WHAT YOU NEED TO KNOW BEFORE THE KIDNEY TRANSPLANTATION
How the kidneys function
Kidneys are one of the most significant organs in the body. They enable the filtration of residual products from the blood and the elimination of excess fluid in urine. They also support the regulation of the blood pressure, the formation of the new red blood cells and the maintenance of the bone health. They are located under the ribs and beside the two sides of the vertebra. They look like a bean and their normal size is 12x6x3 cm in a healthy adult. Some people are born only with one kidney and in such cases the size of the unique kidney is generally bigger than normal. Such people can live normally with one healthy kidney.
What renal insufficiency is
Chronical renal insufficiency is a permanent impairment of renal functions. This may proceed to the so called ‘last stage renal insufficiency’ which is a stage where the renal functions are completely impaired and dialysis and kidney transplantation treatments are obligatory for life.
The risk factors
Diabetes may lead to renal disease. A not well-controlled blood sugar damages the blood vessels in the kidneys.
- Hypertension (High blood pressure)
Non-controlled hypertension impairs the capillary structure of the kidneys and leads to damage.
- Renal stone disease
The stones formed in the kidney and urinary tract directly or indirectly prevents the urine flow and may lead to permanent impairment.
Glomerulonephrite leads to inflammation in the renal vessels and impairs the renal tissue; leads to protein in urine, blood in urine and progressive renal disease. Pyelonephrite arises with the recurring urinary tract infections spreading to kidneys.
- Structural Impairments
In polycystic renal disease, a high number of cysts (vesicles full with fluid) are found in the kidneys
The side effects of many medicines especially the ones excreted through the kidneys may impair the renal functions. Care must be taken with antiinflammatory and analgesic medicines used in rheumatic diseases. Any kind of medicine should be definitely used under the supervision of physicians. Furthermore some toxins and heavy metals also impair the kidney.
- Other diseases
Secondary lupus and other connective tissue diseases
Kidney transplantation is the operation where the kidney of one person is taken and placed into another person’s body. The kidney to be used for transplantation is supplied from two sources: living donor or the people with cerebral death.
What are the advantages of kidney transplantation compared to dialysis?
In sucessfull kidney transplantations which are performed with the kidneys from living donors and donor with cerebral death, all renal functions are fullfilled rather than some of them as in dialysis treatments. Furthermore, the quality of life is better since the physical and psychological drawbacks due to dialysis are eliminated. Poisonous substances like urea and creatinine are not accumulated in the body, they are eliminated from the body through the kidneys. It provides the patients with a more qualified and longer life.
The best treatment of the last stage renal insufficiency is the kidney transplantation!
HOW THE KIDNEY TRANSPLANTATION IS PERFORMED?
How is the suitable kidney selected fort he transplantation?
For kidney transplantation, the AB0 blood groups of the recipient and donor shuold be suitable just like in the blood transplantation. The group 0 is the general donor whereas the group AB is the general recipient. According to this rule, the people with the blood group 0 can give their kidneys to everybody whereas the people with the blood group of AB can receive kidney from everbody. The Rh factor is not important. Someone without Rh factor can receive kidney from a person with Rh factor. After blood groups, the tissues should also be suitable.
After the necessary preparations are completed, the kidney taken from the donor is treated in the protecting fluid and subsequently placed in to the left and right inguens (iliac fossa) of the recipient. After the kidney transplantation, medicines suppressing the immune system are used to avoid the patient from rejecting the new kidney. Today’s medicines make a successfull kidney transplantation possible in the majority of the patients. With the new medicines to be developed, organ transplantations from animals might be possible or the development in genetics may result in artificial organ production.
Approval of ethics committee
‘The National Coordination System for Organ and Tissue Transplantation” was carried into effect by the Ministery of Healrh in order to make the regulation of the organ and tissue transplantations from the living donors easier. According to that, organ and tissue translantation from living donors can be done from the relatives of the recipient who are up to the fourth level (the fourth level is included). The organ and tissue donor canditates which are not included in this classification will be evaluated by the local ethics committee of the related Organ and Tissue Transplantation Centre and the transplantation can be performed if it is approved by this committee.
With regard to the fourth level relation; the 17th clause of the Turkish Civil Code includes the following definition: ‘The level of the blood relation is determined with the number of births relating the people to each other’.
In the blood relation::
- level relatives: Mother, father, children
- level relatives: Siblings, grandfather, grandmother, grandchild
- level relatives: Uncle, aunt, niece, nephew (child of the sibling)
- level relatives: The children of the 3.level relatives.
In the relation of in laws, the relatives of the spouse are classified in the same way.