Kidney transplant is a surgical procedure in which one or both diseased kidneys are removed and replaced with a donor’s healthy kidney. A donor can be living or nonliving, as the donor can survive on one kidney easily, with a higher risk of some complications. A kidney transplant improves the quality of life. But, it may require a regular follow-up until unless body completely adapts to the kidney given by the donor. Although, like every other transplant, there are some risks of a kidney transplant. We will discuss the surgical complications, rejection of the organ by the recipient’s body, graft failure, and other major complications due to the kidney transplant.
Surgical Complications in Kidney Transplant
There are multiple complications related to surgery as follows:
- Complications Due to Anesthesia: Anesthesia can be risky for some patients. A patient can face difficulty in breathing, heart-related issues, and allergies.
- Infection at the Surgical Site: Even after sterlising everything, there could be a chance of infection at the surgical site. This infection may require the addition of antibiotic medicines.
- Loss of Blood during or After Surgery: While performing surgery, surgeons need to connect many of the blood vessels, which may result in major blood loss. And to prevent the hemorrhaging at the operational site, there could be a need for another surgery.
- Blood Clot Formation: Blood can clot in the blood vessels of the body and may influence the blood supply to a new organ. This can cause a graft failure or the kidneys to adapt to the body.
- Damage to Surrounding Structures: Nearby blood vessels, bladder, and intestine can be accidentally damaged due while surgery, which may require additional corrective surgery.
Risks of Organ Rejection After Kidney Transplant
In some cases, it is seen that the receiver rejects the donor’s organ from accepting. The different types of rejections are as below:
- Acute Rejection: In this, our immune systems attack the new kidney within the first few months. It causes fever, low urine output, body pain, and an elevated creatinine level that requires immediate immunosuppressive treatment.
- Hyperacute Rejection: It is one of the fastest rejections; the body rejects the kidney within minutes or hours, because of the antibodies that are already present in the body. This requires the immediate removal of a donated kidney.
- Rejection due to Antibodies: Our body produces antibodies. Especially for the new donated organs attached to the body. So, due to this, sometimes it is very difficult for a new organ to survive for a long time.
- Chronic Rejection: It is a long-term failure of the transplant, as the kidney function starts to fail slowly over the years. It is almost impossible to reverse the functionality in the same kidney.
Risks and Complications due to Immunosuppression
- The immunosuppression drugs make the body more sensitive and vulnerable to catching infections due to viruses, fungi, and bacteria easily. Sepsis and urinary tract infection are some common infections that occur due to this.
- Some immunosuppressive drugs can affect diabetic mellitus. Tacrolimus and corticosteroids are some major drugs responsible for this. Triggered diabetes can require lifelong medications.
- Many cancers, including liver cancer, skin cancer, kidney tumor, and other major diseases, might develop due to the intake of immunosuppressive drugs for a long time.
- Some drugs are way too strong, which can damage the kidneys themselves. It requires very careful dose management and should be monitored regularly.
- Immunosuppression can raise blood pressure, increase cholesterol levels in the body, which results in a higher chance of getting a heart attack or heart failure, and may also cause death.
- Many drugs, like Corticosteroids, can weaken the bone over time, which may result in a higher chance of getting fractures and chronic pain in joints. A bone-strengthening medication may be required.
- Many rare but critical threats can damage the kidneys easily, like BK virus, cytomegalovirus (CMV), fungal infections like candidiasis, and Epstein-Barr virus.
Graft Failure After Kidney Transplant
- Life of a Kidney: A kidney donated from a living person could last for 15 to 20 years, whereas a kidney donated from a deceased person could last for 10 to 15 years. It simply means, a young patient can require multiple kidney transplants in their lifetime to survive.
- Early Graft Failure: Due to a technical problem in surgery, a transplanted kidney may fail within days to months. Poor blood flow to the organ or a low quality of the donated organ can be the reason too.
- Late Graft Failure: Due to infection, any chronic disease, or strong doses of medication can lead to kidney failure, years after transplant. There will be a need for dialysis again after this.
Side Effects and Risks of Medications in Kidney Transplant
- Effects on the Brain: Some drugs can cause headaches, seizures, and tremors, which can also affect the quality of sleep.
- Gastrointestinal Issues: Some common related medications can cause nausea and upset stomach. These side effects can easily affect the nutritional level in the body.
- Affects Liver: Liver can be affected as some drugs increase the liver enzyme levels. To prevent this, there is an immediate change in the dose of medications.
- Weight Gain and Changes in Appearance: Drugs like Corticosteroids cause facial swelling, moon face, and weight gain. It can also increase the growth of hair on the body and problems related to acne on the face.
Urological Complications in the Kidney
- Urinary Tract Infections: Due to immunosuppressive medications, a higher rate of UTI in people with transplanted kidneys is seen.
- Obstruction in the Ureter: Blockage in the ureter can cause kidney damage, extreme pain, and may prevent urine from flowing through it properly.
- Urine Leakage: The connection between the bladder and the donor’s kidney ureter can leak in between, which requires additional surgery by placing a drainage tube
Psychological and Quality of Life Issues
- Depression and Anxiety: Constantly worrying about the lifestyle changes, fear of graft failure, mental preparation, financial burden of medication, and side effects of drugs.
- Financial Strain: The Lifetime need for immunosuppressants can be very costly, and if there are gaps in insurance coverage, then it affects the patient financially as well as mentally.
- Limitations on Lifestyle: Change in diet, risk of infection, and limited to only certain activities. Moreover, the quality of life can be impacted significantly due to multiple hospital visits.
- Risk due to Missed Medication: The peer pressure of taking medication may lead to missed doses, and carelessness in taking medicines timely may result in kidney failure.
Long-Term Health Risks After Transplant
- Chronic Kidney Disease Progression: Due to chronic rejection, sometimes the functioning transplant gradually starts losing its function. It may require dialysis or another transplantation.
- Increased Mortality Risk: It is seen in many cases that mortality rate is generally higher in transplanted cases. This is due to the high risk of infections and cardio-related diseases.
- Development of Metabolic Syndrome: The combination of transplantation and immunosuppressive medications can result in diabetes, hypertension, obesity, and cardiovascular risks.
Conclusion
The renal transplant is a lifesaver, as this treatment has already saved the lives of millions. It is the best alternative option to get through long-term dialysis. There are multiple benefits of this transplant. But as you know, every treatment and transplant comes with some risk and complications. Kidney transplant comes too. But the risks of a kidney transplant are a major thing to consider. Having regular checkups and changing your lifestyle accordingly, and taking all your medications on time, can help avoid the risk to some extent.