"The main advantages of live donation are that it shortens the waiting time and that it is the organ of a very healthy person".
DR. PALOMA MARTÍN MORENO SPECIALIST. NEPHROLOGY DEPARTMENT
What is a kidney transplant?
A kidney transplant is the removal of a kidney from a previously healthy individual (cadaver or living) and its placement in a patient with chronic renal failure.
Technically, the operation is simple and consists of three anastomoses or joints (arterial, venous and urinary). The duration of the operation on the recipient is about 3-4 hours. It allows the integral recovery of the renal function and to carry out a normal life. It requires the taking of anti-rejection or immunosuppressive medication for life and frequent medical checks.
Depending on the origin of the graft, it can be from a related living donor (parents, siblings, children, cousins), an emotionally related living donor (for example, between couples) and a corpse donor (for brain death or asystole). The best results are obtained with living donor kidney transplantation.
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When is a kidney transplant indicated?
In all patients with chronic end-stage renal failure and without contraindications, prior to the start of dialysis or once included in a hemodialysis or peritoneal dialysis program.
It requires the performance of a series of analytical and immunological studies, various imaging techniques, assessment of cardiac, pulmonary, neurological and urological status, etc., being subsequently included in the waiting list for kidney transplantation at its reference center.
Most frequent indications for this treatment:
Do you have advanced chronic failure?
You may need a kidney transplant
Learn more about kidney transplantation
Not all patients with end-stage renal disease can be transplanted due to problems or limitations of a medical or surgical nature.
This is the case of patients with significant problems of cardiac, hepatic, neurological, pulmonary origin, chronic infectious pathology, unresolved tumour diseases, etc.
Any patient in whom the vital risk of the operation and the complications associated with anti-rejection medication are considered excessive or important, is better to contraindicate the renal transplant.
Currently, the results of cadaver kidney transplantation are very good, achieving a survival of the graft of about 90% per year, 70-75% at five years and 50-60% at 10 years.
The main causes of long-term graft loss are chronic rejection and death of the patient with a working graft in relation to cardiovascular problems, infections and tumors.
The results of living donor kidney transplantation are superior to those of a cadaver and are characterized by a lower incidence of acute rejection and superior results in terms of graft survival that can be 98% at one year, 85% at five years, and 75% at 10 years.
The main one is that it restores or normalizes all the functions of the kidney, including the production of erythropoietin-type hormones (necessary for the production of red blood cells), vitamin D (for the normal maintenance of the bones), etc., and not only the function of eliminating water and waste products such as urea, creatinine, potassium, phosphorus, etc. that the different techniques of peritoneal dialysis or hemodialysis perform.
It also allows a better physical and psychological condition, a better quality of life and it is the cheapest therapeutic option from the year with working graft.
The most frequent early complications are those related to surgery (urinary obstruction, urinary fistula, liquid collections, surgical wound infection, urinary and lung infections, etc.)
The incidence of high blood pressure, increased uric acid, increased cholesterol is high.
In the longer term, the main complications are infections, malignant tumors, chronic rejection and cardiovascular complications.
The person receiving the transplant must follow a series of care and recommendations to avoid complications and achieve a successful transplant:
- Take the medication correctly with the dosage and interval indicated by the doctor responsible for your follow-up.
- That the blood pressure, weight and temperature are controlled periodically.
- To consult quickly in case of fever, edema, decrease of diuresis or any other complication related or not to the renal transplant.
It is also important to carry out daily physical activity, to have an adequate diet, to avoid tobacco, to maintain the ideal weight, etc.
You should take immunosuppressive medication to avoid rejection and achieve tolerance of the graft. There are different immunosuppression protocols depending on age, degree of immunological risk, depending on whether it is the first or more grafts, etc. The most frequent agents currently in use are delayed-release Tacrolimus, mycophenolate mofetil or sodium mycophenolate, Sirolimus or Everolimus, and corticosteroids.
Polyclonal or monoclonal antibodies can also be used for short periods of time.
Where do we do it?
IN NAVARRA AND MADRID
The Nephrology Service
of the Clínica Universidad de Navarra
The Nephrology Service of the Clínica Universidad de Navarra has more than five decades of experience, both in the diagnosis and treatment of all kidney pathologies and in the transplant of this organ.
Our specialists have completed their training in centers of national and international reference.
We have the best facilities in the Dialysis Unit in order to offer the highest quality care to our patients.
Why at the Clinica?
- National reference in kidney transplantation, pioneer in living donor kidney transplantation.
- Specialized nursing for the care and follow-up of our patients.
- Cardiovascular and renal damage prevention program.