Living donor kidney transplantation Benefits and risks

Introduction

Kidney transplantation is a treatment option for people with end-stage kidney disease (ESKD) where the damaged kidney is replaced with a healthy one. Living donor kidney transplantation (LDKT) is a type of kidney transplantation in which a living donor donates one of their kidneys to someone with ESKD. LDKT is a safe and effective treatment option for patients with ESKD. In this article, we will discuss the benefits and risks of LDKT in detail.

Benefits of Living Donor Kidney Transplantation

1. Improved Quality of Life
Kidney transplantation is the most effective treatment option for people with ESKD. It can improve the quality of life of patients by restoring kidney function, reducing symptoms, and allowing patients to resume their normal activities.

2. Increased Life Expectancy
Patients who receive a kidney transplant have a higher life expectancy than those who remain on dialysis. According to a study, the average life expectancy for a patient who receives a kidney transplant is 15-20 years, whereas for patients on dialysis, it is 5-10 years. LDKT can be particularly beneficial as it allows for transplantation to occur sooner than waiting for a deceased donor kidney.

3. Better Long-Term Outcomes
Living donor kidneys tend to have better long-term outcomes than deceased donor kidneys. This is because living donor kidneys are generally healthier and have been screened for compatibility with the recipient. Living donor kidneys are more likely to function immediately after transplantation and have a lower risk of rejection.

4. Reduced Time on Dialysis
LDKT can reduce the amount of time a patient spends on dialysis, which can improve their overall health and well-being. Dialysis can be time-consuming and disruptive to a patient's daily life. LDKT can help patients return to work, and resume their daily activities, without the need for frequent dialysis sessions.

5. Cost-Effective
LDKT can be cost-effective for both the patient and the healthcare system. The cost of transplantation is generally lower than the cost of long-term dialysis. Studies have shown that LDKT is less expensive than deceased donor kidney transplantation over time. Study published in the Journal of the American Society of Nephrology in 2019 found that LDKT was associated with lower costs and better quality of life compared to dialysis over a 5-year period. Specifically, the study found that the average cost per patient-year for LDKT was $73,000 compared to $88,000 for dialysis. In India, the gap is wider with the 5 year cost for LDKT being around USD 25,000 compared to more than USD 50,000 for dialysis.

6. Psychological Benefits
LDKT can provide psychological benefits to both the donor and the recipient. For the recipient, the ability to receive a kidney from a living donor can reduce the stress associated with waiting for a deceased donor kidney. For the donor, the ability to help a loved one can be emotionally rewarding.

7. Shorter Waiting Time
The waiting time for a deceased donor kidney can vary greatly and can be several years long. LDKT allows patients to receive a kidney transplant more quickly, which can improve their quality of life and increase their life expectancy.

8. Better Health Outcomes for the Donor
Studies have shown that living kidney donation is safe and does not have a significant impact on the donor's long-term health outcomes. In fact, donors may experience health benefits such as a lower risk of hypertension and obesity. A study published in the Clinical Transplantation journal in 2019 followed 50 living kidney donors for 10 years after donation and found that the donors had lower rates of hypertension, obesity, and metabolic syndrome compared to a matched group of non-donors.

Risks of Living Donor Kidney Transplantation

1. Surgical Risks
LDKT is a major surgical procedure and carries risks, such as infection, bleeding, and damage to surrounding organs. However, the risks are generally low, and the procedure is considered safe. The surgical risks associated with LDKT are similar to those associated with any major surgery.

2. Donor Complications
Living kidney donation is a safe procedure, but complications can occur. Some possible complications include bleeding, infection, and blood clots. In rare cases, the donor may experience a partial loss of kidney function, which may require additional medical treatment.

3. Long-Term Health Risks for Donors
Living kidney donation is generally considered safe, but there are some long-term health risks associated with the procedure. Donors may be at a slightly increased risk of developing high blood pressure, diabetes, and kidney disease later in life. However, the risk is relatively low, and most donors do not experience any long-term health complications.

4. Rejection
Although LDKT has a lower risk of rejection compared to deceased donor kidney transplantation, there is still a risk of rejection. The recipient's immune system may recognize the transplanted kidney as foreign and attempt to reject it. Medications can be used to suppress the immune system and reduce the risk of rejection.

5. Infection
The use of immunosuppressive medication to prevent rejection increases the risk of infection. Patients who have received a kidney transplant are more susceptible to infections, such as pneumonia and urinary tract infections. Patients must take precautions to reduce their risk of infection, such as practicing good hygiene and avoiding contact with people who are sick.

6. Side Effects of Medications
The medications used to prevent rejection can have side effects, such as nausea, vomiting, and diarrhea. Long-term use of these medications can also increase the risk of developing certain cancers, such as skin cancer and lymphoma.

7. Cost
While LDKT can be cost-effective in the long run, it can still be expensive in the short term. The cost of the surgery, medications, and follow-up care can be a barrier to access for some patients.

Conclusion 

At Vanya Health, we recognize the importance of kidney health and the impact it has on overall health and well-being. Our mission is to empower individuals to take control of their health by providing accessible and affordable healthcare services. We offer a variety of services, including kidney health screenings and consultations with healthcare professionals. We are committed to improving the lives of those living with kidney disease and providing support to those considering LDKT.