Your kidneys have the important job of filtering out urea and other wastes from the blood and maintaining the proper balance of acids and electrolytes in the body's fluids. When the kidneys fail due to inherited conditions or disease, symptoms can include weakness, shortness of breath, decreased muscle function, heart problems and eventually death. The two main treatments for kidney failure are dialysis and kidney transplantation. Kidney transplants usually offer the best quality of life improvement for those with kidney disease.
Kidneys are the number one most successfully transplanted organ around the world. Depending on the reasons the transplant is needed and the age of the recipient, success rates for kidney transplantation range from 80 to 90 percent 5 years after the operation is completed. Getting a transplant can often provide much higher quality of life for patients with kidney failure as compared to renal dialysis, in which the patient is hooked up to a machine that takes over the kidneys' job of cleaning the blood of waste and toxins.
The two main types of kidney transplants are (1) from a deceased donor and (2) from a living donor. Transplants from a living donor are somewhat more successful long term, but it can sometimes be difficult to find a living relative or friend who is both a close match in terms of blood type and antigen compatibility who is willing to donate a kidney.
According to the Mayo Clinic, someone who receives a transplant from a living donor has a 90 percent chance of being alive after 1 year and about an 80 percent chance of surviving for 5 years after the transplant. Success rates for transplants from deceased donors are somewhat lower, around 80 percent at 1 year out, though that difference has been shrinking in recent years.
Not everyone who has kidney failure is a good candidate for a kidney transplant. Younger patients generally do better than older patients, though life can be extended for several years for patients as old as their mid-70s. Additionally, those with unstable heart disease or other medical conditions may not be good candidates for a kidney transplant.
One of the main dangers of kidney transplantation is that the recipient's body will reject the donated organ. The body's immune system may perceive the donated organ as foreign matter, like bacteria, and may attack the donated tissue. Rejection may mean the organ is lost or merely that additional treatment is needed. Several steps can be taken to reduce the chances of a rejection. First, doctors make a strong effort to find donor kidneys that are a close match to the recipient's, including blood type and antigen type. The most compatible donor will share a blood type and six antigens with the recipient. The best bet for getting a good match is to get a donation from a sibling or another close relative. Second, kidney transplant patients take medication to suppress the immune system and keep it from attacking the foreign tissue. However, these drugs often have side effects ranging from bloating and tremors to an increased susceptibility to cancers.
A young patient who receives a well-matched kidney from a live donor may live with the donated kidney for 10 to 15 years. Those who undergo a successful kidney transplant often have more energy and need a less-restricted diet than those who are in the midst of kidney failure or who are on dialysis. Even with the expense and risks of taking drugs that suppress the immune system, recipients of donated kidneys generally have fewer expenses and fewer complications than kidney failure patients who stay on renal dialysis.
New research in 2005 and 2006 funded by the Immune Tolerance Network indicates that bone marrow transplants from the donor of the organ may lessen or eliminate the need for the recipient to take immune-suppressing drugs. The treatment involves using drugs to weaken the patient's immune system several days before the transplant occurs and then infusing bone marrow from the donor after the transplant is completed. The recipient will have to take anti-rejection drugs for several weeks or months but may be able to be weaned from the drugs several months after the transplant is completed. A handful of patients were able to stop taking the immune-suppressing drugs and maintain healthy kidney function for 2 or more years after the treatment.