Kidney Transplantation

Those eligible for kidney transplantation must meet the following criteria:

Sources of Donor Kidneys:

Deceased Organ Donors (Brain-Dead Donors): Kidneys from individuals who are legally declared brain-dead but still have functional kidneys. Consent for organ donation must be obtained from the deceased person’s relatives, and the donation is facilitated through the Thai Red Cross Organ Donation Center. Organs are then allocated to waiting recipients fairly, transparently, and ethically.

Living Donors: Kidneys from living donors who are typically relatives or spouses, as per the regulations outlined in the Medical Council of Thailand’s “Professional Code of Ethics for Medical Practitioners (5th edition) 2017.” Living donors must be blood relatives or married for at least 3 years. The 3-year requirement is waived if the couple has children together.

Donating one kidney and having one remaining: How does it affect health?

Doctors will conduct a health examination on kidney donors to ensure that they are in good health. After donating one kidney, the remaining kidney should be able to function as a replacement for the donated kidney. Additionally, organ donors must be individuals who have reached legal age and are generally advised not to be older than 60 years.

Complications that may occur after kidney transplantation include:

1. Rejection: The body may reject the new kidney. If the rejection is severe, the transplanted kidney may need to be removed, and the patient may require dialysis or another kidney transplant.
2. Recurrence of Original Kidney Disease: The disease that affected the original kidneys may recur in the transplanted kidney.
3. Side Effects of Immunosuppressive Medications: Medications to suppress the immune system may have side effects, such as toxicity to the kidneys, liver, nervous system, etc. The medical team will provide guidance on managing and preventing these side effects.
4. Infectious: Immunosuppressed patients are more susceptible to various infections, including respiratory ailments such as COVID-19, influenza (including Type A and B), pneumonia caused by Pneumocystis Jirovecii, and more. Patients who undergo kidney transplants will receive medication to prevent such infectious diseases. However, during outbreaks of infectious diseases, individuals with suppressed immune systems should exercise caution, especially in crowded and poorly ventilated places. It is advisable for individuals who have undergone kidney transplants to avoid such environments. Furthermore, regular blood and urine tests are conducted to screen for viral infections that may lead to diseases. These tests include screening for Cytomegalovirus (CMV), the BK virus, hepatitis B and C viruses, as well as Human Immunodeficiency Virus (HIV).
5. Cancer: Certain cancers, including genitourinary cancers, renal cell carcinoma, prostate cancer, hepatocellular carcinoma, colon cancer, and cancers in other organs, may occur after transplantation.
6. Surgical Complications: Complications from the surgical procedure, such as narrowing of the blood vessels, urine blockage, or intestinal complications, can occur.

Success Rate

Currently, kidney transplantation in the country has been very successful and can be compared to kidney transplantation outcomes in other countries. The one-year and five-year survival rates for transplanted kidneys are approximately 90% and 80%, respectively.

Risk

Patients undergoing kidney transplantation face various potential risks that may be encountered. These include infections due to the need for immunosuppressive medication to reduce the rejection rate. Complications from surgery may arise, leading to bleeding, clotting in the new kidney’s blood vessels, and obstruction of the ureter connecting the new kidney to the bladder, which can result in urine leakage. Patients are closely monitored for these risks, and if complications occur, they may be treated with medications, blood transfusions, or surgical interventions.