The organ donation process & life after transplantation
You are already on the waiting list, relatively high up, and are now actively waiting for the call from your transplant center. The eagerly awaited call could come at any time. This article explains to you how a transplantation works, if you live in a country where Eurotransplant is active (Belgium, Germany, Croatia, Luxembourg, the Netherlands, Austria, Slovenia, Hungary). Other countries may have a similar process for organ donation.
What happens at Eurotransplant in the background?
In order for the transplant to function properly, the kidney's time outside the body should be minimized. Once Eurotransplant has selected the most suitable recipient for an organ, the transplant centre receives important data about the donor. It evaluates this data once again to see whether the kidney is actually suitable.
What happens when it starts?
As a patient on the waiting list, you should always be available. It is best to know the quickest way to the clinic and have a suitcase packed at all times, because the call may come at night as well. You should also have the telephone number of a taxi that also drives at night on call. If you are doing peritoneal dialysis, you should also take all your consumables for dialysis with you.
What happens in the clinic before the transplant?
In the clinic, your most important blood values will be checked again. You may also have to undergo dialysis again. A anaesthesiologist will then prepare you for the anaesthetic relatively soon. It is possible that several recipients will be called to the transplant centre at the same time. This ensures that a replacement recipient is ready in case the first in line is not eligible for the transplant. An experienced nephrologist will also talk to you again about the whole process and answer any final questions.
What happens after the surgery?
Immediately after the operation, you will be monitored for a while in the recovery ward and then will soon be transferred to a normal ward. Often the kidney will produce urine immediately after the transplantation. It is also possible that you will need a recovery period of a few days to weeks, during which you may need dialysis again. From the first day after the kidney transplant, you will already be doing exercises for your mobility, circulation and breathing therapy. Strength and performance will usually return fairly quickly. If the new kidney works well, dialysis will no longer be necessary.
Can the transplant go wrong?
Unfortunately, it can also happen that the transplant does not work, either immediately or after a few weeks or months. If this happens, you will be put back on the Eurotransplant waiting list. In the meantime you will have to dialyze again.
The kidney is working! What do I have to do from now on?
While you stay in the hospital for 2-3 weeks after the surgery, you will learn directly what you will have to do in your everyday life in the future in order to be able to live with your new kidney for as long as possible. This includes three important things: strict adherence to your medication, independent measurements and regular check-ups.
Why is medication so important?
After your transplantation, you will usually be given 3 very important medications to prevent rejection. You should only change the frequency and dose of these medications after a thorough discussion with a transplant nephrologist. The drugs that prevent attacks by your immune system are called immunosuppressants. Be well informed about them, because they are particularly important.
Regarding documentation and diaries, it is best to keep a record of how much you drink, your urine output, your body weight, your temperature, your blood pressure and your pulse. Control examinations are also important in order to detect any problems as quickly as possible and to prevent possible risks in a targeted manner. Your doctor will tell you more details.
Shortly after the transplant, your body is particularly exposed to infections, as the immune system is suppressed the most. Hygiene is therefore also of great importance.
How long does the new kidney actually work?
Meanwhile, the chances of success of a transplanted kidney are very good. On average, a transplanted kidney survives well over 10 years today. Even more than 20 years can be possible without big surprises. For your kidney to be in service for many years, the first year after the kidney transplant is critical. Here you must take special care of yourself and listen to the recommendations of your nephrologist.
However, risk factors such as smoking can reduce this duration. Your original kidney disease and so-called immunological factors also play a role here. Your body will always want to fight off the new kidney.
Will the "new" kidney function with certainty?
The fact that your new kidney will function well after a transplant also depends to a large extent on you. Regular control examinations, the reliable intake of important medication and also the clean documentation of important measured values should therefore be carried out in order to be able to keep your new kidney for as long as possible.
By the way…
…living donations logically eliminate all the stress of the sudden phone call. You can schedule your transplant at your leisure. That's a big advantage, too, of course, if you manage to find a living donor in your close family.
Before a transplant, extensive tests are carried out to determine whether the donor and recipient kidneys will be a good match
After the transplant, you will need to take regular medication and possibly go on dialysis a few more times, as your new kidney will not always function fully straight away
To make sure your kidney lasts as long as possible, it is very important to follow your medications and health instructions -- you are largely responsible for determining how long your new kidney will function!