Old kidneys are generally not removed after a transplant unless they are causing significant problems.
Surgeons typically leave the recipient's original (native) kidneys in place after a kidney transplant. According to Dr. Gelb, nonfunctioning kidneys usually shrink over time. Removing them is generally unnecessary unless they pose specific health risks.
Reasons for Leaving Old Kidneys
Here's why old kidneys are usually left in place:
- Reduced Surgical Risk: Removing the native kidneys adds extra surgical time and complexity, increasing the risk of complications for the patient.
- Potential for Residual Function: Even if the original kidneys aren't functioning optimally, they may still contribute to some level of kidney function or hormone production.
When Old Kidneys Are Removed
The native kidneys are removed in specific situations:
- Enlargement: Greatly enlarged kidneys may cause discomfort or compress other organs.
- Severe High Blood Pressure: If the original kidneys contribute to uncontrollable high blood pressure.
- Infection: If the original kidneys are a source of recurrent or chronic infections.
In essence, the decision to remove the original kidneys is based on a risk-benefit analysis, weighing the potential complications of surgery against the potential benefits of removing problematic kidneys.
