The purpose was to help you grasp the Surgical procedures for both the kidney donor & the kidney recipient that we cover in this article.
Now let’s take you through an outline of the steps of Donor Surgery & the Recipient Surgery.
NOTE: The intellectual property rights of the videos shared below lie entirely with the respective YouTube channels as duly credited below the videos.
I.Who constitutes the Transplant Surgical Team
Like every surgery, Kidney Transplant is a team effort of multiple health professionals & enabled by specialized equipment.
A typical Renal Transplant operating team consists of:
🔸️Transplant Surgeon – Head & Assistants
🔸️Nurses specializing in assisting in Transplant Surgeries
II. Anaesthesia in Kidney Transplant
For a major surgery like a Kidney Transplant, both the donor & the patient are put on General Anaesthesia or GA for their respective surgeries. This type of anaesthesia allows doctors to:
🔸️Put the patient to “dose-controlled” sleep throughout the surgical procedure
🔸️Ensure the patient doesn’t feel any pain or pressure during the operation (dampening all senses temporarily)
🔸️Maintain adequate muscle relaxation in the patient
Whatever you inhale, eat, drink or get an injection of, eventually circulates through your kidneys at some stage. It is the same for Anaesthesia medication as well. Some drugs even pass out of the body through kidneys via urine.
Patients undergoing a kidney transplant obviously have critically low function left in their native kidneys. So, Anaesthesia doctors need to precisely calculate the adequate anaesthesia dose before the surgery to ensure that the medication does not buildup to toxic levels in a backdrop of poor kidney function in kidney recipients. However, this is not the case with healthy kidney donors.
Please note, it is imperative to follow all pre-operative instructions strictly.
Both donors & patients must avoid taking any solid food or drinking a lot of liquids within 12 hours before their surgery. This is because, if there is food or liquid in the stomach at the time of the surgery, administering General Anaesthesia may bring-up the food/liquid to the patient’s mouth & the patient may even choke on it. This could be potentially life-threatening.
III. Harvesting the kidney: Donor Surgery
Here, we share a video demonstration of a kidney donor surgery by Johns Hopkins Surgery. All steps are duly explained in course of the video. Correlate the steps in the video with the anatomical insight here to get a clearer idea.
Courtesy: Johns Hopkins Surgery
IV. Pre-implant processing of the Donor kidney
Once the Donor Kidney is safely removed with all necessary tubes, nurses immediately place the organ on an ice tray in the bench. This helps cool the organ temperature & keeps it viable for longer. This is sort of like storing our food in the refrigerator to increase it’s shelf life.
Keeping the Donor Kidney in the ice tray, the transplant team thoroughly flushes the kidney of any residual blood or urine within, using a preservation solution.
The so-called Preservation Solution has all necessary minerals to help prolong the survival of the kidney outside of the donor’s body until it “finds its new home” within the patient. The solution does so by:
🔸️ Lowering the temperature uniformly throughout the kidney. Cold temperature effectively prevents any harmful enzymes from decomposing any kidney cells until implantation into the patient.
🔸️ Neutralizing any acidic buildup or swelling within the donor kidney until implantation.
Once flushed & cleaned properly, the donor kidney is sent for implantation into the Patient. The donor kidney is safely transported within the Organ Preservation Solution in sequential plastic bags, placed on ice to maintain a low temperature & transported in a cooler (insulated container).
V. Implanting the kidney: Recipient Surgery
Find below, video demonstrations of kidney recipient surgery. The first video is an animated demonstration by Centre for Innovation, Leiden University Medical Centre, The Netherlands.
Following this, there is a real-life video demonstration by Northwestern Medicine. Both videos explain the steps of the surgery. Correlate the steps in the video with the anatomical insight provided in the previous article here to grasp the surgical steps better.
Courtesy: Centre for Innovation, Leiden University Medical Centre
Courtesy: Inside the OR | Northwestern Medicine
(Because of potential graphic content, YouTube requires you to sign in & confirm your age before you can watch the video)
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