Kidney transplantation refers to replacement of the failed kidneys with a working kidney from another person, called a donor. This one new kidney takes over the work of your two failed kidneys.
Kidney transplantation is not a complete cure, although many people who receive a kidney transplant are able to live much as they did before their kidneys failed. Renal transplantation improves the quality of life and increases life expectancy.
The new kidney inside your lower abdomen and connects the artery and vein of the new kidney to your artery and vein. Your blood flows through the new kidney, which makes urine, just like your own kidneys did when they were healthy. Unless they are causing infection or high blood pressure, your own kidneys are left in place.
In the year 2000, nearly 47,000 people in the United States were waiting for a kidney transplant. Because of a shortage of donor kidneys, each year only a small percentage of people who need a transplant actually receive a kidney. The wait for a donor kidney can take years. Successful transplantation is often enhanced if organs are matched between members of the same ethnic and racial group. A shortage of organs donated by minorities can contribute to longer waiting periods for transplants for minorities.
There are three types of renal transplant. The first is possible through deceased donors. The second is through a living related donor transplant. The availability of excellent new immuno-supressants also has made possible a third type of kidney transplant through non blood related donors such as the spouse, friends, etc. At the present time, even kidneys from a donor of a different blood type can be transplanted.
In addition, for older patients in need of transplant donors, donor kidneys can be used under broader criteria. Under the broader criteria, the donors may include the kidneys of donors who died from cerebrovascular accidents (strokes), high blood pressure patients, older patients, or existing renal insufficiency patients, among others. For the elderly recipients the extended criteria donor offers better survival than dialysis.
More important than a perfect match in kidney transplant is a warm kidney donated by a living relative or friend that has not had more than a few minutes of cold ischemia( lack of blood) that is then in turn transplanted right away into the donor. The waiting period of time for a cadaveric kidney transplant varies form center to center, but a fair time could be around one and a half years. A living related kidney transplant can occur within a few months if all goes well.
For diabetic patients, a double transplant of kidney and pancreas is an option that not only brings back a new kidney function but improves the diabetic clinical picture, symptoms, complications, therapy and overall quality of life. After combined transplantation of the kidney and pancreas, the kidney will be able to filter and excrete wastes so dialysis will not be needed. The transplanted pancreas will produce insulin to control the diabetes.
People who receive a transplant must take medication and must be monitored by a physician specializing in the kidneys (nephrologist) for the rest of their lives.