What is the use of kidney transplant

Kidney transplant

In a kidney transplant, the function of the diseased kidney is replaced by a kidney from an organ donor. The surgeon will either transplant a kidney from a dead person or from a living person. According to the Transplantation Act that came into force in Germany in 1997, the requirement for organ removal for a donation is the determination of brain death. Several experienced medical professionals have to diagnose this. In the case of brain death, the organs still work, but the brain functions have completely failed. Resuscitation of the patient is therefore medically impossible.

In 2005 around 2,700 kidneys were transplanted in Germany, around 9,000 dialysis patients are currently waiting for a kidney transplant.

requirements

In Germany, a prerequisite for a donation from a deceased person is that the donor gives his / her written consent during his / her lifetime, e. B. with an organ donation card, or has declared verbally. If he has not done this, his relatives can be asked about his "presumed will" and decide whether the dead relative would have agreed to a donation.

With a living donation, a kidney patient receives a kidney from a living relative or a "close person". The prerequisite is that the blood type and other certain genetic characteristics match so that the new kidney is not rejected by the body's immune system. It is also important that No economic motives or emotional pressures influence the decision to donate. For couples in whom one partner wants to donate a kidney to the patient despite having a different blood group, some clinics offer a so-called "cross-over donation" 2 couples together whose blood type of one potential donor matches that of the other partner. However, the legal regulations for these "cross-over donations" have not yet been fully clarified.

procedure

If a patient would like to have a new kidney instead of dialyzing further, the doctor will register him with the international agency Eurotransplant after extensive examinations regarding his other suitability for a transplant. There he will be put on a waiting list. In Germany, the German Organ Transplantation Foundation coordinates organ donations. She can be reached at all times via the organizational centers and sends employees to the hospitals to support the transplant team and organize the process of organ donation. The data of a potential donor are anonymized and passed on to Eurotransplant. Eurotransplant determines which patient on the waiting list will receive the organ according to defined criteria (blood group, genetic characteristics, waiting time). Currently, patients enrolled for a transplant have to wait around 6 years to receive a donor kidney.

A kidney transplant is an exciting event for the recipient (including the living donor in the case of living donation). Often times, the call comes as a complete surprise. Many people who are waiting for a kidney have therefore always packed a suitcase with the most important utensils in order to be prepared for the longed-for call.

Most of the time, the kidneys that are no longer functioning remain in the patient's body. The new kidney is placed in the pelvic fossa and connected to the blood vessels in the pelvis. After the operation, the patient has to take drugs that suppress the immune system for the rest of their life. The body recognizes the new organ as "foreign" and turns against it with its immune system. These so-called immunosuppressants prevent the new kidney from being rejected. If, on the other hand, the organ donor and recipient are identical twins, the recipient does not need to take any medication the donor organ does not trigger a rejection reaction in the body.

Forecast & course

After the procedure, the patient has to visit his nephrologist regularly to have the function of the new kidney checked. This is important so that the doctor can identify possible rejections and infections, as well as other secondary problems, at an early stage. During the transplant follow-up care, the doctor has blood values ​​such as creatinine determined, measures the blood pressure and examines the kidney using ultrasound. The transplanted kidneys often survive 10-20 years. After 5 years, around 70% of the kidneys from a brain-dead donor and over 80% of the kidneys from a living donor are still functional. People with a kidney transplant tend to live longer than those on dialysis. The most common causes of death after a kidney transplant are complications in the cardiovascular system, infections or malignant tumors.