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Kidney Transplant (1)


When was the first kidney transplant performed in Singapore and how many have been done since then?

The first cadaver renal transplant was performed in 1970. The patient is still alive. The first living related donor transplant was performed in 1976. As of December 1988, a total of 141 cadaver transplants and 151 living related donor transplants have been performed.


What are the transplant survival rates in Singapore like?

For cadaver transplants the graft survival rate is 63% for the first year, 52% for the fifth year and 22% for the tenth year using conventional immunosuppression with azathioprine. With cyclosporin A the cadaveric graft survival rate is 83% at one year and 80% at four years.

For living related donor transplants the graft survival rate is 82% at one year, 68% at 5 years and 63% at 10 years using azathioprine. With cyclosporin A it is 93% at one year and at 4 years it is still at 93%.

Only parents and siblings (brothers and sisters) sharing 1 or 2 haplotypes are used in living donor transplants as transplants from relatives with zero matched haplotypes on tissue typing have only a success rate similar to those of cadaver kidneys.

What is tissue typing?

There is a particular set of genes called the HLA genes in our body. HLA stands for Human Leucocyte Antigen. Leucocyte is another name for the white blood cells. Each person has 4 sets of HLA gene series. Each of these gene series codes for the production of different types of tissue typing proteins or antigens. There are many different types of these proteins or antigens. Since the number of individual tissue typing antigens is very large, it is therefore difficult to have matching tissue typing antigens for unrelated individuals.


What is the significance of ABO blood grouping in kidney transplant?

All of us have a certain type of blood group on our red blood cells. For a kidney transplant to be successful the blood group between the donor and the recipient must be compatible, otherwise the transplanted kidney will be rejected very quickly by the recipient's body. Blood grouping rules apply to both cadaver and living related transplants.


Who is fit to donate a kidney?

The kidney donor for living related transplant must be at least 21 years old so that he can give his consent for kidney donation. He should not be more than 60 years old.

He must be healthy and have no illness or systemic disease like diabetes and hypertension which might cause damage to his kidneys. He must of course not suffer from any kidney disease himself.

Is it safe for a parent or sibling to donate a kidney? Will it do any harm? What about people who do heavy work? Can young women marry and have children after giving away one kidney?

These are the usual questions that are often asked at the same time by several anxious relatives of the patient with kidney failure. A normal person has two kidneys. Only one kidney is sufficient to enable one to lead a normal life. The other kidney acts like a reserve. It is like a car with 4 spare tyres. If the 4 spare tyres are removed, the car can still function normally. Or expressed another way, one can say that the 2 kidneys represent 200% kidney function. So, after donating a kidney, the donor can still lead a normal life with no restriction whatsoever. He can continue to do heavy work. In the case of a man he can still father children and in the case of a woman, she can still marry and have babies. However should the donor meet with an accident and the remaining kidney is damaged he runs the risk of kidney failure, since the other kidney which acts as a reserve has been donated.


What are the complications of a kidney donation?

Apart from the slight inescapable risk which occurs in any major operation, the donor suffers no shortening of life or adverse effects on the quality of life. The donor may experience some pain over the operative wound which can be relieved by injections of pethidine (painkiller). He has to stay in hospital for about 10 days and after that, given medical leave to rest at home. He should be back at work within a month's time. Once a year, he has to go for a renal check-up. His blood pressure, urine and blood are checked to make sure that the remaining kidney is functioning well. Next >>>


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