Kidney transplantation is an alternative treatment that allows kidney disease patients to return to a comfortable and happy life. Ramkhamhaeng Hospital is dedicated to helping patients with high-efficiency technology under the care of nephrology specialists, because the patient's life is most important. Therefore, our physicians have prepared this guide for kidney patients to prepare themselves for a smooth treatment process.
Kidney Transplantation
Kidney transplantation is the best treatment for end-stage renal disease (ESRD), as it provides good long-term results and higher survival rates compared to other treatments. It is categorized into two types:
Living Donor Kidney Transplant: Taking one kidney from a donor who may be a parent, relative, or legal spouse (such as siblings, children, grandchildren, aunts, or uncles). However, the donor must be healthy and donate voluntarily.
Deceased Donor (Brain Death) Kidney Transplant: Taking a donated kidney from a deceased person. In cases of kidneys donated from brain-dead patients, the Thai Red Cross Society acts as the recipient of the donation and allocates the kidneys to patients with renal failure.
Currently, patients with renal failure who successfully undergo kidney transplantation will have a longer life expectancy and can return to a normal life with a good quality of life. They can maintain a career, and after transplantation, patients can also become pregnant and have children normally.
Recipient Qualifications for Kidney Transplantation
Must have end-stage renal disease (ESRD), with kidney function measured at less than 15%.
In the case of waiting for a kidney from a brain-dead donor through the Organ Donation Center of the Thai Red Cross Society, the patient must first undergo hemodialysis or peritoneal dialysis treatment.
No active infection.
Must not be HIV positive.
Does not have liver cirrhosis of a type that precludes kidney transplantation.
Does not have cancer, or has had cancer that has been fully treated and in remission for at least 2–5 years, depending on the type of cancer.
Kidney Rejection is a condition where the body begins to attack the new kidney, which may occur gradually or acutely. When a new organ enters the body, the immune system naturally identifies it as foreign, similar to the reaction against germs or cancer. Doctors must manage this condition by administering immunosuppressive drugs and providing education regarding the side effects of these medications.
Living Donor Kidney Transplantation
The donor must have a blood group compatible with the recipient. Physicians will perform blood tests to check compatibility through Human Leukocyte Antigen (HLA Typing) and DNA testing for genetic compatibility. If characteristics are similar, shared genes can be identified, which benefits the recipient by helping the kidney last longer.
Crossmatching
Crossmatching (Lymphocyte crossmatch) is a predictive test to determine how the recipient's cells respond to the donor's blood cells. This is done by mixing a blood sample from the donor with that of the recipient. Ideally, there should be no reaction. If the result is negative, it means there is no reaction against the donor's cells, which indicates a high chance of a successful transplant.
Life with a Single Kidney
If one is physically healthy, donating one kidney does not impact daily life. A single kidney is still capable of efficiently eliminating waste and excess water, as well as performing other functions. Research over several decades globally has found that having only one kidney does not cause other kidney diseases compared to non-donors, or the risk is very minimal—such as potential high blood pressure, protein in the urine, and life expectancy remains as long as a normal person's.
Qualifications for Living Kidney Donors
Age 18 to 60 years. If over 60, the donor must be in excellent health as determined by medical discretion.
No hypertension (systolic pressure not exceeding 140 mmHg and diastolic pressure not exceeding 90 mmHg).
No diabetes.
No history of chronic kidney disease.
Urine protein not exceeding 300 mg per 24 hours or urine albumin not exceeding 100 mg per 24 hours.
Glomerular Filtration Rate (GFR) greater than 90 ml/min/1.73 m². If the rate is between 70 and 90 ml/min/1.73 m², donation may be possible but other risks must be considered.
No obesity.
Not suffering from serious medical conditions such as Chronic Obstructive Pulmonary Disease (COPD), ischemic heart disease, cancer, Hepatitis, or severe liver failure. No systemic infections, drug addiction, psychiatric disorders, or certain neurological disorders.
Must not be HIV positive.
Must be a blood relative (Genetically Related) or a legal spouse according to Medical Council regulations.
Must not involve the sale or purchase of kidneys.
Both the donor and recipient can cancel the donation at any time.
Advantages of Receiving a Kidney from a Living Donor
Living donor kidneys typically have a longer functional lifespan and the recipient may have a longer life expectancy.
The surgery can be scheduled, allowing time for physical and mental preparation.
Lower doses of immunosuppressants and other medications may be required, helping to avoid potential risks from complications.
Reasons to See a Doctor Following Kidney Transplantation:
To monitor overall physical and mental health.
To monitor the function of the new kidney. Abnormalities from rejection or recurrence of the original disease sometimes show no symptoms and can only be detected through blood and urine tests.
To screen for various complications. Significant complications that can be life-threatening include infections, heart disease, liver disease, cancer, diabetes, and dyslipidemia.
For inquiries and registration for the kidney transplant waiting list, contact 064-5646059
