Renal Transplant: Procedure, Anatomy and Physiology of Kidney, and Potential Complications

Running Head: RENAL TRANSPLANT
Renal Transplant
Name of the Student
Name of the University
Author Note

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Essay on Renal transplant
Kidney transplant is a type of surgical process for placing healthy kidney from a
deceased or living donor into the person having dis-functioning kidney. The kidneys are the
bean-shaped organs which are situated in the spine’s two sides below the rib cage. The size is
similar to a fist and it functions as filter for removing waste, fluid and minerals from the body
through producing urine (Hricik et al., 2015). When human kidneys lose the ability of filtering,
harmful fluid and the waste accumulate in the body raising the blood pressure. It results the
ability to renal failure. This is also called the end-stage renal diseases when the kidneys lose
almost 90 % of the strength to work normally. There are many reasons behind the end stage
kidney disease are uncontrolled high blood pressure, diabetes, chronic glomerulonephritis,
polycystic kidney disease. It is known that human can live without one kidney but then kidney
donation or transplant is not accepted in the United Kingdom (Colombo et al.,2017).. The study
showed that most of the donations were from the deceased people not the living ones.
When the case of Mr. Holm is taken, it is seen that he is a 68 years old man being
detected with the end-stage renal disease and hospitalized for the renal transplant surgery from
the deceased donor. Almost nine years ago, he had been diagnosed with hypertension and
diabetes . As per the AIHW or Australian Institute of Health and Welfare, kidney damage is the
result of hypertension and diabetes. The Australian College of Operative Room Nurses
( ACORN) , the Australian National Standards, the Organizational policies and the World Health
Organization ( WHO) have given proper guidelines for delivering quality care reducing the risk
at the time of surgery. This essay discusses the issue and potential complications during the
surgical journey of Mr. Holm and it will also depict how the implementation of guidelines
supported in the delivery of this care.

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The renal transplant is an extremely crucial in reducing the patient’s burden. Those
patients who underwent renal transplant do not necessarily undergo dialysis because it is a very
time-consuming process. There are many concerns related to the after effects of kidney
transplant. This is called the postoperative complications as delayed function in the transplanted
kidney, dysfunction due to refusal of taking foreign body organ by the patient’s body , the deep
vein thrombosis and many others. Thrush, infections, hypertension, diabetes mellitus and many
others can cause these complications (Naylor et al., 2016). The past health history of Mr Holm
reveals that he diabetes mellitus and hypertension has been diagnosed in his body in the year
2010. He also has a history of dyslipidaemia, hypertensive nephropathy, Hepatitis B infection
(HBV) and gout too. These diseases have cumulatively accentuated the possibility of the chronic
kidney and it rapid progression toward end stage renal disease and related complications.
The renal transplant is a long-term process because the number of deceased donor is
limited but in some cases, living donors are also found reducing the waiting time. The patient for
the renal transplant needs proper evaluation such as laboratory studies, social issues, infectious
profile, immunologic evaluation, diagnostic procedures for highlighting factors, which may
affect the surgical outcomes. The patients for renal transplant are required to be supported with
whole life immunosuppression. This helps to prohibit the organ rejection, infection and the drug
toxicity.
The renal transplant department confirmed Mr Holm that he is free from any infective
symptoms along with the fact that both his diabetes and blood pressure were under control. On
the other hand, the peripheral oedema was nil, the lung fields were also clear, and the abdomen
was perfect for the process. The department decided to give modified immune suppression to
avoid the risk of HBV re-activation. As a whole, Mr Holm was prepared for the operation and as

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psychological concern, the surgeon assured him along with the transplant co-ordinator. The
donor was also prepared by the transplant coordinator after brain death of the donor . The family
consent was also received for the donation of organ and the organ care was handed over to
procurement co-ordinator. They took all necessary measures to ensure that the organs adequately
perfused till the time of reaching the operation theatre.
ANATOMTY and PHYSIOLOGY OF RENAL SYSTEM (Kidney)
The renal system functions as filtering the blood and creating urine to be the waste by-
product. The organs in the urinary system consist of renal pelvis, kidneys, ureters, urethra and
bladder. The structure of kidney is such that it is divided into two of the principle regions. The
regions are the central medulla and peripheral rim of the cortex. The kidneys receive almost 25
% of the cardiac output. These are protected by the renal fat pad in the retroperitoneal space
which overlays the muscle and the ribs. At the renal hilum, the lymph vessels, ureters, blood
vessels and the nerves come and leave (Locke et al.,2015).The renal arteries rise from the aorta
and on the other hand, the renal veins directly drain into the vena cava. The kidney function is
extracted from the activities of almost 1.3 million nephrons in each kidney, which are called the
functional units.
The Bowman’s capsule captures the glomerulus, capillary bed and blood filters. There is
a portal system created when during the blood flow through second capillary bed covering the
proximal and distal convoluted tubules along with Henle loop. The solutes and water are
recovered by the second capillary bed. This is a particular filtration processed by collecting
ducts which drains into the minor calyces. The filtrate progresses towards the renal pelvis and
ureters lastly. Kidneys take the blood supply from the aorta through the renal arteries. Blood
returns to the vena cava through the renal veins. Urine is excreted from the kidneys and passes