What is a Kidney Transplant?

Kidney transplant, also known as nephrectomy, is a surgery performed on your kidneys to remove all or part of your swollen kidneys and treat a variety of conditions. A urologist or urologic surgeon usually performs the surgery.

A kidney transplant is required to treat conditions like kidney cancer, chronic kidney diseases, kidney stone removal, kidney infection, renal hypertension, traumatic kidney injury, and kidney donation.

Your urologist may remove your swollen kidney through open surgery or laparoscopically. Laparoscopic surgery involves smaller incisions and takes a shorter time to recover. Recovering from a nephrectomy can take several weeks and may be very painful.

Why is a Kidney Transplant Performed?

Knowing how the kidneys function is essential to understanding why a kidney transplant is performed. Most people have two kidneys, fist-sized organs near the back of the upper abdomen. Your kidneys are the organs that:

Filter waste, excess fluid and electrolytes from your blood
Produce urine
Maintain proper levels of minerals in your bloodstream
Produce hormones that help regulate your blood pressure

The most common reason a urologic surgeon performs a nephrectomy or kidney transplant is to remove a tumour from the swollen kidney. These tumours are usually cancerous, but they can be noncancerous or benign. There are many kidney conditions to be treated, hence there are many different types of kidney removal surgeries that can be done; the two most important are:

Damaged Kidney

If your kidneys are damaged or swollen, you may need to remove part or all if they aren't functioning correctly. The main reasons for swollen kidney removal include damage or scarring, which may be caused by disease, injury, or infection. Cancer is another reason for kidney removal.

Donating a Kidney

This is another reason why kidney transplants are performed. Very often, people may donate their healthy kidney to a person who needs a new kidney. The healthy donor kidney then replaces the recipient's damaged kidney.

What Are The Conditions That Require a Kidney Transplant?

The conditions that require a kidney transplant may include:

Kidney Cancer

Kidney cancer, also called renal cancer, is caused when kidney cells become malignant or cancerous and grow out of control, forming a tumour and swelling. Surgery is often the only recourse for those who have kidney cancer. There are very slim chances of surviving kidney cancer without surgery being performed. Even people whose cancer has spread to other organs may benefit from surgery to take out the kidney tumour. Very often, the removal of the swollen kidney, which is cancerous, may enable people to live longer. In cases like these, a doctor may recommend surgery, even in cases where the cancer may have spread to areas beyond the kidney.

Chronic Kidney Diseases

The cause of chronic kidney disease includes conditions that damage your kidneys and decrease their ability to keep you free from toxins. If kidney disease worsens, your body's waste can build to high levels in your blood and make you feel sick.

Kidney Stones Removal

A kidney stone is a rigid mass created from salts and minerals of calcium and uric acid in the urine. Urine has various wastes dissolved in it. Excessive waste in very little liquid causes crystals to form. These crystals in the kidney act as magnets, attracting other elements and uniting together to create a solid mass that gets typically larger until it is excreted out of the body with urine. These chemicals usually pass away in the urine, directed by the body's master controller: the kidney. After formation, the hard mass may remain in the kidney or move down the person's urinary tract into the ureter.

Kidney Infection

Your kidneys are part of your urinary tract, which makes urine and removes it from your body. The urinary tract comprises your kidneys, ureters, bladder and urethra.

If any of these parts are exposed to bacteria, they can cause a urinary tract infection (UTI). Most often, the bladder gets infected. This is a sure sign of a kidney infection, which must be treated immediately.

Renal Hypertension

Renal hypertension, also known as renovascular hypertension, is increased blood pressure that may be caused by kidney disease. It is also caused when the arteries that deliver blood to the kidneys become narrow. In this condition, the arteries of one or both kidneys may be narrowed.

Traumatic Kidney Injury

Kidney or renal trauma occurs when an external force injures a kidney. The back muscles and the rib cage protect the kidneys. But injuries can happen as a result of:

Blunt trauma is a damaging condition that may be caused by impact from an object that doesn't damage the skin.
Penetrating trauma is a damaging condition that may be caused by an object that pierces through the skin and, after that, enters the body.

Kidney Donation

Among the most common reasons for kidney donation are emotional ties, such as those between spouses or other family members. However, an increasing number of donors are interested in donating to those in need despite having no familial ties.

Types of Kidney Transplant

Kidney Removal Surgery:

Kidney removal, also called nephrectomy, is a type of surgery that removes the entire kidney or part of it. It may involve:

Part of one kidney being removed - partial nephrectomy
All of one kidney being removed - simple nephrectomy
Removal of a single kidney, including the surrounding fat and adrenal gland – radical nephrectomy.

Simple nephrectomy or open kidney removal:

It requires you to be lying on your side. The surgeon will make an incision or cut up to 12 inches long. It will involve making an incision cut on your side, just below the ribs or right over your lowest ribs. Then, the tube that takes urine from your kidneys to the bladder or ureter and blood vessels are surgically separated from the kidney. The kidney is then removed.

Partial Nephrectomy:

It requires just a part of the swollen kidney to be removed. The cut is then closed with stitches or staples.

Radical Nephrectomy or open kidney removal:

In this procedure, the surgeon makes a cut about 8 to 12 inches long. This incision is on the front side of the belly, just below the ribs. It may also be done on your end. The swollen kidney is then removed.

Laparoscopic kidney removal:

It is a procedure in which the surgeon makes three or four small cuts, most often no more than 1 inch each, in your belly and side. The urologic surgeon uses microscopic probes and a camera to perform the surgery.

Tow Surgery for Kidney Stones: it end of the procedure, the surgeon makes one of the cuts larger, about 4 inches, to remove the swollen kidney.

Surgery for Kidney Cancer:

Your surgeon will evaluate your condition based on factors such as the size and location of the tumour. Depending on your situation, he may use a standard open surgical approach or a minimally invasive technique using tools, such as laparoscopes, that can remove tissue.

A procedure called radical nephrectomy is used to remove the entire swollen kidney. The presence of large tumours may force a kidney specialist hospital to recommend this option.

Kidney transplant:

Kidney transplant surgery typically lasts three to four hours. During surgery, the transplanted kidney is placed in the pelvis near one of your hip bones, and the surgeon connects the blood vessels from the transplanted kidney to the blood vessels in the pelvis.

The ureter (urine drainage tube) from the transplanted kidney is connected to your bladder so urine can be excreted. A flexible, narrow tube stent is inserted into the ureter and passes into the bladder to keep an open connection. The stent will then be extracted around six weeks after surgery using a surgical procedure called a cystoscopy.

There are five types of surgery procedures for removing kidney stones.

Extracorporeal Shockwave Lithotripsy Procedure (ESWL) – This is a procedure in which a non-electrical shock wave is passed through your body to the area that is infected to impact the stone until it reduces to a sand-like consistency and passes on.
Percutaneous Nephrolithotomy (PNL) – When the kidney stone is situated in a location that is difficult to reach by non-electrical shock waves, this procedure comprises making a tunnel to the kidney through an opening at the back; the location of the stone is determined and extracted by a nephroscope.
Ureteroscopic Stone Removal – In this procedure, a ureteroscope is passed into the ureter, and the stones are shattered using shockwave-producing equipment or removed using a cage-like device.
Open Surgery – here, the area that is infected is cut open, and kidney stones are completely removed.
Coagulum Pyeloloithotomy – This is the least invasive procedure. It uses antibiotics to remove the kidney stones.

Kidney Cyst surgery:

A kidney cyst is a fluid-filled sac that develops on one or both kidneys. These cysts are round and thin-walled and can range in size from microscopic to around 0.5 inches in diameter. They may be associated with a serious condition, but in most cases, they are harmless and referred to as simple kidney cysts.

If the kidney swells or becomes large enough to cause pain, discomfort, or high blood pressure, it may need to be surgically removed. Some approaches used to remove a cyst are described below.

Retrograde Intrarenal Surgery:

A procedure is the go-to choice for cases where a cyst can be accessed from the part of the kidney basin involved in draining. A small telescope is passed into the ureter to the kidney, where a laser is used to cut the cyst and open it to drain it.

Percutaneous Kidney transplant:

This minimally invasive technique is employed in cases of larger cysts that have developed in the posterior of the kidney. It enables the surgeon to perform endoscopic surgery on the swollen kidney using a small opening called a tract. A tract is created by making a tiny cut in the skin and tissue, leading straight into the kidney.

A sleeve is placed into the organ to cover the distance between your kidney and skin. Endoscopic instruments are then guided through the sleeve and into the kidney so that the cyst can be opened and a large portion of the wall removed under X-ray guidance.

Laparoscopy and Removal of the Cyst:

It is usually performed when a patient has multiple cysts or a huge cyst. Laparoscopy and cyst removal is the most suitable kidney specialist hospital for a genetic condition called polycystic kidney disease (PKD).

Are You THhe Right Candidate for Kidney Surgery?

Many people think that a successful kidney transplant is the gateway to a better quality of life than dialysis. You must be evaluated at a transplant centre or kidney specialist hospital to be considered for one. It is carried out to ensure that a kidney transplant is genuinely the very best choice for you. The evaluation will be comprehensive and may take several months to complete. You will meet with transplant team members, including a transplant surgeon, nephrologist, nurse coordinator and dietitian. Your transplant team will need to know a lot about you to help them—and you—decide if a transplant is right for you.

Your evaluation

Most kidney specialist hospitals or centres have a coordinator who will speak to you over the phone and start the process. The coordinator will get basic information and then send you a questionnaire to complete.

The next step is an initial visit to a kidney specialist hospital. At the transplant centre, you will meet with several people. The team will then discuss the transplant process with you and examine your physical, psychosocial, and financial needs. You can best help with the process by completing all your testing as quickly as possible.

At the kidney specialist hospital or evaluation centre, you can expect to have the following:

A medical and surgical history
A physical exam
A psychosocial assessment
Compatibility tests

After the follow-up evaluation is complete, the transplant team at the kidney specialist hospital will meet to discuss your results. You will not be present for this meeting. The person coordinating the transplant will contact you about the team's recommendation for a kidney transplant and the next steps.

How Do i Prepare For Swollen Kidney Transplant?

You'll receive instructions at the kidney specialist hospital about what to do the day before and the day of your surgery. Make a note of any questions you might have:

When do I need to begin fasting?
Can I take my prescription medications?
If yes, how soon can I take a dose before the surgery?
What non-prescription medications should I avoid?
When do I need to arrive at the hospital?

Complications and Risks that may arise

Recovery time after the procedure and the length of your kidney specialist hospital stay depends on your overall health and the type of nephrectomy performed. You can expect to receive thorough instructions before leaving the hospital on issues like restrictions to your diet and other activities. You may be advised when you can begin light, everyday activities as your ability permits. You'll also need to avoid strenuous activity, like heavy lifting, for several weeks.

Kidney transplant surgery is a procedure that bears the risk of the following complications:

Blood clots and bleeding
Leakages from or blockage of the ureter that connects the kidney to the bladder
Infection
Failure or rejection of the donated kidney
Any infection or cancer that could be transmitted via the donated kidney

Precautions to take after a kidney transplant

After your kidney transplant, you can expect to:

1. Spend several days to a week in the kidney specialist hospital:

Doctors and nurses will monitor your condition in the hospital for any signs of complications. Your newly treated kidney will make urine like your kidneys did when they were healthy. You can expect soreness or pain around the surgery site during healing. Many kidney transplant recipients return to work and resume their normal activities within eight to ten weeks after the transplant.

2. Have frequent check-ups as you continue recovering:

After you leave the kidney specialist hospital, close monitoring is necessary for a few weeks to check how well your new kidney works after the kidney specialist hospital or transplant and to ensure your body is not rejecting it.

3. Take medications for the rest of your life:

You will need to be taking several medications after your kidney transplant. A category of drugs called immunosuppressants or anti-rejection medications will help to keep your immune system from attacking and rejecting your newly transplanted kidney.

4. Diet and Nutrition

After your kidney transplant at the kidney specialist hospital, you may need to adjust your diet to keep your new kidney healthy and functioning well. You will probably have fewer dietary concerns than when you were receiving dialysis before your transplant, but you still may need to make some diet changes.

5. Exercise

Once you recover from your transplant surgery, exercise and physical activity should be a regular part of your life to continue improving your overall physical and mental health. After your transplant, doing regular exercise helps boost your energy levels and increase your strength.

KIDNEY TRANSPLANT FAQS: ALL YOUR CONCERNS ADDRESSED

Q1. What is a kidney transplant?
A1. Kidney transplant, or nephrectomy, is a surgery performed on your kidneys to remove all or part of your swollen kidneys and treat various conditions. A urologist usually performs the surgery.

Q2. Why is a kidney transplant performed?
A2. The two most important reasons are:

Damaged kidney
When your kidney/s are damaged, you may need to have part or all of your kidney/s removed if they aren't functioning correctly.
Donating a Kidney

This is another reason why surgery is performed on swollen kidneys. Sometimes, a person will donate their healthy kidney to someone needing a new one. The healthy donor kidney then replaces the recipient's damaged kidney in a surgery called a kidney transplant.

Q3. What are the various types of kidney surgeries?
A3. Kidney Removal Surgery

Kidney removal, or nephrectomy, is a surgery performed to remove the entire kidney or part of it. It may involve:
Part of one kidney being removed
All of one kidney being removed
Removal of one entire kidney

Q4. Surgery for Kidney Cancer
A4. The surgeon at your kidney specialist hospital will evaluate your condition based on factors such as the size and location of the tumour.

Q5. Kidney Transplant
A5. Kidney transplant surgery typically lasts about three to four hours. During surgery, the transplanted kidney is placed in the pelvis near one of your hip bones. The surgeon connects the blood vessels from the transplanted kidney to the blood vessels in the pelvis.

The ureter, or urine drainage tube, from the transplanted kidney is connected to your bladder so urine can be excreted. A stent is a flexible, narrow tube inserted into the ureter and entered the bladder to keep an open connection.

Q6. How do I take care of my kidneys?
A6. To preserve normal kidney function, your doctor may recommend eating a healthy diet, engaging in daily physical activity and attending regular check-ups to monitor your kidney health. If you are awaiting a donated kidney or a transplant surgery is scheduled, you need to be intentional and work towards staying healthy. Be as healthy and active as possible; this will better prepare you for the transplant surgery. It will certainly help to speed up your recovery from the surgery.

Q7. How long does it take to recover from Kidney Surgery?
A7. Recovery after kidney surgery usually takes between three and six weeks. Your doctor may recommend staying in the hospital for up to seven days. Ask your doctor about the success of the surgery and any follow-up treatments you might need.

Q8. What are the risks of kidney removal?
A8. Surgical procedure of removal of all or part of a kidney is called nephrectomy. Most often, a nephrectomy is performed to remove a benign (noncancerous) tumour or to treat kidney cancer. There are risks associated with it as it's a major surgery. Some of them are:

Blood loss
heart attack
stroke
Pulmonary Embolism (Blood clot in legs that moves into the lungs)
Breathing difficulties

Q9. What are the side effects of living with one kidney?
A9. A Kidney surgery nephrectomy or organ donation of a kidney can lead to this condition of living with only one kidney. Some people are born with only one kidney. This condition is called Renal Agenesis. Another condition, called Kidney Dysplasia, causes a person to be born with two kidneys, but only one of them works. Most people born with only one working kidney live a healthy life daily. Your kidneys filter out waste and extra fluid from your blood. Medically, although a human body has two kidneys, you only need one functioning kidney to live a healthy life. So yes, you can live an active life with one kidney. The measures recommended for healthy living, if you have only one kidney, are the same for people with two kidneys

Eat a healthy diet
Exercise Regularly
Maintain a healthy weight
Drink a sufficient amount of water and fluids to stay hydrated.
Maintain normal blood pressure and blood sugar.