Kidney Transplant Unit
Who we are
The transplant center at Asiri Central Hospital, offers laparoscopic donor nephrectomy for living kidney donors. This minimally invasive surgery results in a shorter hospital stay, less pain and scarring for the donor and better outcomes for the recipient. We provide care for patients before and after kidney transplants including patients requiring 2nd and 3rd transplants.
A kidney transplant is a surgical procedure to place a healthy kidney from a living or deceased donor into a person whose kidneys no longer function properly.
The kidneys are two bean-shaped organs located on each side of the spine just below the rib cage. Each is about the size of a fist. Their main function is to filter and remove waste, minerals and fluid from the blood by producing urine.
When your kidneys lose this filtering ability, harmful levels of fluid and waste accumulate in your body, which can raise your blood pressure and result in kidney failure (end-stage kidney disease). End-stage renal disease occurs when the kidneys have lost about 90% of their ability to function normally.
Common causes of end-stage kidney disease include:
- Chronic, uncontrolled high blood pressure
- Chronic glomerulonephritis — an inflammation and eventual scarring of the tiny filters within your kidneys (glomeruli)
- Polycystic kidney disease
People with end-stage renal disease need dialysis to keeps your body in balance by removing waste, salt and extra water to prevent them from building up in their bloodstream via a machine (dialysis) or a kidney transplant to stay alive.
- As per the Ministry of Health guidelines, Female above 30 years of age/Male above 25 years of age (preferably less than 55 years old)
- A citizen of the same country as the recipient
- Agreeable to donate a kidney without financial other pressure
- Can be related or non-related (altruistic donors) – there is a higher chance of the donor’s kidney being a match to your kidney if the donor is related
- Mentally stable and competent to give consent for the procedure (decision making ability, is donating on their freewill, preexisting psychiatric illnesses and the ability to comprehend transplant process and all possible outcome
- No significant medical history or behavioral risk factors that will interfere with the kidney donation process
- Physically fit to donate a kidney which must be proved by history, examination and multiple investigations (which will look at current, immediate or future health risks of donations, including testing for HIV, Hep B, Hep C and Cytomegalovirus)
What is rejection?
The most important problem that may occur after transplant is rejection of the kidney. The body’s immune system guard against attack form anything foreign such as bacteria. This defense system may recognize tissue transplanted from someone else as “foreign” and attack this foreign invader. This may even lead to failure of the transplant. However, rejection rates are very low worldwide. You will need to take immunosuppressant medicine every day to prevent rejection of your new kidney.
Types of kidney rejection that may happen after your transplant.
- Acute rejection will usually happen within the first 3 to 6 months after the kidney transplant. Many kidney transplant patients have some acute rejection episodes, which means their body shows signs that it is fighting the new kidney. Less than 1 in 20 transplant patients have an acute rejection episode that leads to complete failure of their new kidney.
- Chronic rejection happens more often and occurs slowly over the years after the kidney transplant. Over time, the new kidney may stop working because the immune system will constantly fight it.
Imaging-CT, Gamma camera
Transfusion medicine - Plasmapheresis
ICU & surgical wards
- Nephrology consultation
- Relevant investigation for the donor and recipient including human leukocyte antigen (HLA) testing and cross match
- Consultation with the Head Nephrologist and Kidney Transplant unit
- Referral to the consultant transplant surgeon
- Referrals to other specialties (Cardiology, Dental etc.)
- Meeting with the hospital ethical committee of Asiri Central Hospital and obtaining their approval (the committee is held to ensure that the rights of both donor and recipient are protected and to ensure that no unethical practice is being carried out)
- Completion of paperwork which will be sent to the Ministry of Health, Sri Lanka (consultant forms, Affidavits)
- Fixing a date for the transplant surgery
- Final surgical and Anesthetic approval and consent
If you were on dialysis before the transplant, you will notice a difference in what you can eat and drink once you have the new kidney. You will need to eat foods low in salt and fat to avoid high blood pressure, and diabetes, you will need to watch your blood sugar.
Once you have recovered from the transplant surgery, you may be able to start a new exercise routine. Exercise can help improve your heart and lung health, prevent weight gain and even improve your mood. Talk to your doctor about the types of exercise that are right for you, how often you should exercise and for how long.
Walking, bicycling, swimming, low-impact strength training and other physical activities you enjoy can all be a part of a healthy, active lifestyle after transplant. But be sure to check in with your transplant team before starting or changing your post-transplant exercise routine.
- Eat only well cooked food. Please avoid eating partially cooked or raw food
- Never use stored, canned or expired food. Avoid raw food which is contaminated by insects
- Eat foods low in salt, fat, and cholesterol. After you are cleared by your doctor, start an exercise routine such as walking, or biking.
- You can consume fruits only after washing and peeling
- Drink plenty of water to stay hydrated.
- Drinking water should be boiled for 10minutes and cooled before drinking
- Avoid people with any symptoms and signs of infection (fever, cough, cold. Diarrhea etc.) specially in the first 3 months after transplant
- Avoid places where people gather
- If you have pain, change of skin colour around your surgical wound, or any noticeable discharge from the wound please consult your transplant surgeon
- Take your immune suppressants and other medicines exactly how your doctor told you.
Head of Kidney Transplant Unit