Kidneys are two bean-shaped organs located just below the ribcage on either side of the spine. Each kidney is about the size of a fist. The primary function of the kidneys is to filter waste, minerals, and fluids from the blood by producing urine and expelling certain harmful and waste substances through the urinary tract. When your kidneys lose this filtering ability, harmful fluids and waste substances accumulate in your body. This can lead to elevated blood pressure and end-stage kidney failure. End-stage kidney failure occurs when the kidneys have lost approximately 90% of their normal function. Treatment options for end-stage kidney failure include dialysis and kidney transplantation.

Common causes of end-stage kidney failure include:

• Diabetes (diabetes mellitus)
• Chronic, uncontrolled high blood pressure
• Chronic glomerulonephritis, which is inflammation of the small filters (glomeruli) in the kidneys, leading to permanent loss of function
• Polycystic kidney disease

Living donor kidney transplantation is a highly comfortable method for both the recipient and the donor. However, kidney transplants from deceased donors, known as cadaveric kidney transplants, also yield successful results.

What Is Kidney Transplantation?

Kidney transplantation is the process of replacing a failing kidney with a kidney taken from a living or deceased donor to ensure the person's kidney functions continue.

Our kidneys are vital organs. Chronic kidney failure signifies a permanent disruption in kidney function. Nowadays, kidney transplantation is the most common treatment for chronic kidney failure, which is also known as end-stage kidney disease. Kidney transplantation can be performed in cases of acutely developing kidney failure known as acute kidney failure. Kidney transplantation allows the patient to regain their health through surgery. Dialysis should not be considered an alternative to kidney transplantation, as it only partially replaces kidney function. Moreover, dialysis patients may face various disadvantages, including strict diets, restrictions on water intake, limitations on travel, social isolation, and interference with work or education.

Dialysis patients also require an array of medications (e.g., blood pressure and erythropoiesis-stimulating drugs) because they are deprived of most of the functions performed by the kidneys. For these reasons, kidney transplant recipients are known to have better quality of life and longer lifespans compared to dialysis patients. With a successful kidney transplant and post-operative follow-up, patients can continue to lead healthy lives.

What Are the Benefits of Kidney Transplantation?

Dialysis can only perform about 10% of the kidney functions in a healthy individual. A successful kidney transplant can replace 100% of a healthy person's kidney functions, offering significant advantages over dialysis.

Does Transplantation Provide an Advantage Over Dialysis?

Dialysis can only perform about 10% of a healthy person's kidney functions. A successful kidney transplant can replace 100% of a healthy person's kidney functions.

In Which Diseases Is Kidney Transplantation Applied?

Kidney transplantation is performed in cases of end-stage kidney failure. Diseases such as diabetes (diabetes mellitus), chronic uncontrolled high blood pressure, chronic glomerulonephritis (inflammation of the small kidney filters, or glomeruli, resulting in permanent function loss), and polycystic kidney disease can progress to advanced stages and necessitate kidney transplantation.

Who Cannot Undergo Kidney Transplantation?

Very few patients are ineligible for kidney transplantation. Patients with active infections cannot undergo transplantation, but they may become eligible once their infections are treated.

Who Can Donate a Kidney? Who Cannot Be a Kidney Donor?

Anyone can be a living donor within the medical and legal framework. However, certain conditions are evaluated:

• Individuals under 18 years of age
• Those with hypertension (blood pressure > 140/90 mmHg) or using antihypertensive medications
• Diabetics (people with diabetes)
• Individuals with morbid obesity
• Those with bilateral or recurrent nephrolithiasis (kidney stones)
• Individuals with a history of thrombosis or thromboembolism
• People with chronic kidney disease (CKD)
• Those with a history of pulmonary embolism or recurrent thrombosis
• Individuals with psychiatric illnesses
• People with serious medical conditions (chronic lung disease, recently diagnosed cancer)
• Low glomerular filtration rate (GFR) (< 80 ml/min)
• Proteinuria (>300 mg/24 hours)
• A history of pulmonary embolism or recurrent thrombosis
• HIV infection

How Is Kidney Transplantation (Renal Transplantation) Performed?

Despite all efforts worldwide, kidney transplants from deceased donors, which are performed after brain death, have not reached sufficient levels, and these numbers have been increasing very slowly over the years. Kidney transplants from living donors have emerged as a solution to organ shortages.

What Are the Risks for Kidney Donors?

Like any surgery, being a kidney donor carries surgical risks. Therefore, no one can guarantee the absolute success of the operation. While the risk of death is very low for kidney donors, there is a low risk of surgical site and urinary tract infections.

What Should Be Done After Transplantation?

Transplant patients are advised not to participate in contact sports (boxing, wrestling, soccer, basketball, etc.). After transplantation, patients should remain active, avoid smoking and alcohol, and follow a healthy dietary program.

Kidney Transplant Duration:

Under normal circumstances, a kidney transplant surgery takes 3-4 hours. This duration includes pre-operative preparations, the surgery itself, and the observation period.

Living Donor Kidney Transplant:

When considering the health and post-operative comfort of living donors, the laparoscopic method, where the kidney is removed through small incisions in the abdomen, is common. In this method, the surgery is performed through small incisions made in the patient's abdomen, allowing for faster recovery.

Diabetics and Patients with Hepatitis:

Individuals with diabetes and hepatitis can be candidates for kidney transplantation, but their cases are thoroughly evaluated.

Kidney Transplantation (Renal Transplantation) for Whom?

Kidney transplantation is performed in cases of end-stage kidney failure. Kidney failure can occur due to conditions like diabetes, high blood pressure, and kidney inflammation.

Kidney Transplantation Surgery:

Kidney transplantation surgery involves the placement of the donor's kidney into the recipient's abdomen, connecting it to the recipient's blood vessels and urinary tract. This procedure is done through the abdomen.

Robotic Kidney Transplantation:

Some kidney transplant surgeries can be performed using robotic surgery, which may provide advantages, especially for overweight patients.

Evaluation Process for Kidney Transplantation:

Kidney transplant candidates undergo various tests, including blood type and tissue typing, to ensure compatibility between the donor and recipient.

Risks and Side Effects of Kidney Transplantation Surgery:

There can be some risks and side effects during the postoperative period, including temporary kidney function deficiency, organ rejection, kidney failure, infections, bleeding, weight gain, high blood pressure, and an increased risk of diabetes.

Recovery Time After Kidney Transplantation:

Patients recover rapidly after kidney transplantation, but they may need to use immunosuppressive medications to prevent rejection.

Immunosuppressive Medications:

These medications, used after kidney transplantation, can weaken the immune system and increase the risk of infection. Additionally,

 they may increase the risk of cancer and diabetes.