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A kidney transplant may be an option for you if your kidneys are not able to properly filter excess fluid and waste from your blood in the case of chronic kidney disease (CKD). A kidney transplant surgery can be done before it is necessary to start dialysis or if your kidneys have already failed and you are already on dialysis.
Kidney transplant is a surgical procedure performed to restore proper kidney function. A donor kidney is required from someone who has passed away and donated their kidney, or from a friend or relative who is healthy, only one kidney is needed to restore lost kidney function.
If your kidney function is declining and you at late stage 4, or stage 5 chronic kidney disease (CKD), you will discuss your treatment option with your team at San Antonio Kidney. These options may include dialysis, peritoneal dialysis or hemodialysis, these are procedure that removes fluids and waste from your blood when your kidneys aren’t functioning properly . Kidney transplant is another treatment option that may be discussed with you, which will replace your kidney function.
The benefits of a kidney transplant include:
- Better quality of life
- Lower risk of death
- Fewer dietary restrictions
Some factors that can reduce your chances of a successful transplant include:
- Advanced age
- Recent cancer
- Severe heart disease
Your physician can determine if you’re a good candidate for a transplant after a full health assessment and a review of your medical history. They also discuss the risks of a transplant as it relates to your specific health needs. An extensive pre-transplant work up is completed at one of the transplant centers in San Antonio to ensure you are a good candidate for a transplant.
The decision is made with your transplant team regarding living vs cadaver donor.
If a living donor is an option the living donor will start the compatibly and medical work-up and when both you (the recipient) and the donor have been thoroughly evaluated, a transplant surgery is scheduled.
If the decision is made that the donor needs to come from a cadaver donor, you will be thoroughly worked up and added to the United Network for Organ Sharing (UNOS) wait list to await a transplant.
If you and your nephrologist decide that a kidney transplant may be an option for you, your nephrologist will send you to one of the transplant centers for an evaluation by the transplant team. Your transplant team and nephrologist will work in conjunction to provide you with a path to transplant.
For a person who will receiving a transplant from a live donor the medical work up for both parties can be done with-in three to six months after initial evaluation, sometimes it can go faster-it really depends on the individuals and transplant center doing work up.
For a person receiving a transplant form someone who has donated their kidney at time of death (also know as cadaver), a medical work up will be completed, and updated while you are waiting for a donated kidney to become available. The wait list is approximately five to eight years long, therefore it is important to get placed on the wait list and to stay healthy while you are waiting for the kidney transplant.
The first step in the kidney transplantation process begins with a referral by your nephrologist, however most transplant programs do have an option for self-referral as well.
The transplant clinic then contacts the patient and the referring physician’s office to discuss expectations and schedule an appointment for a half-day pre-transplant evaluation. You will be encouraged to bring someone with you, as a lot of information will be shared at this initial visit.
You may be emailed or mailed information to be filled out prior to your first visit, so all information is available at the time of your first visit to the transplant clinic.
During the initial clinic visit, the patient meets with the transplant team for a comprehensive health evaluation.
After the initial transplant evaluation, recommendations are made by the transplant team and
additional diagnostic tests are usually required. The transplant program’s scheduling staff will work with the you and your nephrologist, dialysis center if applicable, and insurance company to coordinate these tests so they can be completed as quickly as possible.
Along with the extensive medical workup for your transplant a financial coordinator and social worker on the transplant team will verify your insurance benefits and begins creating a financial plan regarding all kidney transplant services. This is done by the transplant program you are referred to.
Private insurance, as well as Medicare and Medicaid, provides coverage for kidney transplants. The cost, however, may not be fully reimbursed. The transplant team helps coordinate benefits with social agencies and other potential funding sources to help finance transplants. The transplant team’s financial coordinators can assist the patient with information and financial planning.
After you receive your kidney transplant you will stay in the hospital for generally less than a week.
While hospitalized, your transplant surgeon, nephrologist, transplant nurse coordinator, dietitian, social worker provide post-transplant education and support to assure you are ready to go home and care for yourself and your new kidney!
After discharge from the hospital, activity will be limited for about six weeks. Mild exercise, such as walking, is usually encouraged other activities will be directed by your transplant team.
It will be necessary for you to take medications for the rest of your life that will prevent your body from rejecting the transplanted kidney, some of these medications also help prevent infections immediately after a transplant.
Following a transplant you will be able to returning to work within two to three months, and follow-up appointments with physicians will be necessary. When your transplant team feels you are ready your care will be returned to your nephrologist for monitoring and treatment of your kidney care.
Undergoing kidney transplantation will help restore kidney function, thus eliminating the need for dialysis. Most patients recover strength and energy and are expected to be able to live twice as long, as compared to remaining on dialysis.
If you have kidney disease, and are interested in a transplant before you need to start dialysis is called a preemptive transplant.
Getting a transplant not long after kidneys fail (but with some time on dialysis) is referred to as an early transplant.
Both have benefits. People who get a preemptive or early transplant receive their kidney when their health is generally good, which allows you to stay healthier and live longer.
Having a preemptive has many benefits, including:
- Less risk that your body will reject the new kidney
- Most people live longer and have a better quality of life
- Avoid being on dialysis completely
- Less restrictive diet than you would have on dialysis
- Most people stay healthier and avoid some of the health problems associated with dialysis
The donated kidney can come from a living donor or a deceased donor but generally, due to the nature of preemptive transplants they come from living donors. A living donor is someone who chooses to donate a kidney when they are healthy and alive.
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