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Living Donor Kidney Transplant: An Alternative Approach to Restore Renal Function without Dialysis

End-stage chronic kidney disease is a condition that no one wishes to face, as it requires lifelong dialysis, which can lead to significant disruptions in both work and daily life. Currently, kidney transplantation is recognized as the best treatment option, allowing patients to restore their quality of life and regain a sense of well-being.

Dr. Nataphut Boonvisuth, a nephrologist at Vejthani Hospital, stated that a kidney transplant is the most effective treatment for patients with end-stage chronic kidney disease. This approach has a high success rate and improves the patient’s quality of life without the need for lifelong dialysis. However, patients are required to take immunosuppressive medication to prevent the body from rejecting the new kidney, a condition known as kidney transplant rejection. This treatment is suitable for all patients without contraindications, such as those with failure of other vital organs, active cancer, or ongoing infections requiring treatment.

There are two types of kidney donations:

Donation from Deceased Donor: Kidneys are donated by individuals who have been legally and medically declared brain-dead due to accidents or other causes while their internal organs are still functioning normally. The success rate of kidney transplantation from brain-dead donors is approximately 85-90%.
Donation from Living Donor: This typically comes from blood relatives or a spouse who has been married and living with the recipient for more than three years. In cases where the couple has children together, the three-year residency requirement is waived. The success rate of kidney transplants from living donors is about 95-98%. Living donors must undergo comprehensive medical evaluations to ensure they are in excellent overall health.

Dr. Thuchchai Pipitpanpipit, a urosurgeon at Vejthani Hospital, explained that the kidney transplant surgery technique is the most essential part of the procedure. Any mistakes during the surgery can lead to irreversible transplant failure. Given the complexity of the procedure, the kidney transplant team must be highly skilled and have extensive experience in all aspects of kidney surgery. There are two types of procedures to remove the kidney from a living donor: open donor nephrectomy and laparoscopic donor nephrectomy.

Open Donor Nephrectomy: This is performed under general anesthesia and takes about 2-3 hours. The incision is around 10-12 inches long, and the donor requires approximately seven days of hospitalization due to postoperative pain or numbness. After this period, they can usually return to their daily activities within 4-6 weeks.
Laparoscopic Donor Nephrectomy: This approach uses a minimally invasive technique. The kidney is removed under general anesthesia, with the surgery lasting 1-2 hours. This procedure results in smaller incisions, less postoperative pain or numbness, and a shorter recovery period of approximately three days. Donors can typically resume daily life within 1-2 weeks.

After donating a kidney to a patient with end-stage kidney disease, donors can continue to enjoy a healthy life. Doctors carefully evaluate multiple factors to ensure that the remaining kidney is fully capable of filtering waste and excess fluids while performing other essential functions. Kidney donors generally have the same life expectancy as the general population. However, they are advised to avoid activities that could potentially harm their remaining kidney. During the first month post-surgery, donors should visit their doctor to monitor kidney function and overall health. Annual check-ups are recommended thereafter to maintain their wellness.

The longevity of the transplanted kidney depends on several factors. Kidneys from living donors tend to last longer than those from brain-dead donors. The initial kidney function, the donor’s age, and their underlying health conditions also play vital roles.

Post-transplant care is also essential in preserving kidney function. By embracing a healthy lifestyle and consistently following prescribed medications, patients can help extend the life of their transplanted kidney, promoting lasting health and vitality.