Sushma Swaraj undergoes Kidney transplant: Know all about the procedure

India is praying for healthy wellbeing of External Affairs Minister Sushma Swaraj, who undergoes a kidney transplant at AIIMS, New Delhi this weekend, with the organ being harvested from a living unrelated donor.

Kidney is one of the most important organs of the body that removes toxins from the body. The kidneys are two bean-shaped organs that are located on each side of the body, just below the ribcage. Kidney works continuously to filter waste products from the blood and convert the waste into urine. 

We bring you all about you need to know about kidney transplant.

What is Kidney transplant?
A Kidney transplant or renal transplant is a surgical procedure to place a healthy kidney from a person living or deceased into a person whose kidney no longer works.

When is Kidney transplant needed?
Kidney transplant is needed  to be performed on the person whose 90% of Kidney fails to perform its function (purifying blood by removing toxins, waste).

Type of Kidney transplant
There are two kidneys in the body and a person needs only one to survive.  Kidney transplant is of two main types – living donation and deceased donation.

Living donation

As name suggests, here Kidney donor is living. The donor should ideally be close relative that only mandatory clause in it is that the blood group and tissue types should match with that of recipients. Tissue types are determined by a test called HLA matching. This type of donation is known as a living donation.

A similar blood and tissue type reduce that risk of body rejecting the kidney. HLA stands for human leukocyte antigen and this is a genetic marker located on the surface of the white blood cells.
All persons inherit six sets of antigens from their parents, three each from mother and father. These antigens from recipients are then from donor antigens and blood group. A higher number of matching antigens increases the chance that the newly donated kidney will last for a long time.

Deceased donation or Cadaveric donation

Kidney transplant is also done from donors who have recently died. However, in this type of transplant matching of blood group and antigens are not done, therefore, chances of Kidney rejection by the body of recipients rise.

The body perceives the new kidney as a foreign object and mounts an immune attack against it. This can be suppressed by using long term immunity suppressing drugs.

How Kidney transplant is done

Doctors around the world widely use operative technique Gibson incision. In this procedure, a cut is first made over the lower abdomen through which the donated kidney is placed into it. Till now, recipient’s own kidney is left in their natural position, If it is free from any infection.

Then, blood vessels from the lower abdomen are attached to the donated kidney much like the original kidney. This ensures that the donated kidney has the blood supply to function properly. Lastly, the ureters are attached to the donated kidney.

After the procedure, the skin is tied up with sutures leaving catheter to flush out blood and fluids collecting in the operative area.

Life after kidney transplant/ future complications

-- Development of ureteric stenosis that includes narrowing of the ureters and obstruction to flow of urine from kidney into the bladder.  

Renal artery stenosis or narrowing of the renal arteries can also be seen in patients with Kidney transplant. Some patients may also develop lymph channel abnormalities called lymphoceles.

-- Over long term there may be a risk of cancers of skin or lymphomas. This could be due to the use of immunosuppressant mediations.

-- Pyelonephrritis or Kidney infection after surgery is another complication that might build on.

-- Sometimes kidney stones may be transplanted with the donor kidney or may form later in the new kidney. There may lead to blood in urine or hematuria, infections and obstruction.

-- In cadaveric donation, because the patients is given heavy immunosuppressant mediations various complication may rise . This may include herpes simplex infection in the first four weeks and then cytomegalovirus infection. Fungal and bacterial infections are also seen.

-- Heart disease like high blood pressure, high cholesterol etc. are few common complications after kidney transplant.