When a person undergoes a kidney transplant, the procedure typically does not involve removing the patient's existing, diseased kidneys. Instead, the new, healthy kidney, usually donated from a living or deceased donor, is placed in a different location within the lower abdomen. This might seem counterintuitive at first, but there are several practical reasons for this approach.
Firstly, the original kidneys, despite being dysfunctional, are not necessarily harmful if left in place. Removing them would require additional surgery that could increase the risk of complications. Such an operation would involve more time under anesthesia, more significant blood loss, and a longer recovery period. By leaving them in place, the surgery focuses only on transplanting the new kidney, simplifying the procedure and potentially reducing the risk of complications.
Additionally, the placement of the new kidney is strategic. It is usually installed in the lower abdomen on the front side of the body, rather than in the kidney's typical location in the back of the abdomen. This makes the surgery less invasive and allows easier access for the surgeon to connect the new kidney to the recipient's blood vessels and bladder. The accessibility of the transplanted kidney in this position is also beneficial for monitoring post-transplant, as it simplifies the process of performing any necessary biopsies to check for organ rejection.
Another reason for leaving the original kidneys in place, unless they're causing problems such as high blood pressure, infections, or are a source of pain, is the belief in maximizing the patient's existing health infrastructure. In some cases, the original kidneys might still perform a minor function, aiding in the body's overall waste filtration, alongside the new kidney. Removing them could eliminate even this small residual function.
On occasion, a recipient's original kidneys may need to be removed at the time of transplant or later due to complications such as severe hypertension, recurring infections, or if they contribute to other health issues like PKD (Polycystic Kidney Disease). However, such instances are relatively rare and are considered on a case-by-case basis, depending on the health needs and condition of the patient.
Therefore, while it might seem unusual, the practice of leaving the original kidneys in place during a transplant is grounded in current medical practice aimed at ensuring the safety and health of the patient, minimizing surgical risk, and preserving any remaining kidney function. This approach has helped streamline kidney transplant procedures, making them safer and increasing the overall success rates of these life-saving operations.
