Kidney Transplants Explained

The facts about kidney transplantation, from the experts. A successful kidney transplant can transform the life of a person with kidney failure, and people with a well functioning transplant often feel much fitter than they did on dialysis. Not everyone is suitable for transplant, however, and even those who are may not be suitable all the time. It is essential to be thoroughly prepared for your kidney transplant. This book will help you by answering all your questions about transplants and what they involve. Indispensable to people considering having a transplant or already living with one, this guide will also be valuable to anyone thinking about donating a kidney. Kidney Transplants Explained includes: • Coverage of the important topics such as the ‘postcode lottery’, organ allocation and deceased and living donor organs • Practical information about the operation, medication and the first three months after transplant • Post-transplant advice: how to look after yourself and your new kidney • Real life accounts of people who have experienced the issues discussed • All the ‘Key Facts’ summarised at the end of each chapter Table of Contents: Part 1 Introduction Part 2 Suitable for transplant? Part 3 Matching a kidney to a patient Part 4 Decreased donor transplants Part 5 Living donor transplants Part 6 The donor's operation Part 7 Living donor transplantation: some considerations Part 8 The transplant operation Part 9 Medication Part 10 The first three months Part 11 Looking after yourself and your transplant over the years Part 12 Living with your transplant Part 13 Relationships, sec and having childrens Part 14 Transplant failure Part 15 Research and future developments

Table of Contents:
Foreword by Timothy Statham OBE xi Authors' Acknowledgments xii Introduction 1 1 Suitable for transplant? 5 Who can have a transplant? 5 Fitness for transplantation 7 Testing for infections 9 Getting information early 10 Getting onto the list 11 2 Matching a kidney to a patient 12 Matching the blood group 12 Matching the tissue type 14 The performance of UK transplant centres 16 New kidneys and old diseases 20 3 Deceased donor transplants 22 Heartbeating donors 22 Non-heartbeating donors 23 The transplant list 24 Average waiting time for a deceased donor kidney 27 Being on the transplant list 29 Do you have to be on dialysis first? 30 Tests before the operation 31 Physical examination 31 The cross-match 32 Being ready for a transplant 32 You and your donor 34 Contacting the donor family after transplantation 37 How long will a deceased donor transplant last? 37 4 Living donor transplants 39 Who can donate a kidney? 40 Tests before living donor transplantation 42 Risks to the donor 45 5 The donor's operation 47 Open nephrectomy (open surgery) 47 Laparoscopic nephrectomy (keyhole surgery) 47 After the operation 50 6 Living donor transplantation: some considerations 54 Rejection 54 Some advantages of living donor transplants 54 The Human Tissue Authority (HTA) 58 Antibody incompatible transplants (AIT) 59 'Exchange' or 'paired donor' transplantation 60 Alternatives to antibody incompatible and exchange transplantation 62 Giving a kidney to someone you have never met 62 Buying and selling organs 64 7 The transplant operation 68 The operation 69 After the operation 70 Heading home 74 8 Medication 76 How immunosuppressant drugs work 76 Types of immunosuppressant drugs and their side effects 78 Working out what is best for you 82 Making sure you know what to expect 84 Continuing your medication 85 Other drugs after a transplant 86 9 The first three months 89 Rejection 89 The rejection process 89 Acute rejection 90 Tests to investigate reduced transplant function 91 Treatment for acute rejection 93 Infections 93 Prevention of infection after a transplant 98 If it all gets too much 98 Three months out, and OK? 100 10 Looking after yourself and your transplant over the years 102 Stay in touch 103 Take control 104 Chronic rejection (or chronic allograft nephropathy) 105 Circulation problems and high blood pressure 107 Cholesterol 108 Diabetes 110 Cancer 114 Problems with your bones 117 11 Living with your transplant 121 Social life 121 Back to work 122 Holidays 123 Eating and drinking 126 Enjoying your freedom while keeping your kidney healthy 126 Keeping fit 127 12 Relationships, sex and having children 129 Drugs to help with erections 129 Contraception 130 Planning a pregnancy 131 13 Transplant failure 135 Success rate for second transplants 135 Causes of transplant failure 135 How does rejection cause transplant failure? 136 Waiting for a kidney after transplant failure 137 Coping with a failed transplant 138 Stress for kidney transplant patients 139 Factors affecting the ability to cope 141 14 Research and future developments 144 History of transplantation - a time of rapid change 144 What is research and how does it apply to me? 145 Possible future developments 148 New therapies 149 Glossary 151 Appendix 1 Kidney disease - what do the numbers mean? 161 Appendix 2 Useful addresses and websites 162 Index 166

About the Author :
Dr Andy Stein MD, FRCP, is Consultant Nephrologist and General Physician at the University Hospitals, Coventry and Warwickshire NHS Trust, and co-author of Kidney Failure Explained, now in its fourth edition.  MD FRCP  Consultant Nephrologist at University Hospitals, Coventry and Warwickshire NHS Trust Janet Wild, RGN is Clinical Education Manager at Baxter Healthcare Renal Division. She has been a Renal nurse since 1988.