Kidney Transplant
Though we no longer have a transplant center here in Columbia, we work with all of the transplant centers in the area to monitor transplant patients' kidney function and problems that can occur after a transplant. We have trained transplant physicians on staff and have a several office clinics each month dedicated to following-up transplant patients. We believe that kidney transplantation is a good option for treatment of kidney failure in many patients. When kidneys fail, three treatment options are available: hemodialysis, peritoneal dialysis and kidney transplantation; treatment can be performed at home or in a dialysis center near where you live. We believe and many patients agree that a successful kidney transplant provides a better quality of life because it allows greater freedom to work and travel and often is associated with increased energy levels. In making a decision about whether this is the best treatment for you, you may find it helpful to talk to people who already have had a kidney transplant. You also need to speak to your doctor, nurse and family members. If you would like to be referred to a transplant center for evaluation for a kidney transplant, talk to your kidney doctor at your next visit. You do not have to be on dialysis to be evaluated for a transplant; but you do need to have a GFR of 20 or less.What is a kidney transplant?
A kidney transplant is an operation in which a person whose own kidneys have failed receives a new kidney to take over the work of cleaning the blood. The transplant is not a cure for kidney disease; it is a lifelong treatment and requires medications to keep the kidney working. If a transplant fails; then the person must either get another transplant or go onto dialysis.Are there different kinds of kidney transplants?
Yes. There are two types of kidney transplants: those that come from living donors and those that come from unrelated donors who have died (non-living donors). A living donor may be someone in your immediate or extended family, your spouse, or a close friend. In some cases a stranger who wished to donate a kidney to anyone in need of a transplant. There are advantages and disadvantages to both types of kidney transplants. Generally, the waiting time for a living donor transplant is shorter and the kidney tends to last longer than a kidney donated by a non-living donor. Also more is known about the health of living donors.How do I start the process of getting a kidney transplant?
Your doctor can discuss the transplant process with you or refer you to a transplant center for further evaluation. The transplant center will do an extensive evaluation to make sure you are a good candidate for the operation and help perform the work-up of a living donor if you have one.How can I pay for my transplant?
Most private health insurance policies cover many expenses associated with kidney transplants, including medications. Call your insurance company and ask them about kidney transplantation and if you can go to any center or if they require you to go to a center they have a contract with. In addition to insurance, most kidney transplant candidates are eligible for Medicare, which will cover 80 percent of the cost of the transplant surgery. After transplantation, you will need to take medications to prevent rejection of your new kidney. Medicare Part B will cover 80 percent of the cost of these anti-rejection medications, but not the cost of other medications you may need. For most patients, this Medicare coverage will stop after 36 months. However, if you are eligible for Medicare coverage based on age or disability, the cost of your anti-rejection medications may be covered for as long as you are on Medicare. The social worker or financial counselor at your transplant center is available to answer questions about your coverage options.What is rejection?
The most important complication that may occur after transplant is rejection of the kidney. The body's immune system guards against attack by all foreign matter, such as bacteria. This defense system may recognize tissue transplanted from someone else as "foreign" and act to combat this "foreign invader." You will need to take medications every day to prevent rejection of your new kidney. Most patients need to take three types. The major one is usually cyclosporine or tacrolimus. In addition, you may need to take some type of steroid and a third medication, such as mycophenolate mofetil or rapamycin. Additional treatment may be needed if a rejection episode occurs. Regular checkups at your transplant center or your kidney doctor will ensure early detection and treatment of rejection.What are the side effects of the anti-rejection medications?
Anti-rejection medications have a large number of possible side effects because the body's immune defenses are suppressed. Fortunately, these side effects usually are manageable for most patients. If side effects do occur, changing the dose or type of the medications will usually take care of them. Some of the most common side effects include high blood pressure, weight gain, infections and tumors. You may also require additional medications to maintain blood pressure, prevent ulcers, and infections.What are the chances that a transplanted kidney will continue to function normally?
Results of transplantation are improving steadily with research advances. If the transplanted kidney fails, a second transplant may be a good option for many patients or the patient would need to have dialysis to sustain life. It is important to realize that a person with a successful transplant often does not have normal kidney function and must follow up with their kidney doctor to treat all of the conditions that can go along with kidney disease including anemia, bone disease, and an increased risk for heart and blood vessel disease.Will I need to follow a special diet?
Kidney transplants, like other treatments for kidney failure, often require following special diet guidelines. If you were on dialysis before, you may find this new diet less restricted. The length of time you must follow the special diet varies. Your progress will be followed closely, and your doctor and dietitian will change your diet as needed.What else can I do?
You should inform yourself fully by reading and talking to doctors, nurses and patients who already have kidney transplants. Talk to your family and your kidney doctor if you think transplant may be a good treatment for you. If you are approaching dialysis, ask to attend the "Your Treatment, Your Choice" classes that are offered in our office.