Kidney Transplant (cont.)
Michael B McDonnell, MD, Staff Physician, Department of Emergency Medicine, University of Southern California
John P. Cunha, DO, FACOEP
John P. Cunha, DO, FACOEP
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
IN THIS ARTICLE
When the doctor diagnoses end-stage renal disease, he or she will discuss the treatment options. Whether kidney transplantation is an option for a patient depends on their specific situation. If the doctor thinks the patient may be eligible for a transplant, he or she will learn about the pros and cons of this treatment. If a patient is a potential candidate, he or she will undergo a thorough medical evaluation. In the meantime, the patient will be treated with dialysis.
Kidney transplantation is replacement of nonworking kidneys with a healthy kidney from another person (the donor). The healthy kidney (the "graft") takes over the functions of the nonworking kidneys. A person can live normally with only one kidney as long as it functions properly.
The transplantation itself is a surgical operation. The surgeon places the new kidney in the lower abdomen and attaches it to an artery and vein in that area (usually the external iliac artery and vein). The kidney is also attached to the ureter, which carries urine from the kidney to the bladder. The patient's own kidneys are usually left in place unless they are causing problems, such as infection.
Every operation has risks, but kidney transplantation is not a particularly difficult or complicated operation. It is the period after the surgery that is most critical. The medical team will watch very carefully to make sure that the new kidney is functioning properly and that the body is not rejecting the kidney.
Is the patient eligible for a transplant?
Before a patient can receive a kidney transplant, he or she must undergo a very detailed medical evaluation.
The medical team, which includes a nephrologist, a transplant surgeon, a transplant coordinator, a social worker, and others, will conduct a series of interviews with the patient and his or her family members.
The patient will also have a complete physical examination. Lab tests and imaging studies complete the evaluation.
Any of the following conditions significantly increase the patient's chance of rejecting the new kidney and may make him or her ineligible for transplant:
Potential kidney donors also must be in good health and undergo a thorough medical evaluation.
If a patient is considered eligible for a transplant, every effort will be made to find a donor among his or her family members (who are most likely to match) and friends. If no suitable donor can be found, the patient's name will be added to the waiting list for a donor kidney.
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