Description

Kidney Transplant Surgery

Medicana Health Group serves patients, who need organ
transplant surgery, with superior healthcare services at organ transplantation
units  of Medicana International Ankara, Bahçelievler, Çamlıca and
Medicana International Istanbul Hospitals – all certified by Ministry of
Health.

Medicana Health Group is among important healthcare
facilities which support organ donation and transplantation.

Medicana Bahçelievler, Medicana Çamlıca, Medicana
International Istanbul and Medicana International Ankara hospitals and their
specialists carry out successful transplant surgeries.

Patients are provided with best healthcare services,
while all details are considered to ensure patient comfort. These services
include but are not limited to foods cooked specifically for patients with
kidney failure, as instructed by our dieticians, and transportation vehicles.
We will continue making our best efforts to keep you smiling.

What is Kidney Transplant?

Renal failure is a disease that occurs when fluid,
urea, creatinine, uric acid and other toxic substances accumulate in body
secondary to untreatable dysfunction of kidneys and inability to excrete and
detoxify toxic substances due to reasons whatsoever. Patients require
treatments, such as dialysis and kidney transplant, due to hypertension
secondary to fluid accumulation in body or complaints, including but not
limited to nausea, abdominal pain, fatigue, weakness and loss of appetite – all
caused by urea and other toxic substances- or due to medical conditions, such
as cardiac arrest that is caused by high potassium level.

There is no chance of survival for patients with
end-stage kidney disease, if they are left untreated. Those patients have two
therapeutic options, namely dialysis and kidney transplantation. Those therapy
alternatives should be discussed and selected jointly by physician, patient and
the family. Dialysis is a treatment method that ensures survival of patient. However,
no machine can fulfill all functions of a native organ. Therefore, kidney
transplant has major superiorities regarding both survival and quality of life.
Patient may survive without any dietary restrictions, including food and drink,
and any other life style restriction. Work and social lives of patients are
normalized. Thus, patients get the opportunity to spare time for them, which
would be, otherwise, spent for dialysis. They will live longer. It is necessary
to emphasize that kidney transplantation costs are far lower than that of
dialysis. If possible, the best approach will be surgery after preparations are
immediately completed, before a fistula is opened and the patient is started on
dialysis.

Kidney transplant surgery involves placing an intact
organ into body of a patient, who has end-stage kidney disease, in order to
fulfill renal functions. Healthy organ is obtained from cadaver or living donor
for kidney transplantation. In our country, living donor kidney transplants
account for a substantial part of all kidney transplant surgeries. Living donor
transplants have better outcomes than cadaver donor transplants. However,
number of organ donations from cadavers should increase to ensure that organ
transplantations can be a cure for more patients.

How is Kidney Transplant Performed?

Kidney transplant implies transferring healthy kidneys
of cadaver or living organ to the recipient. In our country, related living
donor transplant is the most common type of kidney transplant. We perform
living donor transplant surgeries with closed (laparoscopic) method in our
hospital. Since surgical wound is very small in transplant surgeries carried
out with this method, postoperative pain and similar complaints are very rare.
Wound-related postoperative problems are also rare. Thus, patients experience a
more comfortable postoperative period.

Inguinal incision (incision made in the groin region)
is made for the recipient surgery. Arteries and veins of the region are
prepared. Blood vessels of the kidney are to those vessels and blood supply to
the organ is achieved. After the urinary tract is connected to the urinary
bladder using an appropriate surgical technique, the surgery is terminated.

When should kidney transplantation be carried out?

Dialysis or kidney transplantation is necessary, when
renal functions are below 15% of normal ranges in a patient with chronic renal
failure. Kidney transplant should be primarily considered and opportunities
should be investigated for all patients without contraindication. Dialysis
therapy saves the life of dialysis patients and ensures survival. However, it
is also associated with various complications, primarily injury of veins in the
course of time. Therefore, transplant surgery before dialysis is superior
regarding kidney and health of person.

Who are not good candidates for kidney transplant?

There are very scarce patients, for whom kidney
transplantation is contraindicated. Transplantation is not an option for
patients with active infection. In this case, transplant surgery is carried
out, after relevant treatment is completed. For patients with tumor, a
particular period, depending on the type of tumor, should elapse, after tumor
is treated, and transplantation can be performed, after recurrence-free
condition is verified. Transplant is not an option in presence of metastasis
(dissemination of tumor to other organs). Transplantation is not recommended
for patients with blood type incompatibility, since transplant kidney will be
probably rejected by the body. Transplant surgery is not performed, if cross
match test is positive, which compares blood types of donor and recipient.
Advanced age is a relative factor that should be considered for kidney
transplant. Biological age, general health status and other organ functions of the
patient should be assessed in combination. Age alone should not be considered
as a contraindication for transplantation.

What Are The Benefits Of Kidney Transplant Surgery?

Dialysis therapy can only fulfill 10% of functions of
a healthy kidney. A successful kidney transplant can achieve 70 to 80% of the
renal functions of a healthy individual.

Has Kidney Transplant Surgery an Advantage Over Dialysis?

It has many significant advantages. Majority of
patients will attain an almost normal life in postoperative 1 to 2 weeks.
Except the medications they will take in mornings and evenings, their work and
social lives will maintain within normal ranges. On the contrary to dialysis
therapy, they will no more have to live dependent to a device for 3-4 hours per
session, three times a week.

Expected Survival after Kidney Transplant

Today, expected survival periods are much longer in
organ transplantations comparing to its alternative, namely dialysis therapy.
Success rate of our Kidney Transplant Center is 99 percent.

Life quality of patients, who undergo kidney
transplantation, is similar to a normal healthy individual. Since dialysis
machine cannot substitute all functions of viable renal tissue, dialysis
patients face too many restrictions, including but not limited to inability to
drink water freely and eating everything they want. They experience extra
problems such as anemia, cardiovascular diseases, various infections etc. in
the course of time. Due to those reasons and since they spend an important part
of their time in dialysis centers, they do not have a chance to live similar to
healthy people.

In brief, patients who undergo kidney transplant
surgery can engage in both work and social life activities thanks to their
psychological and physical health and since they gain the time they spend in
dialysis therapy.

Who can donate kidney for transplantation?

Today, rules of the coordination system that is
established by the Ministry of Health apply to all cadaver kidneys. Lists of
patients registered in organ transplantation centers are also available in
computers of the coordination system. A list of patients eligible for kidney
transplant is sent to the center by the Ministry. The organ is transplanted to
the patient according to the turns written on the list.

Patients with living donors can have a quicker and
earlier transplantation. Up to four-degree relatives can donate organ to a
patient according to the applicable laws of our country. It is also possible to
receive organs from other related or unrelated donors. However, a decision of
the ethics committee is required for transplantations from these types of
donors. A person must be above the age of 18 in order to donate an organ or
tissue. There is no certain upper limit of age. The decision is based on
examinations and tests and studies to determine whether organ can be obtained
from a particular donor candidate.

Can Elderly Persons Donate Organ or Tissue?

Undoubtedly, age is an important factor, but it should
be considered personally for each case. Biological age is more important than
the identity age. Review of heart, kidney, lungs and other systems is required
for the donor. By this way, kidney transplantations from healthy elderly donors
is and can be successfully carried out.

Blood Type Compatibility in Kidney Transplantation

ABO blood type compatibility is necessary. Rh
compatibility is not necessary. Donor-recipient pairs are indicated at the
table below.

Who Cannot Donate a Kidney?

Patients with cancer, active infection and diabetes
mellitus and pregnant women as well as patients with a kidney disease and any
other organ failure cannot donate a kidney. Decision should be made for
hypertensive patients after all relevant examinations are made.

Living Donor Kidney Transplant

In our country, living donor kidney transplants
account for a substantial part of all kidney transplant surgeries. Since there
is no sufficient cadaver organ donation, waiting period is usually too long.
Therefore, patients need to receive long-term dialysis therapy.

It is required to start patients with an end-stage
chronic renal disease on medical treatment. A patient must either receive
dialysis therapy or be undergone kidney transplant surgery. Kidney
transplantation is by far the best modality regarding quality of life, survival
and treatment costs. Therefore, the most ethical and correct decision for a
physician is to recommend kidney transplantation initially. A living donor is
required in order to transplant a kidney without need to wait for a long time.
The best solution for patients with a donor, who meets above mentioned legal
and medical conditions, is to undergo a transplant surgery immediately.
Likewise, transplant surgery is the best option for patients who are actively
maintained on dialysis therapy, if there is a living donor.

Is Kidney Transplant Surgery an Option for Patients with Hepatitis?

Detailed examinations should be made for patients with
hepatitis regarding cirrhosis and chronic hepatitis. Transplantation can be
performed, if such conditions can be ruled out. Medicines used for the
treatment of hepatitis B can be maintained after the transplantation. Thus,
management of Hepatitis B can be successfully maintained, after kidney is
transplanted. For patients with Hepatitis C, medications used to manage
hepatitis C cannot be used after the kidney transplant surgery. It may lead to
loss of kidney. Therefore, if a treatment is required for patients with
Hepatitis C, it is recommended to complete treatment before the
transplantation. Patients with hepatitis should be consulted with Hepatologist
to determine whether the patient is eligible for transplantation.

Is Transplantation An Option For Diabetic Patients?

Diabetic Patients can also undergo transplant surgery.
Superiorities of kidney transplantation also apply to diabetic patients.
Recently, diabetes mellitus is one of the most common underlying cause of renal
failure. Therefore, many diabetic patients undergo kidney transplant surgery.
Diabetic patients should be closely followed up and managed after the
transplantation.