Kidney Transplant & Conservative Care
Sometimes, a kidney transplant surgery may be a treatment option for chronic kidney disease (CKD). For others, supportive care without dialysis may also be a suitable option.
What is a Kidney Transplant?
A kidney transplant is a surgical operation where a healthy kidney from a donor is placed in your body. This new kidney will filter your blood and remove excess fluids the way your own two kidneys would if they were healthy.
A successful kidney transplant is the most effective treatment for chronic kidney disease (CKD), because it’s the closest alternative to having your own kidneys function properly. However, not all patients are suitable candidates for a kidney transplant. So, this option should be discussed with your clinicians.
What is Required to Have a Kidney Transplant?
The success of a kidney transplant depends on a variety of factors. If your overall health is good, your clinician may decide that you’re an ideal candidate for a kidney transplant and will recommend that you are put on the kidney transplant waiting list, or explore any living donors, such as family members.
Timing plays a crucial role in the success of a kidney transplant. If you are able to have a kidney transplant operation, you should aim to have it as early as possible. It is ideal to get your kidney transplant even before your chronic kidney disease (CKD) is severe enough to require dialysis (before stage 4 and stage 5). Given that the average waiting time for a kidney transplant is between 3 and 5 years, this may be difficult. If you are not able to get a kidney transplant before you start on dialysis, be sure that you choose the type of dialysis that best suits your health and lifestyle needs, making it as easy as possible for you to stay on your treatment plan.
For your kidney transplant to succeed, the healthy kidney must come from a donor whose blood and tissue types are compatible with yours. It is also beneficial if the donor’s genetic characteristics are similar to your own. There are two types of kidney donations:
A healthy kidney can be surgically removed from a living donor and transplanted into you. A living kidney donor can be a relative, friend, spouse, or anybody else who is willing to donate and has the same tissue type as you and a blood type that is compatible with your own. Even if you find a living donor, your clinician may still recommend that you register for a kidney transplant waiting list.
If you are not able to get a donation from a living kidney donor, you will need to place yourself on a waitlist to receive a deceased-donor kidney. Your clinician will help guide you through this process. Most countries have a centralised organisation that manages this process and helps patients navigate the system.
How Likely is a Kidney Transplant To be Successful?
The success rate after a kidney transplant with a living-donor kidney is reported by the National Organ Procurement and Transplantation Network to be 97% one year after the operation and 86% five years after the operation. Similarly, the success rate of kidney transplants with a deceased-donor kidney is reported to be 96% one year after the operation and 79% five years after.3
After you’ve received a kidney transplant, you are likely to remain in the hospital to recover for a few days. Throughout your kidney transplant recovery, you should expect to experience soreness around the incision site and throughout your abdomen. The status of your kidney transplant will be monitored carefully by your care team. You may be given immunosuppressants to prevent your immune system from recognizing the transplanted kidney as a “foreign object” and consequently rejecting it. You will also need to take other medications to reduce your risk of infection and other post-operation complications. It is likely that these medications will need to be taken for as long as you have the transplanted kidney, not only during your kidney transplant recovery period.
Benefits of a Kidney Transplant
A successful kidney transplant may allow you to live a longer and higher quality life than while you were on dialysis. You will no longer need to receive dialysis treatments or restrict your diet as much as you had before. However, life after a kidney transplant can be hard. Kidney transplant recovery may require immunosuppressant therapy, which can take a while to get used to, and involves many visits to the hospital.
Kidney transplants are not without risks.
Although kidney transplants can be an extremely effective treatment for chronic kidney disease (CKD), there are still risks. Like with any other operation, your body may have difficulty recovering and you may experience complications, including:
- Your body may reject the new organ, and you will need to take medication to prevent this from happening.
- Your new kidney may not function properly at first. You may need to remain on dialysis until your new kidney starts to work.
- Your new kidney may fail immediately (though not common), or at any time after your transplant. You must be mentally and physically prepared to receive a new transplant or go on dialysis if this happens.
Be sure to talk to your clinician about the potential risks of a kidney transplant operation.
If you and your clinician decide that neither dialysis nor a kidney transplant is right for you, you may consider conservative care. This is when your healthcare team cares for you without dialysis or a kidney transplant. Instead, they focus on controlling your symptoms and providing you with the best possible quality of life. Conservative care is not a treatment, it is a means for making you comfortable for the remaining time of your life. If you choose conservative care, your healthcare team will help you create a plan that meets your physical, emotional and lifestyle needs.
Where to go next?
Peritoneal Dialysis (PD) at Home
Peritoneal dialysis (PD) is a type of dialysis which can be done at home. We explain more on PD
Continuous Ambulatory Peritoneal Dialysis (CAPD)
CAPD can be performed at work, home or during travel.
Automated Peritoneal Dialysis (APD)
APD allows dialysis to be performed while you sleep.