KIDNEY KNOWLEDGE SERIES - (14)

Complications of Kidney Transplants

Q:     Why should one have a kidney transplant?

A:     With improved surgical techniques and better anti-rejection drugs, renal transplantation has become the treatment of choice for end-stage renal disease (ESRD). It offers a much better quality and quantity of life, compared to dialysis.There is also substantial cost savings on treatment cost over a long time.

Q:     What are the complications of kidney transplant?

A:    

·        Although a transplant is an excellent treatment for most people with kidney failure, transplantation is not problem-free.

·        Most of the complications are mainly due to three factors.

o   First, many people having a transplant have health problems in addition to kidney failure. These can include diabetes, high blood pressure, heart disease, or other complications of kidney failure and dialysis.

o   Secondly, the body recognizes a transplanted kidney as an invader or foreign body, in the same way it would recognize a germ. This means that the body will try to destroy the transplant, and this is what is called rejection.

o   Thirdly,the long term use of anti-rejection drugs may result in some side effects and increase susceptibility to some infections. The incidence of certain types of Cancers is also higher after prolonged use,  compared to the general population.

Q:     What are the common complications after kidney transplant?

A:     Several complications can occur after transplant. The most common complications are:

1.     Rejection -This happens when your body's immune system thinks your new organ is "foreign" and attempts to destroy it. The patient requires anti-rejection medications for life, to prevent rejection.

There are several types of rejection:

Hyperacute rejection - happens when the body immediately destroys the new kidney, this is rare because of the crossmatch testing used before transplant.

Acute rejection - although this can happen at any time after the transplant, most often it happens during the first several months. This can be treated by giving the patient higher doses of medication by mouth or by intravenous infusion.

Chronic rejection - this may happen months or years after the transplant. This type of rejection is resistant to treatment with current medications. This will cause your new organ to slowly stop working.

2.     Infection - The drugs taken to prevent rejection can decrease the ability to fight infections. Infections in a transplant patient can be serious and even life threatening and can be viral, bacterial or fungal. It is very important to seek help if symptoms of an infection develop.

3.     Acute tubular necrosis (ATN, or delayed graft function) - The new kidney may not start to function immediately. Some kidney recipients need to continue to dialyze for a week or two. During the time the recipient remains on dialysis, a kidney biopsy may be performed to ascertain the exact cause of poor kidney function.

4.     Hypertension (high blood pressure) - High blood pressure after transplant is very common. Most patients' blood pressures can be controlled with multiple anti-hypertensive medications. Controlling weight, limiting salt in the diet and exercising will also help.