Living-Related Kidney Transplantation

Director: Salvatore Piazza

The living-related kidney transplant is a high-complexity surgical operation performed under general anesthesia, and consists in the insertion of a whole kidney from a living donor in the abdomen of a recipient. This is a long and complex surgical operation lasting several hours (from 2 to 4-5 hours) and performed in the operating room, where a team of 8 to 9 people (surgeons, anesthesiologists, nurses, and technicians) work together to perform the intervention. A kidney from a living donor can be used because the remaining kidney can perform the functions normally carried out by two kidneys.

Living-related kidney transplantation is one of the main surgical activities performed at ISMETT, and is based on the principle that donating a kidney, especially to a loved one, is one of the most rewarding experiences in one’s life. Currently, the procedure of laparoscopic nephrectomy is the standard of treatment at ISMETT. Laparoscopic surgery was developed to make the post-operative period less painful and allow the donor to recover earlier after discharge home. It also guarantees better aesthetic outcomes.

The indications for a living donor liver transplant are the same as those for a deceased-donor transplant. A kidney transplant is indicated in patients experiencing a progressive deterioration of renal function. This occurs in the majority of cases due to secondary diseases, congenital or hereditary diseases, or congenital malformations.

When the progressive deterioration cannot be stopped with medical treatment, there are two different replacement therapies: dialysis or a kidney transplant. Dialysis is associated with high morbidity and mortality, and in the long term it causes cardiovascular damage, skeletal alterations, anemia, and growth retardation. Furthermore, dialysis is an artificial therapy that implies a constant dependence on a machine, and for many patients the quality of life is compromised and unsatisfying. Kidney transplantation allows the patient to be independent and return to a normal life.