About 3200 kidney transplants are performed in the India every year and many more could be performed if more kidneys were available.

The transplanted kidney provides enough kidney function. After a successful transplant, there is no need for dialysis. The average lifetime for a donated kidney is ten to fifteen years. When a transplant fails, a patient may opt for a second transplant, and may have to return to dialysis for some intermediary time.

PROCEDURE

In most cases the barely functioning existing kidneys are not removed, as this has been shown to increase the rates of surgical morbidities. Therefore the kidney is usually placed in a location that is different from the location of original kidney, often in the iliac fossa, so it is often necessary to use a different blood supply. The renal artery of the kidney, previously branching from the abdominal aorta in the donor, is often connected to the external iliac artery in the recipient. The renal vein of the new kidney, previously draining to the inferior vena cava in the donor, is often connected to the external iliac vein in the recipient.

The transplant surgery lasts five hours on average. Hospital stay is typically for 4–7 days. Living donor kidneys normally require 3–5 days to reach normal functioning levels, while in case of cadaveric donations the kidneys reach normal functioning levels in 7–15 days. If complications arise, additional medications (diuretics) may be administered to help the kidney produce urine.

Immunosuppressant drugs are used to suppress the immune system from rejecting the donor kidney. These medicines must be taken for the rest of the patient's life. Blood levels must be monitored closely and if the patient seems to have declining renal function, a biopsy may be necessary to determine whether this is due to rejection or cyclosporine intoxication.

POST OPERATION DIET

Grapefruit can decrease the proper metabolism of many drugs, and therefore decrease/or almost cancel out the effect of many critical drugs given after kidney transplants. Therefore grapefruit products and certain other citrus products must be avoided.

COMPLICATIONS

Acute rejection occurs in 10–25% of people after transplant during the first sixty days. Rejection does not necessarily mean loss of the organ, but may require additional treatment and medication adjustments.

Problems after a transplant may include:

• Transplant rejection (hyperacute, acute or chronic)
• Infections and sepsis due to the immunosuppressant drugs that are required to decrease risk of rejection
• Post-transplant lymphoproliferative disorder (a form of lymphoma due to the immune suppressants)
• Imbalances in electrolytes including calcium and phosphate which can lead to bone problems amongst other things
• Other side effects of medications including gastrointestinal inflammation and ulceration of the stomach and esophagus, hirsutism (excessive hair growth in a male-pattern distribution),hair loss, obesity, acne, diabetes mellitus type 2, hypercholesterolemia, and others

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