When do you need a kidney transplant?
A kidney transplant is sometimes the only chance of survival for patients with kidney failure. This is because the paired organ is vital: The kidneys excrete metabolic waste products and substances foreign to the body. They also regulate the body’s water balance and produce hormones. Various diseases can lead to irreversible kidney failure:
- diabetes mellitus
- repeated inflammation of the renal pelvis
- shrunken kidney, for example due to long-term use of painkillers
- cystic kidney disease (cystic kidneys – a genetic disease in which fluid-filled cavities form throughout the kidneys)
- urinary retention in the kidneys with tissue damage
- Inflammation of the renal corpuscles (glomerulonephritis)
- Kidney damage due to high blood pressure (nephrosclerosis)
The first kidney transplant was performed in the USA in 1954.
The living kidney donation
Most organ transplants (such as heart, lung, or cornea) come from deceased individuals. The kidney is an exception: Because even a healthy person can donate one of his or her two kidneys to a kidney patient. Currently, about 25 percent of all donor kidneys in Germany come from living people. It has been shown that a living donor kidney functions better and longer than a kidney from a deceased person. This is due, among other things, to the fact that the kidney transplant can be planned more precisely and the recipient has a shorter waiting time for the organ.
What do I have to take care of after the kidney transplantation?
After the kidney transplantation, you will be cared for in the transplant center for one to two weeks, provided that no problems occur. During this time, the doctor will adjust the necessary immunosuppressive therapy to your individual needs: You will need lifelong medication that suppresses the immune system (immunosuppressants) so that it does not reject the foreign organ. The dosage of these drugs is chosen to achieve the best possible effect with as few side effects as possible.
Immunosuppressive therapy is not necessary only if the donor and the recipient of the kidney are identical twins.
In most cases, the transplanted kidney produces urine right away. In some cases, however, it takes some time for the transplanted kidney to recover from the procedure and resume its function. Until then, dialysis therapy is necessary.
Kidney transplantation: life expectancy and chances of success
Out of 100 transplanted kidneys, 88 are still functioning one year after the procedure and 75 after five years, according to a Europe-wide study with data from 1990 to 2019.
The chances of success of a kidney transplant are therefore generally quite good – a transplanted kidney performs its task in the “foreign” body for about 15 years on average. In individual cases, however, the prognosis may be different – depending, for example, on the patient’s general state of health, the underlying disease that made the kidney transplant necessary, and any secondary or concomitant diseases.
As soon as a transplanted kidney can no longer do its job, the patient will again require dialysis; a new kidney transplant may then be necessary.
