Learning the basics of kidney transplantation

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Learning the basics of kidney transplantation

Updated: 5/4/2009 10:59:59 AM
By: Ivanhoe Broadcast News
       
When an individual's kidneys fail, three treatment options are available: hemodialysis, peritoneal dialysis and kidney transplantation.

Many patients feel that a successful kidney transplant provides a better quality of life because it allows greater freedom and is often associated with increased energy levels and a less restricted diet.

A kidney transplant is an operation in which a person whose own kidney has failed receives a new kidney to take over the work of cleaning the blood. There are two types of kidney transplants: those that come from living donors and those that come from unrelated donors who have died. A living donor may be someone in your immediate or extended family or your spouse or close friend, and in some cases, a stranger who wished to donate a kidney to anyone in need of a transplant. Typically, the donor and the recipient have matching blood types.

   More Information
            
Georgetown MD Physician Referral Line
(202) 342-2400
      
            
If someone doesn't have a donor in his/her family or circle of friends, he/she usually puts his/her name on the kidney transplant waiting list. In 2007, at least 70,000 patients were on waiting lists for kidney transplants at one of 240 centers around the country, according to the Organ Procurement and Transplantation Network.

Patients are prioritized by blood type, immune system activity and other factors. The longer a person waits, the more dialysis he or she gets, the poorer the life expectancy. Kidney transplantation doubles life expectancy compared to dialysis treatment. On average, wait time nationally for a deceased-donor kidney is four to five years, but in some states, it is more than seven.

The most important complication that may occur after a transplant is rejection of the kidney. The body's immune system guards against attack by all foreign matter such as bacteria. This defense system may recognize tissue transplanted from someone else as foreign and act against it.

An incompatible kidney transplant could be one solution in speeding up the pace of the waiting list. It's a transplant that involves a living donor and a recipient whose blood types don't match. The organ recipient goes through a series of procedures before the transplant that cleans the blood and forces the blood to be compatible with the donor's despite the incompatibility. It also helps people who have antibodies that cause their bodies to reject the transplanted organ.

"Women who have had pregnancies, people who have had blood transfusions, they build up antibodies against human antigens. These people, before, we could never transplant them because they would have what's called a hyper acute rejection. What we can do now is actually get rid of these antibodies and then perform transplantation," Keith Melancon, M.D., from Georgetown University Hospital, told Ivanhoe.

Harmful antibodies are removed with a process called plasmapheresis, which is a procedure that removes the plasma portion of the blood where antibodies are located. After each plasmapheresis treatment, the recipient receives an intravenous infusion of immune globulin to replace antibodies needed to fight infections and help prevent harmful antibodies from returning. Once the antibodies against the donor's blood type decrease to very low levels, the transplantation can take place.

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