1 AnswerNational Kidney Foundation answeredYes, in fact, there are long-term benefits of having a "pre-emptive" kidney transplant, meaning a transplant without having dialysis first. Your healthcare professional can refer you to a transplant center for tests or you can contact a local transplant center directly. If a family member or friend is willing to donate a kidney, the tests can be started right away. If there is a “match,” surgery can be scheduled. However, if you do not have a living donor, you will need to be on a waiting list until a kidney from a suitably matched deceased donor becomes available. In the meantime, you can have dialysis treatments.
There are many things a person can and should do while waiting for a kidney transplant, including:
- Consider living donation and share their story with friends and family to create an opportunity for potential living donors to come forward.
- Develop a strong community of support -- a network of friends and family members who will be available to assist throughout the transplant process.
- Continue to exercise regularly to promote endurance and faster recovery after transplant.
At the Penn Transplant Institute, kidney transplant survival rates for people with the human immunodeficiency virus (HIV) are similar to those of other high-risk populations. As part of the in-depth kidney transplant evaluation process, people will receive a consultation with an infectious disease specialist. To initiate the evaluation process, people with HIV must be well controlled for at least three months. They should also be receiving HIV medications and have a CD4 count greater than 200.
Before people become kidney transplant candidates, the transplant team performs an extensive evaluation of their kidney disease and general health to determine if transplant is the right option.
During the evaluation visit, potential transplant recipients and their families meet with members of the transplant team and receive detailed information about transplant preparation, health management during the waiting period, anti-rejection medications and an overview of the transplant process. People see a transplant nephrologist - a doctor who specializes in kidney diseases - and sometimes a transplant surgeon to discuss their medical history, receive a physical examination and to describe the different types of kidneys that are available for transplantation.
People are encouraged to consider living-donor transplantation, since it offers the best chance of success and survival.
In addition, potential transplant recipients meet with a financial coordinator to ensure they have adequate insurance coverage for the procedure and medications. Other members of the kidney transplant team including the social worker and nutritionist may meet with potential recipients and their families as well.
Tests and procedures performed during the evaluation include:
- Blood tests
- Tissue-typing tests, performed as part of the blood tests
- General lab screening for evidence of hepatitis or other viral disease
- Prostate specific antigen (PSA) for men over the age of 50
- Electrocardiogram (EKG) if not recently performed elsewhere
- Chest x-ray if not recently performed elsewhere
- Depending on age and gender, additional tests may be required.
The kidney transplant team will then meet to determine whether kidney transplant is the best treatment option for each person evaluated. A member of the transplant team then contacts the person with the results of this discussion. If the kidney transplant team decides that transplant is the best option and potential transplant recipient agrees, they are "listed for transplant."
People who may be helped by a kidney transplant undergo an extensive evaluation by the transplant team. Based on the evaluation results, the transplant team decides whether or not a transplant is appropriate as the best therapeutic option.
The decision to proceed with a kidney transplant represents a strong commitment to self-care and medical follow-up, so the ultimate decision rests with the patients. Only they can evaluate their quality of life and determine whether or not a kidney transplant is worth pursuing.
Kidney transplant may be a better treatment for you than dialysis, because survival rates are better after transplant. You will also be able to live a more normal life, because you won't have to have dialysis. Although a kidney transplant is an expensive procedure, it may actually be less costly than long-term dialysis treatments.
There is often a long wait before you receive a donor kidney. And there is no guarantee that the transplant will be successful. Fewer complications occur in people who are good candidates for surgery and who do not have other serious medical conditions, such as unstable coronary artery disease or cancer, that may limit their life expectancy.
Not everyone is able to have a kidney transplant. You will not usually have a kidney transplant if you have an active infection or another life-threatening disease, such as cancer or significant heart or lung disease.
After having a kidney transplant, you will have to take medicines that suppress your immune system (immunosuppressive medicines) to help prevent your body from rejecting the new kidney. You will need to take these medicines for the rest of your life. Because these medicines weaken your immune system, you will have an increased risk for serious infections. There is also the chance that your body may still reject your new kidney even if you take these medicines. If this happens, you will have to start dialysis and possibly wait for another kidney transplant.
Immunosuppressive medicines also increase your risk of other diseases, such as skin cancer and lymphoma. You have a greater risk for diabetes, high blood pressure, heart disease, cataracts and inflammation of the liver (cirrhosis) if you are taking these medicines.
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If you have severe chronic kidney disease and choose to have a kidney transplant, you may live longer than if you choose only to treat your kidney disease with dialysis alone.
Transplants using a kidney from a first-degree relative, such as your father, mother, brother or sister, are the most successful. And transplants from living donors are usually more successful than transplants from deceased donors.
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A kidney transplant is surgery to replace your own diseased kidneys with a healthy (donor) kidney. See a picture of a kidney transplant. There are two types of donors:
- Living donors. A living donor may be a family member, a friend, a coworker or any person who is willing to give a kidney to someone in need. A person only needs one healthy kidney to live.
- Cadaver donors. A cadaver donor is someone who has recently died. Most donor kidneys come from this source.
In both cases, the key to success is having the closest possible blood and tissue matches. A family member is not always the best match.
You will need to have tests to make sure the donor kidney matches your tissue type and blood type. This helps reduce the chances that your body will reject the new kidney. You will also be evaluated to make sure that you do not have significant heart or lung disease or other diseases, such as cancer, which might decrease your life span.
Kidney transplant surgery takes about 3 hours. During surgery, the donor kidney will be placed in your lower abdomen, blood vessels from the donor kidney will be connected to arteries and veins in your body and the ureter from the donor kidney will be connected to your bladder. Blood is then able to flow through the new kidney, and the kidney will begin to filter and remove wastes and to produce urine.
The new kidney usually begins to function right away. In most cases, diseased or damaged kidneys are not removed unless you have a severe infection of the kidney (pyelonephritis), kidney cancer, nephrotic syndrome, or extremely large polycystic kidneys.
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A transplant rejection is the body's destruction of a newly introduced organ or tissue. A person's immune system does not recognize the cells of the transplanted material, which triggers it into action to kill the transplanted tissues.
The immune system's response eventually makes the organ or tissue unable to function.
Medicines are given to suppress the immune system. But taking them can make it easy for a person to get sick. Having a suppressed immune system makes it hard for a person to fight off all types of infections. But transplants are usually successful.
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1 AnswerAmerican Diabetes Association answeredTo fool the body into accepting the donor kidney, doctors try to match the donor and recipient for a blood protein called human leukocyte antigen (HLA) type. Despite the best HLA matching, the body may still not recognize the new kidney as part of itself. For this reason, people with kidney transplants must take certain drugs the rest of their lives. These drugs are called immunosuppressants, because they suppress the immune system to keep it from fighting the new organ. These drugs include azathioprine and cyclosporine A. Despite these drugs, some kidney transplants fail. When the body attacks the new organ as foreign, it is called rejection.