What to Expect Before, During & After Kidney Transplant?

A kidney transplant is performed to replace a diseased kidney with a healthy kidney obtained from a living or deceased donor. Kidneys are two bean-shaped organs on each side of the spine below the rib cage. Their primary function is to filter and remove minerals, fluid, and other wastes from the body by producing urine. In addition, the kidneys also balance electrolytes, such as sodium and potassium, salts and other substances in the blood, produce erythropoietin – a hormone that aids the development of red blood cells –, regulate blood pressure as well as the acid-base and fluid balance in the body to keep it neutral. This is generally required for maintaining the normal function of several processes in the body. 

When they lose their filtering ability, waste and fluid accumulate in the body, which can not only raise blood pressure but also cause end-stage renal disease or kidney failure. 

Some of the common causes of end-stage kidney disease are:

• Uncontrolled and chronic high blood pressure

• Repeated urinary infections

• Polycystic kidney disease

• Diabetes

• Chronic glomerulonephritis – inflammation and eventual scarring of the small filters in the kidneys

• Hemolytic uremic syndrome, a rare disorder that causes kidney failure

Why Manipal Hospitals?

At Manipal Hospitals, our veteran and highly qualified nephrologists offer a plethora of therapies for nephrological and renal diseases. Our specialists have advanced degrees in renal sciences, general nephrology, preventative nephrology, and acute kidney transplantation and have performed over 1500 successful kidney transplants since we started providing kidney transplant services around 20 years ago. 

In addition, our Department of Nephrology boasts state-of-the-art equipment and technical facilities which help our doctors perform some of the most complex procedures with ease. Besides, our Centre of Excellence in Nephrology also offers innovative procedures, such as laparoscopic and robotic surgeries, for treating renal and nephrological issues. Book an appointment to consult with our experts.

Patient Success Stories

Mr. Baladudeen, a 54-year-old gentleman from Bangladesh, came to us a couple of years ago to get treatment for advanced kidney failure. Our proficient transplant specialists led by Dr. Sankaran Sundar, Consultant-Nephrology and Head of International Transplant Services and Dr. Saurabh Vashishtha, Consultant-Urology, Robotic Surgery & Renal Transplantation at Manipal Hospital, Old Airport Road, Bangalore recommended a pre-emptive transplant, which is a transplant that is performed before the kidney function deteriorates to the point of requiring dialysis for replacing the filtering function of the kidneys. 

With pro-active support and assistance from the Karnataka government for legal clearance and under the supervision and guidance of our expert transplant specialists, the surgery was performed successfully, following which, a personalized post-surgery rehabilitation program was prescribed by our experts to prevent any post-surgery complications and ensure a quick recovery.

In another instance, Imam Hasan, a 44-year-old Bangladeshi citizen, came to Manipal Hospital, Jaipur when he couldn’t get treatment for his breathing problems and high blood pressure and blood sugar levels in his native country. In addition, he experienced a sharp drop in his appetite and noticed constantly increasing swelling in his body. Our experts recommended immediate admission to the hospital and then took him through a dialysis procedure. They also brought his blood pressure and blood sugar under control to stabilize him and then recommended a kidney transplant. Visit Manipal Hospitals Global and consult with our best nephrologist in India regarding kidney transplants.

Following the successful transplant, his breathing problems went away and his creatinine level dropped from 15 to 1 (which is an indicator of good kidney function). Mr. Hasan is now leading a healthier and dialysis-free life with no restrictions on food and water intake. 

Are There Any Risks Associated with Kidney Transplant?

While a kidney transplant is usually considered a safe procedure, some complications can occur during or after the procedure, such as:

• Infection

• Bleeding

• Blockage of the blood vessels to the new kidney

• Blockage or leakage of urine in the ureter

• Improper functioning of the new kidney

Sometimes, the body may consider the new kidney as a foreign object or tissue and reject it. Thus, for the transplanted kidney to survive, medications must be taken by the patient as they trick the immune system into accepting the new kidney instead of attacking it. 

What Can Patients Expect Before, During & After Kidney Transplant?

Before Transplant:

A thorough evaluation (performed by the transplant team, which includes transplant nephrologists, transplant surgeons, transplant nurses and psychologists/psychiatrists) is initially recommended before a kidney transplant, which consists of:

• Blood tests

Blood tests are performed to find the correct donor, which, in turn, ensures that the transplanted kidney will not be rejected. 

• Mental health evaluation

This is recommended to assess social and psychological issues associated with organ transplantation, such as financial issues, stress, and support by family and friends as these problems can significantly affect the outcome of the procedure. 

• Diagnostic tests

Diagnostic tests are performed for checking the kidney function as well as the patient’s overall health. These tests may include ultrasound, X-rays, dental exams, and kidney biopsy. Women may be recommended to undergo gynecology evaluation, mammograms, and Pap tests. 

Following the above-mentioned tests and evaluation, the patient is put on the waiting list as a willing organ donor may not be immediately available. After a donor is found, the following steps will happen before the procedure:

• Dialysis will be performed on patients who are already on routine dialysis.

• The patient will be told to fast for 8 hours before the transplant, usually after midnight. 

• A sedative may be given to the patient to help them relax before the procedure.

During Transplant:

A kidney transplant generally follows this process:

• A kidney transplant is generally performed under general anesthesia.

• An intravenous (IV) line will be initiated in the patient’s hand or arm. A few catheters may be inserted in the patient’s neck and wrist to monitor the status of the heart as well as the blood pressure and also for taking blood samples. 

• This will be followed by the insertion of a urinary catheter into the bladder. 

• The procedure involves the creation of a long incision in the lower abdomen on one side so that the surgeon can visually inspect the donor's kidney before the transplant. 

• The donated kidney will be implanted inside the patient’s belly. The right donor kidney will be placed on the left side while the left one will be placed on the right side.

• The renal artery and vein of the new kidney will be connected to the external iliac artery and vein.

• After the vein and artery are attached, the blood flow through these vessels will be monitored for bleeding at the suture lines. 

• The donor ureter – the tube that drains urine from the kidney – will be attached to the bladder, following which, the incision will be closed with surgical staples or stitches. 

• A sterile dressing or bandage will be applied. 

After Transplant:

• After the procedure, the patient will be taken to the recovery room and after their blood pressure, pulse and blood pressure become stable, they will be transferred to the ICU (intensive care unit) for close monitoring. 

• While a kidney obtained from a living donor may start to produce urine right away, urine production in a kidney obtained from a deceased donor may take longer. Thus, dialysis is usually continued until urine production and output become normal.

• A catheter will be placed in the bladder to drain urine. Moreover, the amount of urine will be regularly measured to check the functioning of the new kidney. To know more, visit Manipal Hospitals Global, the top nephrology hospital in India.

• IV fluids will be continued till the time that patient is able to eat and drink on their own.

• The doctor will closely watch how the antirejection medicines are working to ensure that the patient is getting the right dosage of medicine.

• Blood samples will be taken regularly to check the functioning of the implanted kidney as well as other organs, such as the lungs and liver.

• Pain relievers may be prescribed to patients to alleviate pain. 

• The patient will be discharged from the hospital once their vital signs become stable and the new kidney starts functioning normally. 

Patients are advised to consult the doctor immediately if the pain around the site of the incision increases sharply or if they have persistent fever and experience swelling, redness, bleeding, or drainage from the site of the incision as these symptoms may indicate that the new kidney has been rejected by the immune system. Moreover, a rise in the blood creatinine level or blood pressure may also indicate rejection.

Department of Nephrology

Manipal Hospitals Global