Surgery is done under general anesthesia and typically takes 2 to 3 hours. The failed kidneys are left in place and the healthy one is transplanted below them in the abdomen. Blood vessels of the new kidney are attached to the blood vessels of the legs and the ureter is attached to the bladder.
Diagrammatic representation of transplant surgery
Many things can go wrong during any major surgical procedure but an experienced transplant surgeon can deal with most contingencies that may occur during this particular complex process.
Since the mid 1980s when the transplant program first began, the overall success rate has been about 70%. In more recent years this has risen significantly, to about 90%. Donor selection has improved, candidate qualification is more rigid and surgical techniques have been developed to overcome some of the common fatal problems that were encountered with earlier transplant cases.
The time period during which the kidney is bloodless is very important and depends upon the expertise of the surgical team. This bloodless period called as “Ischemic time” determines the immediate functioning of the transplanted kidney.
A very good functioning graft starts to work just after harvesting and re- establishing the blood supply but some times it may take 2-3 days to start urine formation. It is necessary to closely monitor the kidney functions as the patient may require a few sessions of dialysis during this critical period.