What is a Kidney Transplant?

A kidney transplant is a surgical procedure where a healthy kidney from a living or recently deceased person (donor) is transferred to a recipient with end-stage renal failure. A kidney transplant involves the removal of a healthy kidney from a living or recently deceased person (donor) and its subsequent transfer to a recipient suffering from end-stage renal failure.

Kidneys control fluid volume and composition, and eliminate metabolic waste. Renal failure occurs when kidneys can no longer perform these functions.

Who can donate a kidney?

Transplants require a kidney from a deceased or living donor. The former is a "deceased donor transplant", the latter a "living donor transplant".

Healthy individuals up to 75-80 years old can be living donors. Thorough examinations ensure they are healthy, free from chronic pulmonary, hepatic, cardiac, vascular, or metabolic diseases (like diabetes), hypertension, and have normal kidney function and urine tests. They must also be mentally competent and free from communicable diseases (cancer, Hepatitis B, C, HIV). Donor suitability evaluation (lab tests and radiological exams) takes 3-4 months.

Who can receive a transplant?

End-stage renal failure, where kidneys lose function due to various reasons (diabetes, hypertension, degenerative or autoimmune diseases), is a life-threatening condition treated by dialysis or transplantation.

While effective, dialysis presents clinical and quality-of-life challenges, making it poorly tolerated long-term. Kidney transplantation is indicated for patients with end-stage (on dialysis) or pre-terminal (pre-dialysis) renal failure to avoid dialysis-related problems.

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When can someone receive a transplant?

Kidney transplantation is ideal for chronic kidney failure's advanced stage, where kidney function is permanently impaired.

Not everyone qualifies. Candidates must meet these conditions:

• Be healthy enough for major surgery. This excludes individuals with cancer, serious infections (AIDS, tuberculosis, osteomyelitis, hepatitis), or severe heart/liver disease.
• Agree to long-term immunosuppressive treatment and regular check-ups.
• Maintain a healthy lifestyle (no smoking, alcohol abuse, or drug use).

Meeting these conditions increases successful transplantation chances.

Advantages and constraints of kidney transplantation

Kidney transplantation enables full socio-professional rehabilitation and a good quality of life. Recipients with a well-functioning transplant undergo regular checks and daily immunosuppressive/supportive treatment.

They can pursue most professions, avoiding strenuous or dirty/dusty environments. Sports are generally permissible, with caution against high-injury risk activities. Travel is possible with appropriate hygiene precautions, particularly in regions with endemic infections or poor sanitation.

Stopping dialysis offers psychological relief for patients and families, promoting autonomy and freedom. The transplanted kidney usually functions immediately, producing urine, though delayed function requiring continued dialysis is possible.

Post-operative complications have decreased significantly; patients usually return home after 15-30 days, with follow-up appointments and guidelines.

Immunosuppressants prevent rejection but often cause side effects and comorbidities, without guaranteeing long-term organ function.

Long-term (12-15 years), chronic allograft nephropathy (CAN) causes function loss in 50% of patients. CAN's causes remain unclear. Research focuses on reducing long-term immunosuppressant use while preventing rejection to improve outcomes and quality of life.

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