What is Kidney Transplant Surgery?
A kidney transplant surgery is one of the most successful treatments for patients whose kidneys have stopped working. Kidney transplant surgery offers a second chance at a healthy, active, and independent life. During the surgery process, a damaged or non-functioning kidney is replaced by a healthy one from the donor. This new kidney then takes over the work of filtering the waste and extra fluids from the blood, something dialysis cannot do completely.
Dialysis only filters the blood by using a machine, whereas a kidney transplant completely brings back natural kidney function. It helps in body remove waste and excessive fluid, control blood pressure, and maintain a proper balance of minerals and hormones, just like any healthy kidneys. For many patients, kidney transplant surgery is not just a treatment but a new beginning.
A successful kidney transplant always begins with a suitable donor. There are two main donor types: living donors and deceased donors. Before the process of a kidney transplant, several compatibility tests are done, namely, blood group matching to make sure that the donor and the recipient are both compatible, tissue typing (HLA test) to examine how well the immune systems match, and cross-matching to check that the recipient’s antibodies don’t attack the donor’s kidney.
Surgical techniques used in a kidney transplant are well-proven and safe procedures, performed by an expert transplant team. There are three main surgical approaches, namely open kidney transplant surgery, which is the traditional and most widely used method, the minimally invasive technique, and robotic-assisted transplant. In most cases, the patient’s original kidney is not removed unless they are infected, enlarged, or causing problems such as high blood pressure. Once the new kidneys are detected to be functioning normally, the incisions are closed and patient is moved back to recovery. Most patients start feeling stronger within a few days.
Kidney transplant surgery is one of the most successful transplant surgeries performed all over the world, with an overall success rate of 90-95% for living donor transplants and 85%-90% for deceased donor transplants. The average kidney lifespan of a living donor kidney is 15-20 years or more, and that of a deceased donor kidney is 10-15 years on average.
In addition to excellent survival rates, kidney transplants significantly improve the quality of life. The patients can return to work, travel, and enjoy normal diets. Studies have proven that people who undergo kidney transplantation have longer survival rates in comparison to patients who undergo dialysis.
Kidney transplants are highly successful, but as with any major surgery, some risks do exist with it, namely, infection, blood vessel problems, urinary issues, and side effects due to medicines. To manage this, the healthcare team will monitor the patient continuously and treat any issues promptly.
| Procedure Name | Kidney Transplant |
|---|---|
| Type of Surgery | Major surgery |
| Type of Anesthesia | General anesthesia |
| Procedure Duration | 3 to 4 hours average, with sometimes about 6 hours |
| Recovery Duration | 5 to 10 days of hospital stay |
Kidney Transplant: Pre-Op & Post-Op Care
A kidney transplant is a difficult but life-altering procedure that replaces a non-functioning kidney with a healthy one from a living or deceased donor. To ensure that the kidney transplant surgery is a success, the process is divided into three main phases: Pre-operative (before surgery), Intra-operative (during surgery), and post-operative (after surgery). Each phase plays quite an important role in making sure that the patient is safe, minimizing complications, and achieving long-term survival of the graft.
Before the Kidney Transplant Surgery
The pre-operative stage is all about examination, preparation, and planning. It makes sure that both the recipient and donor (if living) are suitable candidates for surgery.
Recipient Examination – Before the transplant, the medical team performs a complete evaluation to make sure the recipient can safely undergo surgery and tolerate the new kidney. That includes
Medical history and physical examination, by checking for chronic diseases like diabetes, hypertension, infections, or cardiac issues. Blood test to evaluate kidney function, liver function, electrolytes, and blood sugar levels.
Immunological tests include blood typing (ABO compatibility) to make sure the donor and the patient’s blood groups are compatible, tissue typing (HLA matching) includes human leucocyte antigen testing to predict how well the patient receives the donor’s kidney. Cross-matching test detects if the recipient has antibodies that might attack the donor kidney.
Infection screening is done for HIV, hepatitis B and C, tuberculosis, CMV (cytomegalovirus), and other infectious diseases. Cardiopulmonary examination involves an electrocardiogram, echocardiogram, and chest x-ray to examine heart and lung health. Cancer screening is done as per age and risk factors.
Donor examination is used if a living donor is utilized, and must be physically and mentally healthy. Renal function tests are done to confirm that one healthy kidney can sustain normal function. Imaging tests are done using CT angiography or magnetic resonance imaging to map kidney anatomy and blood vessels, and a psychological examination makes sure of voluntary and informed consent.
Patient preparation includes dialysis optimization if the patient is on dialysis; sessions are adjusted before the surgery. Immunosuppressive medicines are started before surgery to prevent rejection. The patient needs to keep fasting for 6-8 hours before surgery, and the entire procedure, risks, and benefits are explained to both donor and recipient.
Surgical planning involves choosing the kidney; the left donor kidney is preferred due to longer vein length. Scheduling of surgery is coordinated between the donor and recipient teams.
Kidney Transplant Surgery – Intra-operative phase
This is the surgical phase, when the actual kidney transplantation is performed. The patient is placed under general anesthesia to ensure unconsciousness and pain-free surgery. The recipient lies on their back, slightly tilted to expose the lower abdomen.
A curved incision in the lower right or left abdomen, called the iliac fossa, is made. The diseased kidneys are usually left in place unless they cause infection, hypertension, or cystic disease.
The donor kidney is placed in the iliac fossa, outside the peritoneal cavity. The donor kidney’s renal artery and vein are carefully connected to the recipient’s external iliac artery and vein using fine sutures under magnification.
Once the blood vessels are connected, the clamps are released, and the kidney receives blood. The new kidney typically turns pink and starts producing urine immediately.
The donor kidney ureter is attached to the recipient bladder, with a small ureteric stent may be inserted to prevent blockage and aid healing.
The surgical site is checked for bleeding, the incision is closed in layers with sutures or staples, and a drain may be placed. Surgery usually lasts 3 to 5 hours. Continuous monitoring of blood pressure, urine output, oxygen, and cardiac status is done continuously.
Laparoscopic donor nephrectomy is commonly performed to remove the kidney minimally invasively. The donor kidney is then flushed with preservative solution and immediately transferred to the recipient team.
After the Kidney Transplant Surgery
After the surgery, the focus shifts to recovery, graft function, and long-term maintenance. The patient is closely monitored to make sure the new kidney functions well and complications are prevented.
Immediate care involves the patient being in the ICU for 24-48 hours for continuous observation. Urine output is monitored hourly; most kidneys begin functioning soon after surgery.
Blood pressure, heart rate, oxygen levels, and creatinine are checked frequently. IV fluids are added to maintain hydration and kidney perfusion.
Pain control, antibiotics, and anticoagulants are given to prevent pain, infection, and clotting.
Lifelong immunosuppressant drugs are started to prevent organ rejection, which include corticosteroids, calcineurin inhibitors, and anti-metabolites.
Common complications include Acute rejection, infections, and surgical issues like bleeding, urine leak, and delayed kidney function.
Long-term care includes regular follow-ups, a healthy lifestyle, getting vaccinated, and avoiding drugs with huge side effects to the kidney’s like NSAIDs.
Benefits of Kidney Transplant at Yashoda Hospitals
- Restores normal kidney function
- Improved quality of life
- Freedom from dialysis
- Longer life expectancy
- Better nutritional status
- Enhanced fertility and sexual health
- Reduced risk of heart disease
- Improved mental and emotional health
- Greater independence and productivity
- Cost-effective in the long term
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