A kidney transplant is performed
when a person’s kidneys have lost
almost all of their normal function (so-
called end-stage kidney failure). Just
one healthy donor kidney can allow a
patient to have a normal lifestyle. The
donated kidney comes from a close
relative of the patient, or from any
person who consented to medical use
of his or her organs after death. To
prevent rejection of the kidney by
the recipient’s
i m m u n e s y s t e m ,
tissue-type and blood group of
recipient and donor must be a close
match (see
T r a n s p l a n t s u r g e r y ) .
The donor kidney is removed. Usually
the left kidney is removed from living
donors, because it has a longer vein than
the right and is easier to remove safely.
With donation from people who have died
(cadavers), both kidneys are used and each
kidney usually goes to a separate recipient.
Kidneys from a cadaver can be maintained
for transplantation by a machine that passes
a cooling saline solution through them.
Donor organs may need to be transported
over long distances, and occasionally to
other countries, to reach the recipient.
A significant proportion of patients with end-stage kidney failure are
suitable for a kidney transplant, but many have to remain on dialysis for some
time until a suitable donor kidney becomes available. A computer system
is used to match donors with the most suitable recipients. The number of
available donor kidneys is considerably less than the number of people
waiting for a transplant.
T h e s u r g e o n i n s e r t s
t h e d o n a t e d k i d n e y
in i t s n e w p o s i t i o n in
t h e p e l v i s .
D o n o r k i d n e y
( fr o m liv in g
d o n o r )
Site of incision
The donor kidney is inserted
low in the patient’s pelvis,
close to the bladder and
major blood vessels.
After removal, a donor kidney is flushed
with chilled saline solution in order to
preserve the tissues and internal structures.
The donor kidney should be transplanted as
soon as possible, but there is a reasonable
success rate even iftransplantation is delayed
for up to 48 hours.
The donor kidney is usually placed in the
pelvis. The renal artery and vein of the donor
kidney are joined to a convenient artery (usually a
branch ofthe external iliac artery) and vein ofthe
recipient. The lower end ofthe donor ureter is
connected to the recipient’s bladder. The donor
kidney usually begins working immediately after
transplantation into the recipient.
The health ofthe donor is not
affected by having a kidney
removed because the body can
work efficiently with just one. The
remaining kidney enlarges to
increase its capacity and takes
over full function.
E n l a r g e d
k i d n e y
O r ig in a l
s i z e
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