TRANSPLANTATIONS
If you have advanced and permanent kidney failure, kidney transplantation may be the treatment option that allows you to live much like you lived before your kidneys failed. Since the 1950s, when the first kidney transplants were performed, we've learned much about how to prevent rejection and minimize the side effects of medicines. But transplantation is not a cure; it's an ongoing treatment that requires you to take medicines for the rest of your life and the wait for a donated kidney can be years long. A successful transplant takes a coordinated effort from your whole health care team, including your nephrologist, transplant surgeon, transplant coordinator, pharmacist, dietitian, and social worker. The most important members of your health care team are you and your family. By learning about your treatment, you can work with your health care team to give yourself the best possible results, and you can lead a full, active life. Getting
Ready You may receive a kidney from a member of your family (living, related donor), from a person who has recently died (cadaveric donor), or sometimes from a spouse or a very close friend (living, unrelated donor). If you don't have a living donor, you're placed on a waiting list for a cadaveric kidney. The wait for a cadaveric donor kidney can be several years. The transplant team considers three factors in matching kidneys with potential recipients. These factors help predict whether your body's immune system will accept the new kidney or reject it.
Possible
Complications Your doctor will give you drugs called immunosuppressants to help prevent your body's immune system from attacking the kidney, a process called rejection. You'll need to take immunosuppressants every day for as long as the transplanted kidney is functioning. Sometimes, however, even these drugs can't stop your body from rejecting the new kidney. If this happens, you'll go back to some form of dialysis and possibly wait for another transplant. Immunosuppressants can weaken your immune system, which can lead to infections. Some drugs may also change your appearance. Your face may get fuller; you may gain weight or develop acne or facial hair. Not all patients have these problems, though, and diet and makeup can help. Immunosuppressants work by diminishing the ability of immune cells to function. In some patients, over long periods of time, this diminished immunity can increase the risk of developing cancer. Some immunosuppressants can cause cataracts, diabetes, extra stomach acid, high blood pressure, and bone disease. When used over time, these drugs may also cause liver or kidney damage in a few patients.
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How
It Works A
surgeon places the new kidney inside your lower abdomen and
connects the artery and vein of the new kidney to your artery and
vein. Your blood flows through the new kidney, which makes urine,
just like your own kidneys did when they were healthy. Unless they
are causing infection or high blood pressure, your own kidneys are
left in place. The
Time It Takes The surgery takes 3 to 4 hours. The usual hospital stay is about a week. After you leave the hospital, you'll have regular followup visits. If someone has given you a kidney, the donor will probably stay in the hospital about the same amount of time. However, a new technique for removing a kidney for donation uses a smaller incision and may make it possible for the donor to leave the hospital in 2 to 3 days. Between 85 and 90 percent of transplants from cadaveric donors are working 1 year after surgery. Transplants from living relatives often work better than transplants from cadaveric donors because they're usually a closer match. Diet
for Transplantation
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Pros
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