End-stage renal disease is a condition where kidney function severely declines, preventing the body from eliminating toxins and excess fluid. Patients at this stage require regular dialysis to sustain life, a process often leading to fatigue, low blood pressure, or muscle cramps. These symptoms significantly impact daily activities and quality of life.

Kidney transplantation is often the optimal treatment for many cases of end-stage renal disease, offering a chance at improved health and a better quality of life. According to Doctor Ha Tuan Hung, Deputy Head of the Department of Nephrology - Dialysis at Tam Anh General Hospital Hanoi, a comprehensive evaluation is essential before transplantation. This assessment considers kidney function, cardiovascular health, infection risk, cancer status, co-existing medical conditions, and the patient's ability to adhere to long-term treatment, which includes lifelong immunosuppressants and regular follow-up appointments.

Not all end-stage renal disease patients can be placed on the transplant waiting list. Typically, candidates are those undergoing renal replacement therapy, such as regular dialysis or peritoneal dialysis, or individuals with chronic kidney disease and a glomerular filtration rate (GFR) of 15 mL/min or less. Patients must demonstrate the ability to adhere to treatment, understand post-transplant care procedures, and commit to long-term follow-up. Family or caregiver support is also a critical factor in monitoring health and early detection of post-surgical abnormalities.

Kidneys for transplantation can come from living donors or brain-dead donors. Living donors are usually family members or unrelated individuals who volunteer to donate a kidney, provided they meet immunological and health requirements. For brain-dead donors, the kidney must have good function and meet specific criteria before transplantation.

Doctor Hung advises a chronic kidney disease patient on kidney transplant conditions. Illustration: Tam Anh General Hospital

However, some end-stage patients cannot undergo kidney transplantation due to high complication risks. These include individuals with severe cardiovascular disease, uncontrolled infections, untreated tuberculosis, active or recently treated cancer, poorly managed psychiatric disorders, or alcohol/substance abuse. These factors can compromise surgical safety and post-transplant treatment effectiveness.

Donor-recipient compatibility is a decisive factor in transplant success. Pre-surgery, patients undergo specialized tests, including blood type, human leukocyte antigen (HLA) tissue typing, anti-HLA antibody identification, and crossmatching, to assess immune compatibility. Higher compatibility reduces the risk of rejection and improves the long-term survival of the transplanted kidney.

Doctor Hung advises end-stage renal disease patients considering a kidney transplant to seek evaluation at specialized kidney and organ transplant centers for comprehensive assessment and appropriate treatment options. Good physical and psychological preparation, along with strict adherence to medical instructions, contributes to a higher success rate and extended longevity of the transplanted kidney after surgery.

Thu Giang