Cross-over kidney transplantation: an opportunity to avoid long waiting times

Thanks to the improvement of medical equipment and the professionalism of doctors, today kidney transplantation operations in developed foreign countries are carried out with a success rate of 98%.

Kidney transplantation is one of the most common types of organ transplantation.

The main advantage of cross kidney transplantation is an alternative for patients who are limited in time.

For example, in end-stage kidney cancer, the 5-year survival rate without adequate treatment is only 8%.

The lack of organs for transplantation, related incompatibility and a long waiting list are still topical problems in the field of transplantation. There are special donor bases in Turkish clinics that will help you find a suitable donor faster. Also, in Turkey, operations for cross-transplantation of kidneys are practiced simultaneously for several patients.

What diseases require a kidney transplantation?

Various diseases can lead to functional and structural damage to the kidneys. With the complete stop of the functioning of the kidneys, blood filtration is disturbed and the elimination of toxins becomes impossible.

Diseases that can lead to kidney failure:

• Severe burns;
• Polycystic kidney disease;
• Urolithiasis disease;
• Stenosis (narrowing) of the renal vessels;
• Hypertension – high blood pressure;
• Injury to the kidney with its subsequent rupture;
• Infectious and autoimmune diseases;
• Congenital anomalies of the urinary system;
• Diabetes mellitus type 1 and 2, causing nephropathy;
• Tumors in the kidneys, both benign and malignant;
• Neoplasms in other organs that have spread metastases to the kidneys;
• Chronic or acute inflammatory processes of the kidneys (pyelonephritis, glomerulonephritis);
• Hydronephrosis – a violation of the outflow of urine and the expansion of the renal structures due to the accumulation of fluid;
• Taking medications (certain antibiotics, drugs, or chemotherapy drugs).

A kidney transplantation is necessary when irreversible end-stage kidney failure develops.

The terminal stage is the last, most severe phase of the development of the disease with a poor prognosis and a limited choice of treatment methods. In this condition, kidney function is reduced to 85-90%.

To undergo diagnostics or sign up for an urological check-up, as well as learn about the latest methods of kidney diseases treatment, leave a request on the MedTour website. The medical coordinator will contact you and answer all your questions.

What are the advantages of a kidney transplantation over dialysis?

Therapy for kidney failure, or chronic kidney disease, mainly consists of a program hemodialysis and a kidney transplantation.

Hemodialysis

Hemodialysis is carried out for the purpose of detoxification, that is, the removal of substances harmful to the body.

• The impossibility of cleaning the body of the products of metabolism and vital activity of cells, as well as the accumulated fluid, leads to intoxication and symptoms such as nausea, vomiting, development of edema and shortness of breath.
• In this case, conservative treatment is not effective enough, and it is necessary to choose a more effective treatment to save life.

The need for continuous dialysis severely limits the quality of life. Carrying out the dialysis procedure forces the patient to visit specialized hospitals and clinic departments about 3 times a week. Often, dialysis can cause side effects or associated complications.

Kidney transplantation

Kidney transplantation can achieve significantly better results.

Such a radical method is turned to when the kidneys become unable to respond to dialysis.

• A successful healthy kidney transplantation provides a near-optimal quality of life. The mortality rate during surgery and the survival of patients after surgery differ significantly from those in patients on dialysis.

For these reasons, kidney transplantation is by far the best solution for patients with irreversible renal impairment. A significant number of patients in the terminal stages of kidney disease are recorded as candidates for kidney transplantation.

What is a cross kidney transplantation?

Cross-over transplantation, or cross-transplantation of the kidneys, is an alternative option for replacing a damaged kidney with a healthy one if it is impossible to directly transplant an organ from family members.

Thanks to cross-donation, several people at the same time have a chance to save their lives.

The essence of a cross-transplantation of the kidneys

If a patient with a diseased kidney (recipient) cannot be transplanted with a kidney from his relative due to incompatibility, doctors perform an organ transplant from the partner of another patient with the same problem.

Specialists select several “donor-recipient” pairs for mutually beneficial exchange of donor kidneys.

For example, a relative (donor) of patient #1, compatible with patient #2. In this case, he donates his kidney to this patient, while donor #2 donates his kidney to patient #1. In this case, the cross transplantation of the organ will be successfully carried out. Under other conditions, these two situations would be considered hopeless.

What are the requirements for a cross donation?

Cross tests

To confirm the compatibility between donor-recipient pairs, cross-tests are carried out:

• Blood groups according to the AB0 system.

The analysis for the blood group is basic and mandatory, it is determined in the first place.

• HLA analysis – antigens (tissue) histocompatibility.

The lack of compatibility according to the HLA system provokes rejection of a foreign kidney in the recipient’s body.

• Crossmatch test.

The final analysis to determine the compatibility of blood in order to exclude a pathological reaction to blood transfusion. Mix the blood of the patient and the donor. If the recipient’s cells attack the donor’s red blood cells, the reaction is considered positive. This means that the risk of kidney rejection is high.

Other criteria

The success of the operation depends on many factors, one of which is the preparation and conduct of the surgical intervention in the transplant center under the supervision of a team of doctors and nurses.

Who can be a donor for a cross kidney transplantation?

Anyone who meets these criteria can serve as a kidney donor:

1. The donor is over 18 years of age.
2. The absence of mental illness in the donor.
3. Voluntary consent of the donor to donate an organ.

How is a cross kidney transplantation performed?

Cross-intervention steps:

     1. Consultation of specialists and examination of patients.

2. Conducting compatibility tests.

With full compatibility, cross-kidney transplantation is carried out in the same week as the examination and collection of tests. In case of incompatibility, the search for a pair for cross-donation continues.

     3. Preparation for the operation (takes several days).

Depending on the general condition of the patient, preoperative dialysis may be performed. The goal is to correct the level of electrolytes in the blood and improve the condition of the body systems. This helps prevent heart problems during surgery.

     4. Kidney transplantation operation.

A team of doctors performs transplantation in a low-traumatic way – laparoscopically – through small incisions. This technique is as gentle as possible for the surrounding tissues, has fewer side effects and promotes speedy recovery.

Doctors perform a kidney transplantation under general anesthesia. The duration of the operation is 2-4 hours.

     5. Postoperative period and follow-up of patients.

After the transplantation, diuretics are administered to patients to stimulate the immediate start of the transplanted kidneys.

     6. Return to the normal life rhythm.

To reduce the likelihood of complications and subsequent care of the transplanted organ, it is necessary:

• Strict adherence to the recommendations and prescriptions of the doctor – do not lift heavy things and give up excessive physical exertion for at least 1.5 months;
• Regular monitoring of blood and urine tests – to monitor the functioning of donor kidneys;
• Take immunosuppressive drugs – medicines that suppress the immune system and prevent rejection of the transplanted kidney.

What are the possible complications after a cross kidney transplantation?

Possible complications after a kidney transplantation include:

• Acute transplant rejection;
• Chronic transplant rejection;
• Relapse of the underlying disease;
• Decreased renal function;
• Increased blood pressure.

What is the recovery period after a kidney transplant?

The average stay in the hospital after surgery is 5 days. The total rehabilitation time takes from 3 to 8 weeks, but all terms are individual. The term for returning to the usual way of life and routine activities varies from 3 to 6 weeks.

What are the contraindications for a cross kidney transplantation?

A kidney transplantation is not possible for the following reasons:

• Mental disorders;
• Active infection (HIV, hepatitis);
• Severe diseases of the heart and blood vessels;
• Cross-donor incompatibility;
• End-stage disease of another body system.

Where is the best place to perform cross-kidney transplantation?

University hospital LIV Istinye in Turkey is one of the world’s leading clinics, where the most complex organ transplant operations are performed.

LIV Istinye is JCI accredited, one of the main areas of the clinic is transplantology.

Thanks to many years of experience in transplantation and a multidisciplinary approach, the success rate of operations in LIV Istinye is 98% on average. This means that 98 out of 100 operations have a favorable outcome.

Turkey was the first country to perform cross kidney transplantation in 7 couples (14 patients) at the same time. Doctors of Turkish clinics are advanced specialists in organ transplantation. To make an appointment in a Turkish clinic for a cross-kidney transplantation, send a request to the medical coordinator of MedTour.

FAQ

How to find a cross-donor for a kidney transplantation?

Foreign clinics have access to special donor databases. Patients are not themselves looking for cross-transplant partners. This is done by a team of experts.

At what age can a kidney transplantation be performed?

Kidney transplantation can be performed in childhood in the presence of congenital developmental anomalies, as well as in adulthood. However, the younger the recipient, the higher the chance of a satisfactory outcome of the operation.

How long do patients stay in the hospital after a kidney transplant?

The hospital stay after a kidney transplant usually takes 3 to 7 days.

How to avoid rejection of a transplanted kidney?

One of the main and basic conditions for the successful engraftment of the graft and its long functioning is the use of drugs that suppress the immune system of the recipient. The goal is to prevent rejection of the donor kidney.

How long do people live after cross kidney transplantation?

With successful engraftment of a donor kidney, the life expectancy of patients varies, depending on the lifestyle and compliance with the recommendations of doctors.

On average, after a cross-transplantation, they live 10-15 years longer.

What is the prognosis after a cross kidney transplantation?

During the first year, the survival rate after cross-transplantation is 98%. This means that 98 cases out of 100 lead to a favorable outcome of the operation and engraftment.

Who can’t be a kidney donor?

People with infectious diseases (HIV, AIDS, hepatitis), chronic diseases (diabetes mellitus, coronary heart disease), cancer patients and pregnant women cannot be donors for kidney transplantation.

To find out more information about cross kidney transplantation in foreign medical centers, leave a request on the MedTour platform. The coordinating doctor will help you choose the best clinic and an experienced transplant surgeon, as well as guide you on the price.

Romodanov Neurosurgery Institute National Academy of Medical Sciences of Ukraine Ukraine,KyivLeave a request

Pallas Clinic LatviaLeave a request

University hospital LIV Istinye Turkey,Istanbul 5.00 (1 review)Leave a request

Published: 24.08.2022

Updated: 15.01.2024

Medical author:

Ilona Baidiuk

Medical author, Medical editor:

Olena Kursabaieva

Information on this webpage verified by the medical expert

Medical Doctor, oncologist, PHD student

Kateryna Maliarchuk