The procedure of transplanting a kidney is one of the most important developments in the field of medicine. It involves the replacement of a diseased kidney with a healthy one obtained from another person. Know more about this medical advancement by reading this Buzzle article.
Kidney transplantation refers to the surgical procedure of removing a diseased kidney, and then replacing it with a new, healthy kidney. The first authenticated renal transplantation was carried out in the United States on 17th June, 1950, on Ruth Tucker, who was suffering from polycystic kidney disease. But unfortunately, the transplanted kidney was rejected by her body. However, the diseased kidney started operating, for which she survived another five years after the transplantation.
More About Renal Transplantation
Renal transplantation can be mainly divided into two types, depending on the source from where the kidney is obtained for transplantation. It is termed as deceased donor transplantation, if the kidney to be transplanted is obtained from a deceased person. Living donor transplantation is the term used when the kidney is donated by a living individual.
The deceased donors can be classified into two types, the brain dead (irreversible loss of brain functions) donors and the cardiac death donors. The living donor transplantation can again be classified into two types – genetically related transplant (if the donor is biologically related to the recipient) and non-related transplant (when the donor is not biologically related to the recipient).
Transplantation is usually required in individuals with terminal renal or kidney diseases, where the filtering capacity of the kidneys slowly reduces and ultimately leads to a complete failure to eliminate waste products from the body. This is known as renal or kidney failure, and is indicated by a high level of creatinine in blood.
In such a situation, the available treatment options are dialysis (the removal of the waste products from the blood by artificial means) and kidney transplantation. Other symptoms of terminal kidney diseases include high blood pressure, an accumulation of urea, hyperkalemia or high levels of potassium in blood, and hyperphosphatemia (reduced elimination of phosphate).
Kidney or renal failure can be associated with diabetes mellitus, malignant hypertension, and glomerulonephritis or the inflammation of the glomeruli or small blood vessels of the kidney. Sometimes, genetic conditions like polycystic kidney diseases, autoimmune conditions, and inborn errors in metabolism can also be responsible for causing renal failure.
The Procedure
The transplantation surgery usually involves the removal and replacement of a single kidney. Sometimes, the diseased kidneys are not removed from the body, and the transplanted kidney is placed in the lower abdomen. In such a situation, the renal artery of the transplanted kidney is connected to the external iliac artery, while the renal vein of the new kidney is usually connected to the external iliac vein of the recipient.
One of the major complication of this procedure is rejection, especially when the transplanted kidney is obtained from a genetically non-identical person. The immune system recognizes the transplanted kidney as a foreign element and hence rejects it. This necessitates the suppression of the immune system with appropriate immune-suppressive medications. However, a suppressed immune system can make the recipient vulnerable to infections.
Therefore, it is crucial to maintain an equilibrium so that the transplanted kidney is not rejected, and at the same time, the patient can be protected from dangerous infectious diseases. For a successful kidney transplant, the compatibility of the blood group of the donor and the recipient is an important requisite. The compatibility of HLA (Human Leukocyte Antigen) and minor antigens is also desirable. Certain complications such as heart diseases, cancer, and infections have been found to increase the complications associated with the transplantation surgery.
Earlier, the removal of the kidney from the body of a living donor required an open surgery. But nowadays, it can be done with the help of laparoscopic surgery, which ensures quick recovery. This has simplified the process of donating a kidney, besides increasing the number of living donors. In the course of time, it is expected that research and studies devoted to this field will significantly simplify the procedure, and reduce the complications associated with it while adding a new dimension to the development of medical science.
