What is a (kidney) transplant?
A transplant is generally understood to be the transfer of living cells, tissue or organs to another location within the same organism (so-called autologous transplantation) or to another (so-called allogeneic transplantation). When transmitting between alien organisms, e.g. Humans and animals, one speaks of xenogenic transplantation.
Depending on the type of organ or tissue transferred, one speaks of heart, bone, kidney transplant, etc.
While autologous transplants (e.g. grafting of skin tissue from one part of the body to another) usually run without complications, allogeneic transplants lead to so-called rejection reactions of the immune system, which have to be controlled.
A kidney transplant is the transplantation of functioning kidneys from a deceased person (or under certain circumstances from a living person (see living donation) to a patient with severely impaired or without kidney function through an operation with the aim of replacing the poor or missing kidney function.
In addition to hemodialysis and peritonial dialysis, a kidney transplant is the third option of kidney replacement therapy.
How does an organ donation / transplant work?
There are two types of organ donation. The donation of corpses, in which organs or tissues of deceased persons who have expressed their consent in a corresponding manner during their lifetime are transferred to a patient; this is the most common in terms of numbers in Germany.
Living donation is the transfer of organs or tissue from living people to the patient. (Living donation).
Transplantation after a corpse donation
The following requirements apply to a possible organ donor:
The irreversible brain death must have been determined by two doctors (neurologist and anesthetist) who were not involved in the transplantation and recorded in writing.
The organ donor must have documented his willingness to donate organs during his lifetime (e.g. organ donation card) or the relatives’ declaration of consent must be available. Since the Transplantation Act was passed on November 5, 1997, the so-called extended consent solution has applied in Germany.
The donor organ must still be functional.
Chronic or communicable diseases in the donor must be excluded.
If the brain death of a patient has been confirmed, the doctors notify the organizational center of the German Organ Transplantation Foundation (DSO) in the nearest transplant center. From here, the question of whether organs can be removed and the necessary medical tests are coordinated.
The DSO then informs the international agency Eurotransplant and organizes the organ removal.
Eurotransplant uses the data stored there to determine a suitable recipient based on medical criteria.
If such a recipient is found, the explanted organs are brought to the relevant transplant center and transplanted there.
The explanted kidneys can be refrigerated for up to 24 hours; they resume their function after they have been successfully transplanted into the recipient’s body. This gives enough time to take the graft to any location, find a suitable recipient and perform the necessary medical tests.
After completing these tests, e.g. If the tissue characteristics match and the negative cross match (see medical principles), the recipient is ordered to the transplant center, examined in detail, dialyzed and operated on if necessary.
Location d. Graft
The “new” kidney is placed in the right or left pelvis and the renal artery and vein are connected to the corresponding pelvic vessels; the ureter is connected to the urinary bladder (see fig.)
The kidney turns red as a sign of blood flow. Depending on the condition of the transplant, it starts working soon or only days after the procedure, which may have to be bridged by dialysis treatment.
Immunosuppressive treatment is started during the operation.
Transplantation after living donation
Living donation is the transplanting of non-regrowing, paired organs from the body of a living person.
The kidney is a paired organ and is therefore basically suitable for a living donation.
The Transplantation Act deliberately sets strict legal limits on the possibility of living donation, e.g. Organ trade or donations that are not made on a voluntary basis but due to e.g. Dependency relationships occur to prevent.
The only possible donors are: first- or second-degree relatives, spouses, fiancés or other persons who are obviously particularly close to the donor; Minors and over 70.