Introduction
When Your Kidneys Fail
How Transplantation Works
The Transplant Process
Posttransplant Care
Financial Issues
Organ Donation
Hope Through Research
Resources
Acknowledgments
About the Kidney Failure Series
Introduction
If you have advanced and irrevocable kidney failure, kidney transplantation may be the treatment odds that allows you to live much like you lived earlier your kidneys failed. Since the 1950s, when the first kidney transplants be performed, we've well-read much about how to prevent rejection and minimize the side effects of medicine.
But transplantation is not a cure; it's an ongoing treatment that requires you to take medicine for the rest of your life. And the continue for a donated
kidney can be years long.
A successful transplant takes a coordinated energy from your whole condition care squad, including your nephrologist, transplant surgeon, transplant coordinator, pharmacist, dietitian, and social worker. But the most important member of your health nurture team are you and your household. By learning in the order of your treatment, you can work with your strength care squad to give yourself the best possible results, and you can front a full, active natural life.
When Your Kidneys Fail
Healthy kidneys clean your blood by removing excess fluid, minerals, and wilderness. They also make hormones that hold on to your bones strong and your blood healthy. When your kidneys founder, harmful inhospitable surroundings build up in your body, your blood pressure may rise, and your body may retain excess fluid and not product enough red blood cell. When this happens, you call for treatment to replace the work of your failed kidneys.
How Transplantation Works
Kidney transplantation is a procedure that places a clean kidney from another person into your body. This one strange kidney takes over the work of your two former kidneys.
A surgeon places the new kidney inside your lower tummy and connects the artery and vein of the spanking new kidney to your artery and vein. Your blood flows through the clean kidney, which makes urine, only like your own kidneys did when they be healthy. Unless they are cause infection or high blood pressure, your own kidneys are vanished in place.
The Transplant Process
[ILLUSTRATION OMITTED]
Your Doctor's Recommendation
The transplantation process begin when you learn that your kidneys are failing and you must start to consider your treatment option. Whether transplantation is to be among your options will depend on your specific situation. Transplantation isn't for everyone. Your doctor may explain to you that you have a condition that would be paid transplantation dangerous or unlikely to succeed.
Medical Evaluation at a Transplant Center
If your doctor see transplantation as an option, the subsequent step is a thorough medical evaluation at a transplant hospital. The pretransplant evaluation may require several visits over the course of several weeks or even months. You'll entail to have blood drawn and x rays taken. You'll be tested for blood type and other similar factors that determine whether your body will adopt an available kidney.
The medical team will want to see whether you're hearty enough for surgery. Cancer, a serious infection, or significant cardiovascular disease would put together transplantation unlikely to succeed. In addition, the medical squad will want to make sure that you can comprehend and follow the schedule for taking medicine.
If a family accomplice or friend wants to donate a kidney, he or she will want to be evaluated for general vigour and to see whether the kidney is a good game. (See the "Organ Donation" section.)
Placement on the Waiting List
If the medical evaluation shows that you're a devout candidate for a transplant but you don't own a family extremity or friend who can donate a kidney, you'll be put on the transplant program's waiting list to receive a kidney from someone who have just died. You may hear your robustness care squad refer to this as a cadaveric kidney.
Every person waiting for a cadaveric organ is registered next to the Organ Procurement and Transplantation Network (OPTN), which maintains a centralized computer introduce yourself linking all regional organ assembly organizations (known as organ procurement organization, or OPOs) and transplant centers. The United Network for Organ Sharing (UNOS), a private nonprofit organization, administer OPTN under a contract near the Federal Government. (See the "Resources" section.)
UNOS rules allow patients to register next to multiple transplant centers. Each transplant center will probably require a separate medical evaluation, even if a patient is already registered at another center.
Some observer of OPTN operations hold raised the concern that populace in some parts of the country hold to wait longer than others because allocation policies for some organs afford preference to patients inwardly the donor's region. Kidneys, however, are assigned to the best match regardless of geographic region. The Federal Government continues to monitor policies and regulations to ensure that every being waiting for an organ has a fête chance. Everyone agrees that the push button to making waiting times shorter is to increase the number of donated organs.
Waiting Period
How long you'll have to hang around depends on many things but is primarily determined by the point of matching between you and the donor. Some citizens wait several years for a moral match, while others procure matched within a few months.
While you're on the waiting document, notify the transplant center of any changes contained by your health. Also, permit the transplant center know if you move or change mobile phone numbers. The center will need to find you without hesitation when a kidney becomes available.
OPOs are responsible for identify potential organs for transplant and coordinating with the national introduce yourself. The 69 regional OPOs are all UNOS member. When a cadaveric kidney becomes available, the OPO notify UNOS, and a computer-generated list of suitable recipient is created. Suitability is initially based on two factor:
* Blood type. Your blood type (A, B, AB, or O) must be compatible with the donor's blood type.
* HLA factor. HLA stands for human leukocyte antigen, a genetic marker located on the surface of your white blood cell. You inherit a set of three antigens from your mother and three from your father. A higher number of harmonizing antigens increases the chances that your kidney will second for a long time.
If you're selected on the spring of the first two factors, a third is evaluated:
* Antibodies. Your immune system may produce antibodies that deed specifically against something in the donor's tissues. To see whether this is the case, a small example of your blood will be mixed with a small indication of the donor's blood in a tube. If no response occurs, you should know how to accept the kidney. Your transplant squad might use the term glum cross-match to describe this lack of counterattack.
Transplant Operation
If you have a living donor, you'll diary the operation in credit. You and your donor will be operated on at indistinguishable time, usually in side-by-side rooms. One squad of surgeons will perform the nephrectomy--that is, the removal of the kidney from the donor--while another prepares the receiver for placement of the donated kidney.
If you're on a waiting list for a cadaveric kidney, you must be primed to hurry to the hospital as soon as a kidney becomes available. Once near, you'll give a blood example for the antibody cross-match test. If you enjoy a negative cross-match, it scheme that your antibodies don't react and the transplantation can proceed.
You'll be given a standard anesthetic to make you sleep during the operation, which usually take 3 or 4 hours. The surgeon will make a small cut within your lower abdomen. The artery and artery from the new kidney will be attached to your artery and capillary. The ureter from the new kidney will be connected to your bladder.
Often, the unknown kidney will start making urine as soon as your blood starts flowing through it, but sometimes a few weeks pass past it starts working.
Recovery From Surgery
As after any major surgery, you'll probably perceive sore and groggy when you wake up. However, various transplant recipients report foreboding much better immediately after surgery. Even if you rouse up feeling great, you'll necessitate to stay in the hospital for roughly a week to recover from surgery, and longer if you enjoy any complications.
Posttransplant Care
Your body's immune system is designed to keep you on top form by sensing "foreign invaders," such as bacteria, and rejecting them. But your immune system will also sense that your unsullied kidney is foreign. To keep your body from rejecting it, you'll enjoy to take drugs that turn past its sell-by date, or suppress, your immune response. You may have to clutch two or more of these immunosuppressant medicines, as okay as other medications to treat other robustness problems. Your health nurture team will give support to you learn what respectively pill is for and when to take it. Be sure that you read between the lines the instructions for taking your medicines previously you leave the hospital.
If you've be on hemodialysis, you'll find that your posttransplant diet is much less restrictive. You can drink more fluids and drink many of the fruits and vegetables you be previously told to avoid. You may even need to gain a touch weight, but be cautious not to gain too much weight too at the double and avoid salty foods that can head to high blood pressure. Work near your clinic's dietitian to make sure you're following a tough eating plan.
Rejection
You can assist prevent rejection by taking your medicines and following your diet, but watching for signs of rejection--like frenzy or soreness in the nouns of the new kidney or a switch in the amount of urine you make--is earth-shattering. Report any such changes to your condition care squad.
Even if you do everything you're supposed to do, your body may still reject the new kidney and you may obligation to go wager on on dialysis. Unless your health exactness team determines that you're no longer a honourable candidate for transplantation, you can turn back on the waiting account for another kidney.
Side Effects of Immunosuppressants
Immunosuppressants can weaken your immune system, which can organize to infections. Some drugs may also change your appearance. Your facade may get fuller; you may gain freight or develop acne or facial hair. Not adjectives patients have these problems, though, and diet and makeup can give a hand.
Immunosuppressants work by diminishing the ability of immune cell to function. In some patients, over long periods of time, this diminished imperviousness can increase the risk of developing cancer.
Some immunosuppressants cause cataract, diabetes, extra stomach acid, illustrious blood pressure, and bone disease. When used over time, these drags may also cause liver or kidney disfavour in a few patients.
Financial Issues
Treatment for kidney breakdown is expensive, but Federal health insurance plans recompense much of the cost, usually up to 80 percent. Often, private insurance or State programs pay the rest. Your social worker can assist you locate resources for financial assistance. For more information, see the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) fact sheet Financial Help for Treatment of Kidney Failure.
No comments:
Post a Comment