LIVING DONOR KIDNEY TRANSPLANT
What is living donation?
Living donation takes place when a living person donates an organ (or part of an organ) for transplantation to another person.
Living related donation-The living donor can be a family member, such as a parent, child, siblings, grandparents, grandchildren or spouses (emotional relationship) Living unrelated donation – Living donation can also come from someone who is emotionally related to the recipient, such as uncle, aunt, In-laws, cousins or a good friend. Thanks to improved medications, a genetic link between the donor and recipient is no longer required to ensure a successful transplant.
What organs can come from living donors?
The organ most commonly given by a living donor is the kidney. Parts of other organs including the lung, liver and pancreas are now being transplanted from living donors. What are the advantages of living donation over deceased donation?
Kidney transplants performed from living donors may have several advantages compared to transplants performed from deceased (Brain dead) donors:
1. Better HLA Match-lessens the risk of rejection.
2. Immediate kidney function
3. Convenient for both the donor and recipient.
What tests are used to determine if someone can be a kidney donor?
Potential donors will have blood, urine and radiology tests to determine suitability for donation. Initially, a simple blood test will determine if your blood group is compatible with the recipient.
If your blood group is a match with the recipient, then additional blood tests will be done. These blood tests include kidney & liver function, screening for infections & tissue typing (HLA) and cross-matching and are done to determine the quality of matching between the donor and the recipient. Additionally, the evaluation will include a full physical examination and psychology evaluation may also be required. Before surgery, special x-rays, ECG, Ultrasonography & a spiral CT scan to check the anatomy of the kidney is also done.
How long does the evaluation process take?
The length of the testing process depends upon the availability of the donor for testing, the results of the completed tests, and the individual policies and procedures of the transplant center involvedl. (Usually takes about 7 working days) When the tests are completed, the results are presented to the transplant team (Nephrologist Transplant Surgeons & Anasthesia teams) to determine if the person is a suitable candidate for donation.
What are the different types of surgery?
A kidney can be removed in either of two ways, the traditional open surgery or the laparoscopic technique. The Laparoscopic surgery has a lot more advantages like less pain, faster recovery and a more cosmetic scar.
Once all the testing has been successfully completed and permissions obtained the operation is scheduled. A general anesthetic is administered in the operating room. Generally. The donor and the recipient are in adjacent operating rooms. The kidney is carefully removed and transplant, into the recipient. Immediately, the donor’s single kidney should take over the work previously done by the recipient’s two kidneys. Typically, the surgery takes 3-5 hours.
What is the recovery period and when fan the donor return to normal activities?
The length of stay in the hospital will vary depending on the individual donor’s rate of recovery and the type of procedure performed (traditional vs laparoscopic kidney removal) although the usual stay is 3 to 6 days. Since the rate of recovery varies greatly among individuals.
After leaving the hospital, the donor will typically feel tenderness, itching and some pain as the incision continues to heal. Generally, heavy lifting is not recommended for about six weeks following surgery. It is also recommended that donors avoid contact sports where the remaining kidney could be injured.
How does living donation affect the donor?
People can live normal lives with only one kidney. As long as the donor is evaluated thoroughly and cleared for donation, he or she can lead a normal life after the surgery. When the kidney is removed, the single normal kidney will increase in size to compensate for the loss of the donated kidney.
Written By: Dr. Prashant Rajput, Consultant Nephrologist, Global Hospitals, Mumbai