Kidney transplantation procedure step by step in Iran

Kidney transplantation procedure step by step in Iran

Kidney transplantation is one of the main treatment options for kidney failure (link to the article "What are the 10 signs of kidney failure?"), in which a healthy kidney is received from a donor and placed in the kidney patient's body. This procedure may have its advantages and disadvantages, which are fully addressed in the article "What are the advantages and disadvantages of kidney transplantation?". On the other hand, kidney transplant surgery has steps that must be performed before, during, and after the operation by the patient and his medical team to maximize the success rate of a kidney transplant and the patient's health. So join us in this article to examine these steps more closely.

A) Preoperative steps

1. Consult a doctor

Some operations may not be suitable for every patient. Therefore, in the first step, the kidney patient should consult a urologist to make sure whether the kidney transplant will be a suitable treatment solution for him/her. For example, some underlying conditions in the patient, such as obesity, may affect the success rate of kidney transplantation. In the article "Does obesity affect the success rate of kidney transplantation?", You can read more about this topic. Therefore, it is necessary for the urologist to first examine the patient's medical and personal condition, and, if the doctor deems the patient appropriate for the operation, refer him/her to a kidney transplant center.

2. Preoperative evaluations and tests

In the next step, at the kidney transplant center, the patient must undergo the necessary evaluations before the kidney transplant operation. At this point, he will face the kidney transplant team. These examinations may take several weeks to several months, during which time the patient will have blood and other tests done to check the optimal function of his or her heart, liver, and other organs. Another critical evaluation is from a psychological point of view. The medical team must ensure that the patient is ready for the required postoperative kidney transplant intensive care. If a kidney is to be donated to a patient by a family member, that person must also undergo the relevant tests to ensure his/or health conditions.

3. Awaiting list

If, after the examination phase, it is determined that the patient is eligible for a kidney transplant, the Iranian patient will be placed on a national waiting list for a kidney transplant, and as soon as a suitable donated kidney is found from a living or deceased person, the patient will be contacted. Of course, at this stage, some priorities are related to the patient's condition and can affect the waiting time. It should be noted that this waiting list in Iran will be relatively short compared to many other countries, especially some Western countries. The reason is the existence of the "Iranian model" of kidney transplantation, which allows a healthy kidney to be donated from a living person to a kidney patient. In the article "Why is Iran the best destination for kidney transplantation?" You can read more about this topic. International patients should introduce a suitable kidney donor with their own nationality regarding Iranian health ministry rules. During the patient's waiting time, a blood sample is taken once a month so that the kidney transplant center could be up to date with the latest changes in the patient's health conditions, and also, can check the latest sample with available donated kidneys. Three general factors can affect the compatibility of a donated kidney with a kidney patient and the success rate of kidney transplantation, which are considered in the reviews of kidney transplant centers:

• Blood type:This factor is the most important in determining the adaptation level between the kidney recipient and the donor.
• Human leukocyte antigen (HLA): which is a type of protein in the human body that helps the immune system distinguishing body tissues and external factors.
• Cross-match antigens: Cross-match or blood compatibility test is one of the last tests before confirmation of transplantation. In this test, a small amount of the kidney patient's blood will be mixed with the donor blood to confirm the possibility of a kidney transplant if there is no reaction and the test result appears to be negative.

If a suitable kidney becomes available to be donated, the kidney patient on the waiting list will be contacted. After that, the patient goes to the hospital.

B) During the Operation

Once the patient arrives at the kidney transplant center, some of the previous assessments and tests will be repeated quickly to inform the doctor about any new medical conditions. If the compatibility between the donor and the recipient is confirmed, the patient will be placed under general anesthesia and transferred to the operating theatre. The surgery will usually be performed on the recipient and donor of the kidney at the same time. One surgeon performs a "nephrectomy" or removal of the kidney, and the other surgery prepares the patient to receive a donated kidney. Sometimes both surgeries are performed by one surgeon. Kidney transplant surgery in the operating theatre usually has several general steps:

• Initially, an incision is made in the lower abdomen of the patient and through it, the donated kidney will be placed in the body (below the original kidneys). The patient's former kidneys will usually be left where they are unless they have caused problems such as pain, high blood pressure, infection, or cancerous tissue.
• In the second stage, the arteries and vessels of the patient's body are connected to the blood vessels of the donated kidney. This is to provide the blood needed by the kidneys to function properly.
• Finally, the ureter (or tube that carries urine from the kidneys to the bladder) connects between the donated kidney and the patient's bladder (ureteroneocystostomy).
• A small plastic tube called a stent may be inserted into the ureter to facilitate the urine flow in the early stages. The tube will usually be removed 6 to 12 weeks after surgery, in a minor operation called a cystoscopy.
• When the donated kidney is placed properly, the incision in the patient's abdomen will be closed with stitches or surgical glue.

Although the steps may seem straightforward, a kidney transplant is considered a very complicated operation that will take about 3 to 4 hours.

C) After the operation

1. Hospitalization

Typically, kidney recipients can leave the hospital after a week. In most cases, after three to eight weeks, these people can return to work and resume their normal, former life. However, until the surgical incision is completely healed (which usually takes six weeks after surgery), lifting objects heavier than 4.5 kg and any sport other than walking is prohibited.

2. Taking certain medications

When the patient regains consciousness, he may in some cases experience pain in the abdominal area, in which case he will be prescribed painkillers. Also, after surgery, the patient will be treated promptly with immunosuppressive drugs. These drugs will help prevent the immune system from recognizing or rejecting a newly donated organ as an external factor. However, these drugs may cause side effects, including some infections, discussed in the article "Infection after Kidney Transplantation: Why it happens and How to prevent". However, their consumption will be mandatory.

3. Possibility of dialysis

In general, all donated kidneys quickly regain their normal performance, especially if the donor was a living person. But in some cases, it may take days to weeks for the kidneys to work properly. In this case, the patient may have to undergo dialysis for some time.

4. Regular checkups

Although the time required to be hospitalized after a kidney transplant is usually not that long, kidney recipients will need to visit the hospital several times after the discharge. During the first month after surgery, the patient may need to have 2 to 3 appointments a week with their doctor. Patients will have blood tests several times a week, and their doctor may change the prescription if necessary in the weeks after surgery. However, over time, the number of such appointments will decrease. After one year, as long as the patient does not face a serious problem, he should only visit the medical center once every 3 to 6 months.

From what has been said, it is clear that kidney transplant surgery is a sensitive procedure that requires an experienced and professional medical team. If you decide to have this operation and still have concerns, do not forget to consult a specialist. The first step is to determine if you, as a kidney patient, have the general conditions necessary for a kidney transplant.  The consulting physicians of TebMedTourism Co. are ready to answer your questions, free of charge, 24/7. 

For achieving more information about kidney transplantation in Iran, click here...