Chronic kidney disease (CKD) is a silent killer that undermines our health. Its prevalence is increasing and is projected to be the fifth leading cause of death worldwide by 2040.

Our kidneys, responsible for filtering waste and maintaining electrolyte balance, progressively deteriorate with CKD. Eventually, they reach end-stage renal disease (ESRD), where these organs fail to function effectively.

This is where kidney transplantation offers a beacon of hope, freeing ESRD patients from dialysis restrictions and empowering them to reclaim a healthier life.

Healthy kidneys are the foundation for a well-oiled body. Kidneys function by removing waste, regulating fluids, and ensuring the right balance of minerals by producing urine. It’s also involved in regulating acid-base balance, blood pressure and production of red blood cells.

When kidney function fails irreversibly, kidney transplantation confers a life-saving procedure and life changing option.

This surgery replaces the function of the diseased kidney with a healthy one from a living or deceased donor. In some cases, compatible family members can donate one of their kidneys.

Understanding Kidney Failure

In cases of chronic kidney disease or end-stage renal disease, kidney transplantation is often considered the optimal treatment modality compared to long-term dialysis.

When kidneys lose their filtering ability, waste products and fluids build up within the body.

This can trigger high blood pressure and ultimately progress to kidney failure, medically termed end-stage renal disease (ESRD), whereby 90% of the kidney function is lost.

Treatment options for kidney failure

Fortunately, a range of treatment options empowers patients with kidney failure to regain control of their health.

However, each approach has its advantages and limitations, making informed decision-making crucial.

Hope to expand your knowledge on kidney diseases? Know all the warning signs to heed through this article on 5 Danger Signs Not to Ignore – Your Kidneys could be in Trouble!

Types of Kidney Transplants

There are two main types of kidney transplants which include:

Deceased donor kidney transplant

The procedure entails transplanting a healthy kidney from a recently deceased individual to replace a non-functioning kidney in the recipient.

This can happen with the family’s consent or based on the donor’s wishes which are documented on an organ donor card.

Deceased-donor transplants can be further categorised into:

• Donation after cardiac death (DCD)
• Donors with high-risk social behaviour
• Double kidney transplants (dual)
• Expanded criteria donors (ECD)
• Standard criteria donors (SCD)

However, this approach also has its advantages and limitations:

Living donor kidney transplant

Living-donor transplants offer an alternative path for recipients in shortening their wait time while increasing their survival rate.

A healthy person, often a close relative like a parent, sibling, or child, donates one of their kidneys to the recipient with kidney failure.

This act of generosity extends beyond family – uncles, aunts, cousins, spouses, friends, and even anonymous good Samaritans can be living donors.

However, this approach also presents a unique set of considerations, offering advantages and limitations.

Kidney Transplant Requirements

While specific criteria vary by hospital, ideal kidney transplant candidates must have several medical eligibilities for a successful implant:

• Capably fit for undergoing major surgery.
• End-stage CKD, nearing dialysis dependence.
• Good chance of a successful transplant.
• Long term kidney failure and is dependent on dialysis.
• Long-term commitment to daily immunosuppressant medications is essential.

Age is often flexible for transplant candidacy. While some hospitals have upper limits, thorough medical evaluations are needed to ensure suitability for all potential recipients.

Are you facing unknown urology symptoms? Check out this article on ‘Recognising the symptoms of common urologic disease’ to help you decide when to see a urologist.

Kidney Transplant Process

1. Preparation and what to expect

• Initial consultation and evaluation
  You and your potential donor will need to undergo a thorough evaluation at a transplant centre. You can either opt for your healthcare provider to refer you to a transplant centre or self-refer.
• Comprehensive testing and assessment
  Extensive testing is crucial for a successful transplant. For instance, blood tests help identify compatible donors, and minimise organ rejection risks. Diagnostic tests, including X-rays, CT scans, ECG, ultrasounds, and biopsies if required, for an overall kidney function and health assessment.Women may undergo additional examinations.

2. Kidney transplant surgery

A kidney transplant typically involves a hospital stay and a surgical procedure that normally lasts up to 3 to 4 hours.

While the specifics may vary based on your health and your doctor’s approach, the general process goes something like this:

1. Intravenous (IV) lines and catheters will be placed for monitoring and blood access.
2. Any excess hair near the surgical site might be shaved.
3. A urinary catheter will be inserted.
4. You’ll be positioned lying on your back for surgery under general anaesthesia.
5. The surgeon will make a long incision in your lower abdomen for placement of the donor kidney.
6. The donor kidney will be placed in your abdomen, with the left kidneys on the right and the right kidneys on the left for an easier ureter connection.
7. The donor’s blood vessels will be connected to your own and blood flow will be checked for leaks.
8. The donor’s ureter will be connected to your bladder.
9. The incision will be closed with stitches or staples and a drain may be placed to reduce swelling.
10. A sterile bandage or dressing will be applied.

Preventing rejection is crucial to your new kidney’s success. To achieve this, you’ll need to take anti-rejection medications exactly as prescribed by your transplant team, following their guidance on dosage and timing.

It is also important to attend all scheduled clinic visits and lab tests so your doctor can ensure your new kidney is functioning properly.

3. Recovery and Life After Transplant

• Recovery time
  Following successful transplant surgery, most patients spend 4-5 days in the hospital’s specialised transplant unit, but this time frame varies depending on individual needs and recovery progress.
• Medications and anti-rejection protocols
  To optimise the long-term function of your transplanted organ, you will require lifelong adherence to an immunosuppressive medication regimen.These medications will suppress your immune response and mitigate the risk of rejection. However, this necessitates heightened vigilance regarding potential infections.
• Follow-up care and monitoring
  Following hospital discharge, a comprehensive, patient-centred approach to your care will be implemented.As your health stabilises, your care will seamlessly transition back to your nephrologist. However, your transplant team will continue to conduct annual comprehensive assessments to ensure optimal long-term outcomes.
• Lifestyle adjustments
  Your doctor might recommend a balanced diet that supports kidney health, followed by approved regular physical activity for your overall well-being.You would also need to be extra vigilant about hygiene, like washing hands frequently and avoiding crowds during cold and flu season.

Regain Control of Your Health with a New Kidney

A kidney transplant offers more than just restored kidney function; it empowers you to reclaim control of your health and live life to the fullest.

With proper care and a commitment to healthy habits, you can significantly improve your quality of life.

If you’re battling chronic kidney disease and considering a transplant, our dedicated nephrology team at Island Hospital in collaboration with NKF, is here to guide you through every step of the process.

We understand your unique challenges, and we’re committed to providing exceptional care, from pre-transplant evaluation to post-surgical follow-up.

Schedule an Appointment with Island Hospital today!

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FAQ

1. How much is a kidney transplant in Malaysia?

Getting a kidney transplant at a private hospital in Malaysia can be expensive. The recipient’s surgery costs between RM70,000 and RM100,000, and there are additional expenses of RM40,000 to RM60,000 for the donor’s care.

2. What happens to your old kidney after a transplant?

In most cases, surgeons will opt to leave your original kidneys in place. However, there are a few situations where removal becomes necessary:

• Infection Risk
  If your original kidneys harbour an infection that could spread to the new, transplanted kidney, removal becomes crucial to safeguard the new organ’s health.
• Uncontrolled High Blood Pressure
  In some cases, uncontrolled high blood pressure stemming from your original kidneys can pose a threat to the transplanted organ.Removal may be necessary to optimise blood pressure control and ensure the success of the transplant.