Contents:
- Medical Video: Troubled Youth Awaits Kidney Transplant - 2/2 - Stacey Simms
- What is a kidney transplant?
- How do kidneys work?
- What causes kidney failure?
- Are there different types of kidney transplants?
- What should be prepared for a kidney transplant?
- What happens during a kidney transplant?
- What happens after a kidney transplant?
- What should be done after a kidney transplant?
- Facing frustration
Medical Video: Troubled Youth Awaits Kidney Transplant - 2/2 - Stacey Simms
The kidneys are parts of the body that you don't often think of - unless you have kidney disease. The kidneys are very important for one's survival because they filter waste, as well as extra fluid and salt, from the body. If they stop working (known as kidney failure), someone needs to do kidney dialysis or get a kidney transplant.
What is a kidney transplant?
Kidney transplantation is an operation in which the doctor places a new kidney in the body of a person whose own kidney is no longer functioning properly. A healthy kidney can do the work of two failed kidneys.
Because people can survive with only one kidney, a person who is still healthy can give one of his kidneys to a person with kidney failure (called a donor). The kidneys can also come from donors who have just died, but waiting for this type of kidney donor can take one year or more.
Most kidney transplants are successful. People who do kidney transplants will need medication for the rest of their lives to prevent the body from rejecting new kidneys. But apart from that, many teenagers who do kidney transplants can live normally, and healthy after they recover from surgery.
How do kidneys work?
The kidney is a nut-shaped organ that is located close to the center of a person's back, just below the rib cage. Most people have one kidney on both sides of their spine. The kidneys help cleanse the blood by removing excess fluids, salts, and waste products. Fluid and waste are converted into urine and out of the body when we urinate.
The kidneys also release hormones that help regulate blood pressure, make new red blood cells, and maintain calcium levels to keep bones healthy.
If the kidney stops working properly (kidney failure), it will cause waste products to become dangerous and excess fluid can accumulate in the body. A person's blood pressure can also increase and the body may not make enough red blood cells. If this problem is not treated, it can quickly threaten a person's life.
What causes kidney failure?
In adolescents, kidney failure is usually caused by:
- Genetic disease. Conditions that run in the family can affect the kidneys; for example, polycystic kidney disease is a disease in which normal kidney tissue is replaced by a fluid-filled bag.
- Glomerular disease. This condition damages the small screening unit in the kidney (called the glomeruli).
Diabetes and high blood pressure are the two main reasons for kidney transplants in adults — and both of these conditions are becoming more common in adolescents. Although it is unlikely that people with this condition will need kidney transplants during their teens, controlling diabetes and high blood pressure from now on can help teens avoid kidney disease when they are adults.
Treating what causes a person's kidney damage can sometimes help heal the kidneys. But if the person has lost too much kidney function, the doctor will recommend dialysis or a kidney transplant.
For teens who are candidates for transplant surgery, transplantation can be a good choice. Because dialysis treatments are usually needed every day or several times a week, they can interfere with a person's routine (for example, school permission). Successful kidney transplantation can make a person lead a life easier as before kidney failure.
Are there different types of kidney transplants?
There are two types of kidney transplants depending on who donated the new kidney.
- Live donor⎯is when someone with kidney failure gets a kidney from someone who is still alive (usually relatives or close friends, but sometimes can also be strangers).
- The donor is not alive⎯is when people donate their kidneys to transplants after they die. This requires that people who need a kidney to write their names on the waiting list until a suitable donor can be found.
What should be prepared for a kidney transplant?
If your doctor thinks you can do a kidney transplant, the first step you need to do is visit a transplant hospital. The health care team will evaluate you to see if you are healthy enough to undergo surgery and use drugs for the rest of your life. Evaluations can include blood tests, X-rays, and other tests, and can take several weeks.
If the transplant team decides you are a good candidate, the next step is to find a kidney. In some cases, the kidneys come from close relatives or friends who have blood and the same type and network and organs that are the same size as the recipient.
If a living donor cannot be found, your name will be added to the waiting list until the matching kidney is from the donor non-life there is. Because more people need new kidneys than the number of donated kidneys themselves, this process can take a long time.
If your name is written on a waiting list for kidney transplants, you should stay in close touch with your doctor and your entire health care team. Make sure they know how to contact you at any time. When kidneys are available, you have to move quickly. Prepare a packed bag and go to the transplant hospital immediately after receiving the notification. When you wait for a transplant, do your best to stay healthy. That way, you will be ready for transplant surgery when the time comes. Eat healthy food and exercise regularly, consume all medications as recommended, and regularly attend all your medical meetings - especially if you need to do dialysis. Tell your doctor and transplant center immediately if there are changes in your health.
What happens during a kidney transplant?
When you arrive at the hospital for surgery, you may give your doctor a sample of your blood so that they can do a cross-matching test for antibodies. This is done to find out whether your immune system will receive the new kidney or not. If the test results are negative, the kidneys can be accepted, and the transplant can begin.
In the operating room, an anesthesiologist will provide general anesthesia so you will sleep during surgery. The surgeon who does the transplant will make it tear small on the bottom of your stomach, just above your hips. A new kidney will be placed in your stomach, and the surgeon will glue the kidney blood vessels (arteries and veins) to the blood vessels in the lower body. Then the new kidney ureter will connect to your bladder.
In most cases, your own kidney will be left in place and will not be removed unless it causes problems such as high blood pressure or infection. Kidney transplant surgery usually takes about 3 to 4 hours.
What happens after a kidney transplant?
After a kidney transplant surgery, you need to be hospitalized for several days (or up to one week) in the hospital during the recovery period. At this time, the health care team will monitor you carefully to make sure there are no complications from surgery, such as bleeding or infection. You will also learn how to use the medicines you need to keep your body from rejecting new kidneys.
This is the point when medical staff say about the body "rejecting" the kidneys: a person's immune system is programmed to feel foreign objects (such as germs) and help the body get rid of them. Unfortunately, the immune system will recognize the new kidney as a foreign object and will try to reject it. To prevent this from happening, you need to take a drug called immunosuppressants.
Immunosuppressants allow you to get an infection (especially in the early days after surgery). So make sure not to get close to people who are sick and tell everyone at home to wash their hands frequently.
During the first few weeks after surgery, you should see a doctor as often as possible to make sure your new kidney is working normally. If you have a fever or pain in the transplant area, immediately notify your doctor. This can be signs that your body is not responding to a new kidney. If a new kidney is rejected or fails, you can do dialysis or maybe have another transplant.
With modern developments in surgical techniques and immunosuppressant drugs, the overall success rate of kidney transplants is very high. When the body receives a kidney transplant, the kidneys usually continue to work for 10 to 20 years. After that, someone will need to do another transplant or do kidney dialysis.
What should be done after a kidney transplant?
There is a good chance that you will be able to do most of the things you enjoy before kidney failure. You may have to reduce violent sports. Sports such as soccer, hockey and wrestling can cause injuries that can damage your new kidney. If you have questions about whether exercise is a good idea for you, ask permission from your doctor before you start playing.
Be sure not to rush into all the activities when you recover, and don't go crazy eating food that is no longer prohibited. Eating well, exercising, and caring for your body will help keep your new kidneys healthy.
Facing frustration
Living with chronic conditions such as kidney failure can sometimes be frustrating. Things like dialysis, time spent waiting for kidney donors, surgery, and drugs can be suffocating. After transplant surgery, some people feel depressed or anxious. This is not easy to handle.
Immunosuppressant therapy can be very difficult for teens because it does have some side effects. The drugs you use to stop your body from rejecting the kidneys can cause acne, weight gain, and excess facial and body hair in women. If you are aware of any side effects, talk to your doctor to find out how to overcome them.
If you feel that living with kidney failure or undergoing transplant surgery makes you stress more than you can handle, talk to someone. Older people are the best, because mom or dad might accompany you through the whole experience. However, some teens choose help by talking to a therapist or joining a support group.
Often, just talking about your feelings with other people who know what you are experiencing is the biggest help. If this sounds like something you might want to do, talk to your transplant hospital to see if they have (or know) a support group for teens who have had kidney transplants.
