Living-Donor Kidney Transplant

A living-donor kidney transplant is a surgical procedure where a healthy individual donates one of their kidneys to a person with end-stage renal disease (ESRD) or significant kidney dysfunction. This type of transplant offers several benefits, including shorter waiting times, improved graft survival rates, and better overall outcomes for the recipient.

Donor Eligibility

To be eligible to donate a kidney, an individual must meet certain criteria:

• Be in good physical and mental health
• Be between 18 and 60 years old (although some centers may accept donors up to 65 years old)
• Have two healthy kidneys
• Not have any significant medical conditions, such as diabetes, high blood pressure, or kidney disease
• Not be pregnant or breastfeeding
• Pass a thorough medical evaluation, including laboratory tests and imaging studies
• Undergo a psychological evaluation to ensure they are making an informed decision

Surgical Procedure

The living-donor kidney transplant procedure involves two separate surgeries: one for the donor and one for the recipient.

• Donor surgery: The donor undergoes a minimally invasive laparoscopic procedure, which involves making several small incisions in the abdomen. The surgeon then removes one of the donor's kidneys through a small incision, usually in the lower abdomen.
• Recipient surgery: The recipient undergoes an open surgical procedure, where the surgeon makes an incision in the lower abdomen to implant the donated kidney. The recipient's diseased kidneys are usually left in place, and the new kidney is connected to the blood vessels and bladder.

Risks and Complications

As with any surgical procedure, there are risks and potential complications associated with living-donor kidney transplant:

• Donor risks: Bleeding, infection, hernia, bowel obstruction, and adhesion formation. Donors may also experience temporary pain, numbness, or weakness in the abdomen.
• Recipient risks: Rejection of the transplanted kidney, infection, bleeding, and complications related to immunosuppression (e.g., increased risk of cancer, diabetes, and osteoporosis).

Post-Operative Care

After the surgery, both the donor and recipient require close monitoring and follow-up care:

• Donor recovery: Donors typically spend 2-3 days in the hospital and may experience some discomfort, fatigue, and numbness in the abdomen. They can usually return to normal activities within 4-6 weeks.
• Recipient recovery: Recipients usually spend 5-7 days in the hospital and require ongoing monitoring of their kidney function, blood pressure, and medication levels. They may need to take immunosuppressive medications for the rest of their life to prevent rejection.

Benefits and Outcomes

Living-donor kidney transplants offer several benefits, including:

• Improved graft survival rates (80-90% at 1 year, compared to 70-80% for deceased-donor transplants)
• Shorter waiting times (average wait time is 1-2 years, compared to 3-5 years for deceased-donor transplants)
• Better overall outcomes, with improved quality of life and increased life expectancy

Overall, living-donor kidney transplant is a safe and effective treatment option for individuals with end-stage renal disease, offering improved outcomes and a better quality of life.