Things to know about kidney transplants

After organ transplantation in general and kidney transplantation in particular, the body will have a rejection of the graft. Therefore, patients after transplantation must often take anti-rejection medication. In addition, the periodic health check regime as well as nutrition and daily life are extremely important measures for patients after transplantation.

Preparation steps for kidney transplantation

Kidney transplantation as well as organ transplantation requires a combination of different disciplines: kidney, immunology, embryonic tissue, artificial kidneys, experimental and surgical surgery (general, extravascular, urinary) anesthesia. , resuscitation, biochemistry, chemistry, hematology - blood transfusion - imaging diagnosis, functional diagnosis; Psychological medicine, pharmacology . Therefore, preparing patients before transplanting especially with kidney donors is a very important living person. The donor must have a suitable blood group, no infectious disease, systemic disease, cancer . two kidneys must have good function and normal surgery. tissue (compatible on DLA system, cross-test, pre-sensitive).

For people who have to live, they must test their psychology so that they will voluntarily have blood ties. For people who believe that death, they must be voluntary or their family will accept it. In many countries around the world, voluntary visceral cards are available so that when brain death can be obtained for organs without asking for relatives.

Kidney transplantation requires a lot of factors and must monitor patients after kidney transplant very carefully.

On the recipient side, it is indicated for all patients with end-stage chronic renal failure or renal failure requiring hemodialysis or peritoneal dialysis. Age from 6 months to 64 years - individuals may be over 70 years old.

Contraindications for kidney transplantation for patients with the following diseases : malignant disease, irreversible heart failure, chronic respiratory failure, developing liver disease, vascular disease (coronary, cerebral or peripheral circuits), malformations Severe congenital urinary tract, chronic infection does not respond to treatment, people with HIV / AIDS, severe coagulopathy, mental illness, heavy alcoholism . The selection of donors and recipients must be very strict . Currently there are about 50 targets to choose pairings.

Things to know after kidney transplantation

Clinical symptoms and graft rejection function vary depending on the organ. Patients often have fever and fatigue. Graft organs often suffer from edema and atony. In order to assess the reaction status, biochemical tests and functions need to be done. Thereby the differential diagnosis between the elimination and infection response. Recently, more powerful 'diagnostic' techniques have been used, including graft tissue biopsy, to draw conclusions about graft rejection.

Treatment after kidney transplantation

The greatest purpose of treatment is to reduce the intensity of the attack of immune mechanisms on organs or graft. Steroids have a rapid and significant effect in reducing the elimination response (up to 60-70% of acute phase excretion). Often, after the injection, the symptoms of withdrawal are exhausted, especially when the fever is gone and pleasant. Steroids can be combined with lymphocytic globulin. This combination is most effective in cases of elimination reactions involving the cellular-mediated immune response. Treatment for acute exacerbations often results. But on the contrary, there is no specific treatment for cases of kidney transplants of the same genotype that have either a dark or chronic elimination response.

Preventing chronic transplant rejection in all patients with other grafted genes of the same type by maintaining immunosuppressive drugs during the post-transplant life. Can use 2-drug regimen: cyclosporin A in combination with prednisolon or in combination with prednisolon imuran. Or 3-drug regimen: cyclosporin A in combination with prednisolon and imuran or cellcept. Using imuran or cellcept in the treatment regimen must monitor leukocytes in the blood. If leukocytes lower than 4.0 x 103 must stop the drug, after 1-2 weeks leukocytes will return to normal and can continue to use the drug but must reduce the dose. When taking the drug, it is necessary to quantify the concentration of cyclosporine in the serum to increase or decrease the dose so as to reach the minimum concentration.

Follow up after long-term kidney transplant

Post-transplant patients must be closely monitored and monitored by specialized physicians.

Kidney transplantation - organ transplantation is a high biomedical technique, requires a lot of specialties, is expensive and requires long-term monitoring, continuous use of a rational drug regimen, especially immunosuppressive drugs. Therefore, post-transplant patients must be closely monitored and monitored by specialized physicians.

Kidney transplant patients must be monitored for life after transplantation : Periodically 1-2 months, urea, creatinine, erythrocytes, leukocytes, SGOT, SGPT, uric acid, blood glucose and urine protein should be checked. Weight and blood pressure must be monitored daily to maintain a diet that does not gain weight and to use blood pressure maintenance medications accordingly. Patients must be monitored for immunosuppressive drug concentrations and adjusted doses to suit individual patients; monitor infections, cardiovascular, cancer after transplantation, complications due to corticosteroids and prolonged immunosuppressive drugs.

Diet, living : Suitable for the immune suppression of the body of kidney transplantation is extremely important. Therefore, follow-up, clinical examination and routine tests to assess the health status of transplant recipients as well as the operation of kidney transplants must be closely monitored. Any abnormal changes in the functioning and function of the renal transplant should be thoroughly examined by special probes to detect situations: acute transplant rejection, chronic graft rejection, and kidney disease that appear on kidney transplant, the effect of immunosuppressive drugs on the body . for timely management.

Moreover , when the kidneys are transplanted into the body, the recipient needs to use immunosuppressive drugs (ACIDs) to avoid transplant rejection. Use correct ACEI, sufficient dose and strict adherence to the time of day.

The determination of the concentration of the ACE inhibitor in the donor's blood is very important because the concentration of the drug should be within a certain limit, if it is low, it will cause graft rejection, and if it is high it will harm the kidney transplant (infection poison) as well as the whole body. If properly monitored, the transplantation life can be maintained for up to 30-40 years, whereas if the kidney transplant is not well monitored, it will only last for a few years or even less.

If the health recovers well, kidney transplant patients can get married after 3 months of surgery and give birth after 1-2 years. However, it is necessary to prevent infection due to unsanitary or scratching the mucosa when having sex. If you want to avoid pregnancy, use a condom.

Patients after kidney transplantation due to psychological comfort should often eat a lot of sleep, easy to increase body weight, affect health, so there should be a plan to eat moderately. Eat cooked food, do not eat raw food, seafood, un boiled water, fresh milk, crushed vegetables. Abstain from alcohol and other alcoholic beverages. Eat foods low in salt, low in fat, low in sugar. Do not eat beans.

Should create a living environment with fresh air, cool, clean the place containing water (is a reproductive source of mosquito transmission). Do not raise birds or animals if you cannot control infection (such as dog scabies, pigs, fleas .). Avoid unclean areas, funerals of people with infectious diseases, crowded places, especially in the season of respiratory disease. Avoid wind directions near contaminated areas. Sunscreen should be used when going to the beach or outdoors. continuous hours. Avoid getting flu, avoid near people with infectious diseases.

What patients need to remember:

In order to ensure the body's health and longevity of new kidneys, patients after discharge should periodically re-examine according to the following regimes:

• First month after discharge: 10 days of follow-up visit 1 time
• 2nd month after discharge: 15 days re-examination 1 time
• 3rd month to 6th month: 1 time per month

After 6 months if you feel that nothing is different or unpleasant, it may be 2-3 months for a follow-up visit (when you feel uncomfortable or abnormal symptoms should be checked immediately).

Patients must use lifelong immunosuppressive drugs. Because this drug has a high toxicity, the use must necessarily follow the doctor's instructions. It is necessary to take medication on time (should have an alarm clock), monitor complications, side effects of drugs. Drinking other drugs must also be ordered to avoid harmful interactions.

Do not stop taking drugs because of side effects (have to consult a doctor) or because you feel healthy.

Do not arbitrarily change the dose and time to take the drug when it is suspected that it is not the same as the previous medicine you bought.