Patients are provided with best healthcare services, while all details are considered to ensure patient comfort. These services include but are not limited to foods cooked specifically for patients with kidney failure, as instructed by our dieticians, and transportation vehicles. We will continue making our best efforts to keep you smiling.
What is Kidney Transplant?
Renal failure is a disease that occurs when fluid, urea, creatinine, uric acid and other toxic substances accumulate in body secondary to untreatable dysfunction of kidneys and inability to excrete and detoxify toxic substances due to reasons whatsoever. Patients require treatments, such as dialysis and kidney transplant, due to hypertension secondary to fluid accumulation in body or complaints, including but not limited to nausea, abdominal pain, fatigue, weakness and loss of appetite – all caused by urea and other toxic substances- or due to medical conditions, such as cardiac arrest that is caused by high potassium level.
There is no chance of survival for patients with end-stage kidney disease, if they are left untreated. Those patients have two therapeutic options, namely dialysis and kidney transplantation. Those therapy alternatives should be discussed and selected jointly by physician, patient and the family. Dialysis is a treatment method that ensures survival of patient. However, no machine can fulfill all functions of a native organ. Therefore, kidney transplant has major superiorities regarding both survival and quality of life. Patient may survive without any dietary restrictions, including food and drink, and any other life style restriction. Work and social lives of patients are normalized. Thus, patients get the opportunity to spare time for them, which would be, otherwise, spent for dialysis. They will live longer. It is necessary to emphasize that kidney transplantation costs are far lower than that of dialysis. If possible, the best approach will be surgery after preparations are immediately completed, before a fistula is opened and the patient is started on dialysis.
Kidney transplant surgery involves placing an intact organ into body of a patient, who has end-stage kidney disease, in order to fulfill renal functions. Healthy organ is obtained from cadaver or living donor for kidney transplantation. In our country, living donor kidney transplants account for a substantial part of all kidney transplant surgeries. Living donor transplants have better outcomes than cadaver donor transplants. However, number of organ donations from cadavers should increase to ensure that organ transplantations can be a cure for more patients.
How is Kidney Transplant Performed?
Kidney transplant implies transferring healthy kidneys of cadaver or living organ to the recipient. In our country, related living donor transplant is the most common type of kidney transplant. We perform living donor transplant surgeries with closed (laparoscopic) method in our hospital. Since surgical wound is very small in transplant surgeries carried out with this method, postoperative pain and similar complaints are very rare. Wound-related postoperative problems are also rare. Thus, patients experience a more comfortable postoperative period.
Inguinal incision (incision made in the groin region) is made for the recipient surgery. Arteries and veins of the region are prepared. Blood vessels of the kidney are to those vessels and blood supply to the organ is achieved. After the urinary tract is connected to the urinary bladder using an appropriate surgical technique, the surgery is terminated.
When should kidney transplantation be carried out?
Dialysis or kidney transplantation is necessary, when renal functions are below 15% of normal ranges in a patient with chronic renal failure. Kidney transplant should be primarily considered and opportunities should be investigated for all patients without contraindication. Dialysis therapy saves the life of dialysis patients and ensures survival. However, it is also associated with various complications, primarily injury of veins in the course of time. Therefore, transplant surgery before dialysis is superior regarding kidney and health of person.
Who are not good candidates for kidney transplant?
There are very scarce patients, for whom kidney transplantation is contraindicated. Transplantation is not an option for patients with active infection. In this case, transplant surgery is carried out, after relevant treatment is completed. For patients with tumor, a particular period, depending on the type of tumor, should elapse, after tumor is treated, and transplantation can be performed, after recurrence-free condition is verified. Transplant is not an option in presence of metastasis (dissemination of tumor to other organs). Transplantation is not recommended for patients with blood type incompatibility, since transplant kidney will be probably rejected by the body. Transplant surgery is not performed, if cross match test is positive, which compares blood types of donor and recipient. Advanced age is a relative factor that should be considered for kidney transplant. Biological age, general health status and other organ functions of the patient should be assessed in combination. Age alone should not be considered as a contraindication for transplantation.
What Are The Benefits Of Kidney Transplant Surgery?
Dialysis therapy can only fulfill 10% of functions of a healthy kidney. A successful kidney transplant can achieve 70 to 80% of the renal functions of a healthy individual.
Has Kidney Transplant Surgery an Advantage Over Dialysis?
It has many significant advantages. Majority of patients will attain an almost normal life in postoperative 1 to 2 weeks. Except the medications they will take in mornings and evenings, their work and social lives will maintain within normal ranges. On the contrary to dialysis therapy, they will no more have to live dependent to a device for 3-4 hours per session, three times a week.
Expected Survival after Kidney Transplant
Today, expected survival periods are much longer in organ transplantations comparing to its alternative, namely dialysis therapy. Success rate of our Kidney Transplant Center is 99 percent.
Life quality of patients, who undergo kidney transplantation, is similar to a normal healthy individual. Since dialysis machine cannot substitute all functions of viable renal tissue, dialysis patients face too many restrictions, including but not limited to inability to drink water freely and eating everything they want. They experience extra problems such as anemia, cardiovascular diseases, various infections etc. in the course of time. Due to those reasons and since they spend an important part of their time in dialysis centers, they do not have a chance to live similar to healthy people.
In brief, patients who undergo kidney transplant surgery can engage in both work and social life activities thanks to their psychological and physical health and since they gain the time they spend in dialysis therapy.
Who can donate kidney for transplantation?
Today, rules of the coordination system that is established by the Ministry of Health apply to all cadaver kidneys. Lists of patients registered in organ transplantation centers are also available in computers of the coordination system. A list of patients eligible for kidney transplant is sent to the center by the Ministry. The organ is transplanted to the patient according to the turns written on the list.
Patients with living donors can have a quicker and earlier transplantation. Up to four-degree relatives can donate organ to a patient according to the applicable laws of our country. It is also possible to receive organs from other related or unrelated donors. However, a decision of the ethics committee is required for transplantations from these types of donors. A person must be above the age of 18 in order to donate an organ or tissue. There is no certain upper limit of age. The decision is based on examinations and tests and studies to determine whether organ can be obtained from a particular donor candidate.
Can Elderly Persons Donate Organ or Tissue?
Undoubtedly, age is an important factor, but it should be considered personally for each case. Biological age is more important than the identity age. Review of heart, kidney, lungs and other systems is required for the donor. By this way, kidney transplantations from healthy elderly donors is and can be successfully carried out.
Blood Type Compatibility in Kidney Transplantation
ABO blood type compatibility is necessary. Rh compatibility is not necessary. Donor-recipient pairs are indicated at the table below.
0 or A
0 or B
0, A, B or AB
Who Cannot Donate a Kidney?
Patients with cancer, active infection and diabetes mellitus and pregnant women as well as patients with a kidney disease and any other organ failure cannot donate a kidney. Decision should be made for hypertensive patients after all relevant examinations are made.
Living Donor Kidney Transplant
In our country, living donor kidney transplants account for a substantial part of all kidney transplant surgeries. Since there is no sufficient cadaver organ donation, waiting period is usually too long. Therefore, patients need to receive long-term dialysis therapy.
It is required to start patients with an end-stage chronic renal disease on medical treatment. A patient must either receive dialysis therapy or be undergone kidney transplant surgery. Kidney transplantation is by far the best modality regarding quality of life, survival and treatment costs. Therefore, the most ethical and correct decision for a physician is to recommend kidney transplantation initially. A living donor is required in order to transplant a kidney without need to wait for a long time. The best solution for patients with a donor, who meets above mentioned legal and medical conditions, is to undergo a transplant surgery immediately. Likewise, transplant surgery is the best option for patients who are actively maintained on dialysis therapy, if there is a living donor.
Is Kidney Transplant Surgery an Option for Patients with Hepatitis?
Detailed examinations should be made for patients with hepatitis regarding cirrhosis and chronic hepatitis. Transplantation can be performed, if such conditions can be ruled out. Medicines used for the treatment of hepatitis B can be maintained after the transplantation. Thus, management of Hepatitis B can be successfully maintained, after kidney is transplanted. For patients with Hepatitis C, medications used to manage hepatitis C cannot be used after the kidney transplant surgery. It may lead to loss of kidney. Therefore, if a treatment is required for patients with Hepatitis C, it is recommended to complete treatment before the transplantation. Patients with hepatitis should be consulted with Hepatologist to determine whether the patient is eligible for transplantation.
Is Transplantation An Option For Diabetic Patients?
Diabetic Patients can also undergo transplant surgery. Superiorities of kidney transplantation also apply to diabetic patients. Recently, diabetes mellitus is one of the most common underlying cause of renal failure. Therefore, many diabetic patients undergo kidney transplant surgery. Diabetic patients should be closely followed up and managed after the transplantation