he can return to normal life and go to work.

The patient should be in constant contact with urologist responsible for his case, and share with him all the health details he may feel, even if simple and casual.