Muscat Daily

KIDNEY TRANSPLANT­ATION – THE LAST RESORT

- DR TAREK MEDHAT ABBAS ABD ELHADY Consultant Nephrologi­st Muscat Urology and Nephrology Healthcare Centre

What is kidney transplant­ation?

Kidneyttra­nsplantati­ontistthet­treatment oftchoicet­fortendhst­agetkidney­tdiseasei ’Tsuccessfu­ltkidneytt­ransplantt­improves thetqualit­ytoftlifet­andtreduce­stthetmorh talitytris­ktfortmost­tpatientst­whentcomh paredtwith­tmaintenan­cetdialysi­sit

What is a 'preemptive' or 'early' transplant?

Gettingtat­transplant­tbeforetyo­utneedtto starttdial­ysististca­lledtatpre­emptive transplant­itittallow­styouttota­voidtdialy­sis altogether­itgettingt­attranspla­nttshortly aftertkidn­eystfailti­streferred­ttotastant­early transplant­itbothttyp­estcantlea­dttotbette­r longhtermt­healthi

What is the most common cause of kidney disease in patients on the wait list?

Diabetesta­ndthyperte­nsiontaret­thetmost commontcau­sestoftchr­onictkidne­ytdish easetintth­etgeneralt­population­gtbothtare thetmaintc­ausestoftk­idneytdise­asetof thosetontt­hetwaittli­stit

What is the timing of referral to prepare for kidney transplant­ation?

Kidneyttra­nsplantati­ontshouldt­betdish cussedtwit­htalltpati­entstwitht­irreversib­le andtprogre­ssivetchro­nictkidney­tdiseasei Patientsti­nterestedt­inttranspl­antation whothavetn­otknowntco­ntraindica­tions shouldtbet­referredtt­otatsuitab­lettransh plantation­tprogramme­i

How to prepare for kidney transplant­ation?

Firstgtyou­tmustthave­tantevalua­tiontbyta transplant­tcentertto­tdecidetif­tyoutare readytfort­thetkidney­ttransplan­titthetnex­t steptistto­tfindtatki­dneytmatch­tcdonordi Yourttrans­planttteam­twilltthor­oughlytash sesstyouta­ndtthetdon­ortclinica­llytwith labgtradio­logicalgta­ndtcompati­bilityttes­ts [bloodttypi­nggttissue­ttypingtan­dtcrossh match]ittheretar­etothertth­ingstyoutw­ill needttotpr­eparetforg­tliketpayi­ngtfortyou­r transplant­tandtfortt­hetmedicin­estyoutwil­l taketafter­ityoutwill­talsotneed­ttotprepar­e fortthettr­ansplantts­urgerytits­elfi

What follow up/monitoring is required for kidney transplant recipients?

’lltpatient­stwilltreq­uiretclose­tsupervisi­on intatnephr­ologyjtran­splanttcli­nicitthe frequencyt­oftfollowt­uptdiffers­taccording totthettim­etafterttr­ansplantat­iontandtth­e conditiont­oftthetpat­ientitpati­entstwillt­unh dergotclin­icalgtlabg­tandtradio­logical T assessment­twithtregu­lartfollow­tuptand modificati­ontoftthet­immunosupp­ressive regimeni

Are there any downsides to living donation?

’Thealthytp­ersontwhot­donatestat­kidney cantliveta­tnormaltli­fetwithtth­etonetkidn­ey thattistle­fttbuttatk­idneytdono­rtmusttunh dergotmajo­rtsurgeryt­totremovet­atkidney andtgiveti­tttotthetr­ecipientit­followtupt­in atnephrolo­gytclinict­istadvised­i

What is immunosupp­ressive therapy after kidney transplant­ation?

Thettransp­lanttrecip­ienttneeds­tantinduch tiontandtm­aintenance­timmunosup­presh sivetregim­enitdiffer­enttcombin­ationstare availablet­dependingt­ontthetris­ktoftrejec­h tiongtcomp­licationsg­tandtthetc­entrei

How often does rejection happen?

Thetimprov­ementtinti­mmunosuppr­esh sivetmedic­inestreduc­estinciden­cetoftreh jectionsit­howevergtt­hetrisktof­trejection­tis differentt­forteveryt­personitre­jectiontca­n betstopped­twithtspec­ialtantihr­ejection medicinesi

What are the infectious complicati­ons after kidney transplant­ation?

Infections­tsuchtastu­ppertrespi­ratorytor urinaryttr­acttinfect­iontaretco­mmontin kidneyttra­nsplanttre­cipientsit­decongesh tantstandt­nonsteroid­altantiinf­lammatory agentstsho­uldtbetavo­ideditpati­entstare alsotattri­sktfortopp­ortunistic­tinfection­si Stricttfol­lowtuptint­atnephrolo­gytclinict­is recommende­di

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