Scope of Service
A kidney transplant is the transfer of a healthy kidney from one person into the body of a person who has little or no kidney function.
The main role of the kidneys is to filter waste products from the blood and convert them to urine. If the kidneys lose this ability, waste products can build up, which is potentially life-threatening.
This loss of kidney function, known as end-stage or kidney failure, is the most common reason for needing a kidney transplant.
Many people suffer from kidney failure and need a kidney transplant. Statistics showed a total of 16,897 dialysis patients in Saudi Arabia by the end of year 2017 and the number is increasing on daily basis.
Who are the candidates for a kidney transplant?
Kidney transplant is a treatment option for people with end stage renal disease.
Kidney transplant is offered to all patients with chronic kidney failure whether this patient is on dialysis or in pre-emptive stage (significant kidney impairment but not yet on dialysis).
Am I eligible for a kidney transplant?
To determine if you are eligible for transplant, you must first have a transplant evaluation. This critical step helps to decide whether transplantation is the correct course of action for your health. During the evaluation, you will meet with several members of the transplant team, including physicians, surgeons, and specialists from transplant team, social, nutrition, psychology, and other disciplines. You will also meet with a transplant coordinator, who will help guide you through the evaluation process. During your evaluation you will be required to complete a set of tests. Once you have completed your evaluation, your health status and history will be presented to the transplant committee. Generally, most prospective patients are eligible for transplant; candidates who are at high risk and or will not benefit from transplant will be considered not eligible.
Tests you may include:
• Laboratory tests, including blood, urine, including immunology (HLA tissue typing/PRA) and others.
• Radiology diagnostics, such as an ultrasound, CT and others
• Cardiac screening to determine the health of your cardiovascular system, such as Echo-cardiography or more invasive tests in selected patients.
• A general health exam, including routine cancer screening and others such as endoscopy, to evaluate your overall health gynecological exam and other tests.
What to expect after workup:
Kidney transplant can be from living donor or from a deceased donor.
• Living Donor Transplants. If a living donor is available and deemed suitable for donation, both the recipient and donor are electively admitted on a scheduled date. Donors are heroes. They step forward putting themselves at risk to help someone else. Our evaluation and care for donors is of paramount importance and the selection process is there to affirm a potentials donor’s suitability to donate a kidney and to undergo surgery. They are fully counseled on the risks involved and how donation does not put them at any other statistical risk for kidney failure than the general population provided they follow a healthy general lifestyle and keep vigilant of their health status. Live donors usually step forward to donate to a relative (related live donor) or as a pure act of generosity and altruism (non-directed live donor). In all cases full evaluation with lab tests and radiological studies as well as a one-on-one medical consultation is done before a donor can be cleared to donate.
• Deceased Donor Kidney Transplants. If you don’t have a donor then after the work-up, you will be placed on a deceased donor list. If you're on the waiting list for deceased donor kidney transplantation, the transplant center will need to contact you at short notice as soon as organs become available for transplantation, so you must inform your coordinator if there are any changes to your contact details. Work up update will be done for the potential compatible recipients to choose the best candidate before organ recovery.
The length of time you wait depends on:
• Blood group
• Immunological matching (HLA, PRA)
• Donor availability
• How many other patients are on the list and how urgent their cases are.
After kidney transplant:
It is imperative for the recipient to remain close by for close follow-up in the immediate postoperative period patient will be advised to stay in Riyadh for 3 months where he or she will be visiting the clinic twice weekly for the first 6 weeks then once weekly for another 6 weeks after which they are followed up lifelong with their transplant nephrologists. This is to ensure adequate graft function and that the patient is receiving the proper medication, social support and timely medical advice.
Donor Information:
Living Donor Evaluation for Live Donation:
Step One
Living related Donor: your Coordinator will arrange for pre-screening – initial interview, consenting, medical, independent living donor advocate interview, psychology and social work assessment in addition to laboratory investigations – full labs including ABO typing, organ function tests and serology.
Living non-related Donor: your Coordinator will arrange for Pre-Screening – initial interview, consenting, medical, Independent Living Donor Advocate interview, psychology and social work assessment in addition to Laboratory Investigations – full labs including ABO typing, organ function tests and serology. Potential donors will be referred to the non-related donation committee for clearance.
Step two
Diagnostic Investigations – CT Abdomen, Chest X-ray or other imaging.
Step three
Final Assessment – all investigations reviewed by the primary team for suitability to donate.
Step four
OR Booking – final re assessment by the medical and surgical consultants, once cleared then proceed for biopsy.
The Renal Transplant and Nephrology Clinic
The Renal Transplant and Nephrology Clinic cares for Adult and Pediatric patients with End Stage Renal Failure and requiring a kidney transplant. This is a hospital-based transplant center providing non-emergency care to both in and outpatients. All patients, recipients and donors are provided with on-going follow-up care. The staff provides support and education for the patient and families.
There are three main areas:
Pre-Renal Transplant (daily clinics, 3 exam rooms); Living Related Donor Program, Deceased Donor program, Living Unrelated Donor program, Paired Exchange, Pediatric Renal Transplant Unit (PRTU), ABO incompatible program, Highly Sensitized Patients
Post Renal Transplant (daily clinics, 4 exam & 1 procedure room); Immediate (0-6 months), Acute (walk-in), Medication Refill, Long Term Patients Need more follow up, Pre-Biopsy Patient, Procedure, Pediatric.
Consultant Clinics (6 exam rooms with 25 clinics/ week), Long Term Renal Transplant, Nephrology, Renal Transplant Surgery Clinic.