Type of Surgery
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Last updated: 11/24/2009
As with any surgical procedure, the kidney transplantation procedure carries some risk for both a living donor and a graft recipient. Possible complications include infection and bleeding (hemorrhage). A lymphocele, a pool of lymphatic fluid around...
the kidney that is generated by lymphatic vessels damaged in surgery, occurs in up to 20% of transplant patients and can obstruct urine flow and/or blood flow to the kidney if not diagnosed and drained promptly. Less common is a urine leak outside of the bladder, which occurs in approximately 3% of kidney transplants when the ureter suffers damage during the procedure. This problem is usually correctable with follow-up surgery.
A transplanted kidney may be rejected by the patient. Rejection occurs when the patient's immune system recognizes the new kidney as a foreign body and attacks the kidney. It may occur soon after transplantation, or several months or years after the procedure has taken place. Rejection episodes are not uncommon in the first weeks after transplantation surgery, and are treated with high-dose injections of immunosuppressant drugs. If a rejection episode cannot be reversed and kidney failure continues, the patient will typically go back on dialysis. Another transplant procedure can be attempted at a later date if another kidney becomes available.
The biggest risk to the recovering transplant recipient is not from the operation or the kidney itself, but from the immunosuppressive medication he or she must take. Because these drugs suppress the immune system, the patient is susceptible to infections such as cytomegalovirus (CMV) and varicella (chickenpox). Other medications that fight viral and bacterial infections can offset this risk to a degree. The immunosuppressants can also cause a host of possible side effects, from high blood pressure to osteoporosis. Prescription and dosage adjustments can lessen side effects for some patients.
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The kidney filters blood to produce urine and can do so because of its unique anatomy. This narrated animation shows the anatomy of the kidney and how that anatomy enables the kidney to filter wastes from the blood.
For a kidney transplant, an incision is made in the lower abdomen (A). The donor kidney is connected to the patient's blood supply lower in the abdomen than the native kidneys, which are usually left in place (B). A transplanted ureter connects the donor kidney to the patient's bladder (C). (Illustration by GGS Inc.)
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Kidney transplantation or renal transplantation is the organ transplant of a kidney in a patient with end-stage renal disease. Kidney transplantation is typically classified as deceased-donor (formerly known as cadaveric) or living-donor transplantation depending on the source of the recipient organ. Living-donor renal transplants are further characterized as genetically related (living-related) or non-related (living-unrelated) transplants, depending on whether a biological relationship exists between the donor and recipient.
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