The Kidneys are one of the most vital organs of the body. They filter out and eliminate waste and toxins from the blood in the form of urine. They also help to maintain the body’s fluid and electrolyte balance. Needless to say, the kidneys must be in good working condition, else waste and toxins build up in the body contributing to various diseases.
In some people, ailments in the kidney progress gradually leading to chronic kidney disease (CKD), kidney/renal failure and End-stage Renal Disease (ESRD). The human body can function well with just one kidney working. However, when ESRD affects both kidneys, it’s a serious situation which requires alternate means to process waste from the body.
One of the options is Dialysis. This involves taking the blood outside the body, cleaning it in a dialysis machine and sending it back to the body. A cumbersome procedure, Dialysis requires one or more visits per week to the hospital as per a committed schedule, and constant medication.
Considering the hassle involved in a Dialysis, many patients prefer the other option, which is a Kidney/Renal Transplant. This involves taking a healthy kidney from another human being, dead or alive, and transplanting into the body of the patient concerned. Both Dialysis and Kidney Transplant have their own pros and cons, but for the purpose of this article, we will only examine the pros and cons of Kidney Transplant.
Pros of Kidney Transplant
- Better quality of life: The first and foremost advantage of Kidney Transplant is the quality of life. Patients can lead an almost normal life with enough time for daily activities. No frequent visits to the hospital, no constant monitoring required.
- Better survival rate compared to dialysis: If you are a suitable candidate for Transplant, the chances of living another 5 to 10 years after the Transplant are high. To determine if you are a good candidate, the doctor will thoroughly examine your lifestyle and medical history.
- Fewer diet restrictions: Since the patient now has one working kidney, it is life as usual, so there are no fewer diet restrictions which are inevitable with dialysis.
- More energy: Patients who have undergone a Transplant have reported better overall well-being and energy compared to the months and years when they suffered ailments in their original kidneys.
Cons of Kidney Transplant
- Can be hard to find a kidney: The first and foremost issue is that a healthy kidney is hard to find. Kidney donors can be living people like family members, friends or even strangers. Or they can be somebody who has just expired from an accident or another ailment which did not affect their kidney. Such expired donors are called cadavers.
However, the survival rate of patients who have had a transplant from a live donor is much better than that from a cadaver. This is the primary reason for the shortage. As a result, there is a perennial list of people who would like a kidney transplant and are awaiting a live donor.
- Not everyone is a candidate: Kidney transplant is not for everybody. Various lifestyle related factors and health conditions can rule out the possibility.
- Health related: Patients who are currently suffering, or have suffered in the past or have a family history of – cancer are ruled out for transplant. So also, patients with a serious infection such as tuberculosis, bone infections or hepatitis, severe cardiovascular disease, liver disease, any chronic illness that could lead to death within a few years, and severe obesity (BMI greater than 40) are all ruled out for transplant. Then, patients who have had unsuccessful attempts at dialysis are ruled out. Finally, those suffering from Dementia, poorly controlled mental illness or any condition contributing to poor memory are also ruled out.
- Lifestyle related: People with current or past – alcohol abuse, recreational drug abuse and frequent smoking are ruled out for transplant.
- Other factors: While this may not be true in India, in some countries, not having health insurance or adequate insurance can rule one out for transplant. This is because of the high cost of transplantation and lifelong-medication that follows.
- Surgery: The transplant involves surgery under general anaesthesia. Although some hospitals do offer minimally invasive procedures for renal transplant, an open incision-based surgery is still preferred. Further, there is constant monitoring for a couple of weeks after the transplant.
- Risks from surgery: During surgery, the patient can develop an allergic reaction to general anaesthesia. And post-surgery, he/she can develop any of these conditions: infection, bleeding, blood clots, heart attack, stroke, a leakage from the ureter and a blockage in the ureter. In rare cases, even death can occur.
- Lifelong medication: The human immune system does not have the intelligence to understand the background behind a transplant. It regards the transplanted kidney as a foreign body and tries to attack or reject the organ. This is a natural impulse from the body that is suppressed using certain drugs called immuno-suppressants. These and some other medications must be taken every day by the patient, as long as he/she is alive. Further, any minor infection or health condition will require the patient to rush to the hospital for close monitoring.
- Side-effects of the medication: In some people, these medicines can have significant side effects such as increased risk of severe infections due to a suppressed immune system. It can also trigger diabetes and cause cancer in some patients.
While renal transplant may have many disadvantages, an experienced and qualified team of doctors can prepare you thoroughly for a successful transplant. Post-transplant, they will guide you on lifestyle changes required to lead a normal and healthy life.