In this article we will discuss about:- 1. Meaning of Kidney Transplantation 2. History of Kidney Transplantation 3. Success Rate 4. Donor 5. Procedure.
Meaning of Kidney Transplantation:
When the kidney failure is not treated with drug and dialysis, a kidney is transplanted from a compatible donor.
History of Kidney Transplantation:
The world’s first successful organ transplant was kidney transplantation which was undertaken by David Hume and Joreph Kelly at the Peter Bent Brigham Hospital in Boston in 1954. The recipient was Richard Herrick who lived for a further eight years.
Previously it was reported that first kidney transplant was performed between identical twins in 1954 by Dr. Charles Hufnagel, a surgeon of Washington. The first kidney transplant in India was performed on Dec. 1, 1971 at the Christian Medical college, Vellore (Tamil Nadu) on a 35 year old patient named Shanmughan.
Success Rate of Kidney Transplantation:
A kidney transplant from an identical twin, called isograft, is always successful. If kidney is transplanted from other person except twin is called allograft, which is also successful with the use of an immunosuppressant. An ideal immunosuppressant suppresses immunity against foreign tissue but maintains immunity against infection.
The drug, named cyclosporin is a good immunosuppressant. Use of antiserum to human lymphocytes is also useful. It destroys T-cell mediated immune responses, while spares humoral antibody responses. The success rate of kidney transplantation is variable. Transplanted kidney may function for over 20 years.
Donor for Kidney Transplantation:
The donor may be an identical twin or a close relative or any other person. Sometimes kidney of a dead person, who died recently due to accident, is also used.
Recipient Donor Matching:
Recipient and donor are tested for three factors:
(i) Blood group:
Recipient’s blood group should match with donor’s blood group.
(ii) Human Leucocyte Antigen (HLA):
It is located on the surface of the leucocytes (WBCs). An individual inherits a set of 3 antigens from the father and 3 antigens from the mother. A higher number of matching of these antigens increases the chances of lasting kidney graft for a long time.
(iii) Antibodies:
Small amount of blood of recipient and donor are mixed in a tube. If no reaction occurs, the recipient is able to accept the kidney.
Procedure of Kidney Transplantation:
Transplantation of kidney is done under general anesthesia. Cut is given in the lower abdomen of the patient and the donor’s kidney is transplanted. Artery and vein of new kidney are connected to the iliac artery and vein of the recipient.
Ureter of the new kidney is connected to the urinary bladder of the recipient. The transplanted kidney takes over the work of two failed kidneys. The old kidneys are left in place unless they cause infection or high blood pressure. In such condition old kidneys are to be removed.