Millions of patients around the world struggle to maintain their lives dependant on dialysis due to chronic kidney failure. Quality of life and survival rates of these patients can be increased with kidney transplant from both living and cadaver donors. Physicians from Organ Transplant Unit of Güven Hospital, answered frequently asked questions on the subject of kidney transplantation.
1. What is chronic kidney disease?
Chronic kidney disease, which decreases life expectancy and leads to additional health problems, is a severe health issue. It can be defined as permanent damage in kidneys. The primary treatment option is kidney transplant. Kidney transplantation is a method which yields highly successful results in treatment of chronic renal failure and provides many positive effects. Kidney transplantation which is performed from a cadaver or living donor, significantly increases survival rate in comparison to dialysis which is another method used in treatment of chronic kidney disease.
2. Who can become living donor candidates for kidney transplantation?
Necessary conditions to become a living kidney donor in Turkey are being mentally capable and being legally older than 18 years of age. Patient’s mother, father, siblings, children of siblings, aunts and uncles, children of these relatives, same relatives of the patient's spouse and all blood relatives up to 4th degree can become kidney donors. Other acquaintance which are not patient’s relatives can also be kidney donors. Individuals who volunteer for being kidney donors should be approved by the ethical board assigned by the Ministry of Health.
3. Who cannot be kidney donor?
Individuals with serious chronic problems such as diabetes, cancer and heart disease, individuals who have AIDS and serious active infections and pregnant individuals are not allowed to become kidney donors. Many individuals who wish to become a kidney donor worry about experiencing health problems following kidney transplant. Donor candidates undergo very detailed examinations to prevent such problems.
4. Who cannot are not eligible for kidney transplant?
The group of people deemed ineligible for kidney transplant in any circumstances are AIDS patients and patients with unmanageable cancer. All patients excluding those may be deemed appropriate for kidney transplant after their diseases are managed and waiting period is completed. Moreover, patients with active infection are not eligible for kidney transplant.
5. Is it necessary to be included in the waiting list for kidney transplant from a cadaver?
It is necessary for patients to undergo necessary examinations in an organ transplant center and be added in the national cadaver list to receive kidney transplant from a cadaver donor. All patients benefit equally from this source. Regretfully, the number of individuals in the waiting lists increases with every passing day in our country due to insufficient amount of organ donation.
6. Is blood type compatibility important in kidney transplantation?
General rules of blood donation are also valid for kidney transplantation. Therefore, blood type compatibility between recipient and donor is important in kidney transplantation. Group AB is the universal recipients and Group 0 is the universal donors. While it is actually possible to perform kidney transplantation between individuals with incompatible blood types, transplantation between individuals with compatible blood types is preferred due to some reasons such as high cost of the procedure and frequently faced rejection of kidney within the first two weeks after the transplant.
7. What is the effect of Rh factor regarding blood type compatibility between individuals involved in the transplantation?
Rh compatibility has no importance in kidney transplantation.
8. What is cross transplantation?
This method is performed by mutually exchanging kidneys between recipients who wish to donate their kidney to a relative despite blood type incompatibility. For example; assume that we have a recipient with blood type A in the transplantation center with a blood-relative donor with blood type B. There is blood type incompatibility between these two individuals in this situation. Cross transplantation can be performed if there is a couple with recipient with blood type B and donor with blood type A in the same transplantation center. Approval of ethical board is necessary in cross transplantations.
9. Is tissue compatibility important in kidney transplantations?
Tissue compatibility is not as important as assumed in kidney transplantation from living donors. However, it is important in transplants from cadaver donor. Tissue compatibility is included in the criteria in decision making stage regarding which patient will receive the kidney obtained from the cadaver.
10. What is preemptive kidney transplantation?
This is the kidney transplantation which is performed for patients who suffer from kidney disease but do not require dialysis yet, with kidney failure under a certain level. In short terms, this is the kidney transplant performed before starting dialysis. The most successful results are achieved in this group among kidney transplant patients.
11. What are the points to be taken into consideration after kidney transplantation?
The most critical issue is presenting for control examinations and using medications regularly. Infection risk of the patients increases following kidney transplantation due to administered medications. Therefore, avoiding contact with individuals who have a known infection and avoiding these environments is important. Moreover, exercising regularly and having a healthy diet are important as some medicines administered following kidney transplantation may lead to elevated blood pressure, elevated blood glucose levels and weight gain.
12. What is kidney rejection following kidney transplantation and what are the signs of this condition?
The kidney transplanted to the recipient during the procedure is a foreign tissue. Therefore, immune system of the patient may show reaction to this foreign tissue. Individuals who undergo organ transplant use certain medicines, which are called immunosuppressive drugs, for the rest of their lives to prevent this reaction. In fact, the term "kidney rejection” implies the reaction of immune system against the kidney. This risk is at its highest level in early period following transplantation and decreases over time; however it continues to be a risk factor for the rest of patient's life. The most crucial precaution against this subject is receiving treatments regularly.
13. Is it possible for kidney transplantation to be performed for a second time?
Yes, kidney transplantation can be performed for a second time. Transplantation can be repeated when transplant patient experiences kidney dysfunction, if no contraindication is identified in light of assessment.
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