(3.8) Kidney transplants and problems - dialysis or transplant? - advantages and disadvantages

Why can you have kidney problems?

Medical problems with your kidney function can arise from several causes e.g. genetic factor, high blood pressure (hypertension damages organs), obesity and lack of exercise, diabetes, excessive alcohol consumption (not just liver damage), smoking (not just lung damage), stress or, though very rarely, from an infection that spreads to the kidneys.

 

Kidney transplants

In kidney transplants a diseased kidney is replaced with a healthy one from a donor.

You can function well, with care, with only one kidney.

This the case if e.g. a living family member donates one of their kidneys to another family member.

This situation gives the best chance of tissue matching and minimises the danger of rejection by the kidney recipient.

 

Source of kidney organs

Kidney transplants are one of the most common organ transplant operations done in our modern health service (eg the NHS of the UK).

The only cure for serious kidney disease is to have a kidney transplant, hopefully from a suitable matching donor.

The donor can be a relative donating one of their kidney's or a fatal accident victim e.g. somebody who has died suddenly.

The person who has died must be on the donor organ register or carrying a donor card (providing relatives agree to the organ donation) - this is the current situation in UK Law - but it may change.

Any donated organs must be stored in cold conditions, for as shorter time as possible, to minimise tissue deterioration.

Since we have two kidneys, one can be transplanted from a living person to the kidney failure recipient, but with some residual risk to the donor.

In the surgical operation the recipient's abdomen is opened below the navel and the new kidney connected to an artery and vein so it can function with full blood supply.

The kidney is further connected to the bladder for urine collection.

The kidney should, at least partially, work immediately, but it may take several weeks to be fully working.

It is a complex operation taking 2-3 hours.

 

Problems with kidney transplants

However, the donor kidney may be rejected by the immune system unless precautions are taken.

The immune system treats the transplanted tissue as 'foreign' and its cells are attacked by antibodies.

Transplant rejection

1. The white blood cells of the organ recipient sense the antigens of the cells of the transplanted kidney are foreign and not part of the body of the transplant patient.

2. The recipient's white blood cells respond to the perceived 'foreign' antigens by producing matching antibodies

3. The antibodies attack the 'donated' kidney cells and destroy them and so the kidney transplant is rejected.

Therefore, precautions must therefore be taken to minimise the risk of kidney rejection.

(i) You can test how well the donor's kidney tissue type closely matches the recipient's kidney tissue.

The tissue-type is based on the cell's antigens.

The more similar the antigens of the donor and recipient's kidney cells, the greater the chance of organ acceptance i.e. the less chance patient's white blood cells identify the donor's antigens as 'foreign' and produce antibodies to attack the donated organ.

 

(ii) The patient needs to be treating with immunosuppressant drugs to prevent organ rejection, but it may still happen.

These drugs are designed to suppress the patient's immune system to stop it attacking the cells of the transplanted kidney tissue.

Unfortunately, these drugs reduce the body's white cells ability to produce antibodies, so they won't attack the kidney cells of the donated organ.

So, these drugs make the patient more susceptible disease that would normally be counteracted by their immune system - there is a risk of both infection and cancer.

There are also problems with availability of kidney organs, e.g. a long waiting list and the cheaper dialysis is often used as an interim treatment.

Antigens are proteins on the surface of cells., and a recipient’s antibodies (from white blood cells of the immune system) may attack the antigens on the donor organ as they do not recognise them as part of the recipient’s body and so the transplanted kidney is rejected.

So, summarising - in order to minimise rejection of the transplanted kidney:

A donor kidney with a ‘tissue-type’ similar to that of the recipient is used - which is where a generous relative can mean the difference between life and death.

The recipient is treated with drugs that suppress their immune system response to reject the kidney transplant.

Tests for blood grouping and compatibility tables are part of the procedure to give the transplant the best chance of not being rejected.

 

Dialysis or transplant? Advantages and Disadvantages - the 'Pros and Cons'

In the long run, transplants are cheaper than dialysis, but there is a shortage of donated kidney organs for transplant operations.

Organ donation involves ethical issues for us and other animals.

Some people may think it is wrong to use parts of other peoples bodies.

Relatives may override the wishes of the deceased even though they may have carried a donor card.

Some poor people are prepared to sell one of their kidneys for money - should this be allowed to increase the availability of organs?

Should we transplant organs from animals? but there are concerns over cross-species infections.

What animal rights involving breeding animals specifically for a particular organ like the kidney?

Will biotechnology enable us to grow complex organs like the kidney in the future?

There is a long waiting list for surgery, but at least dialysis keeps patients with kidney failure alive, and increases the chance of undergoing kidney transplant surgery!

For elderly patients, dialysis can reduce life expectancy due to complications - maybe due to other underlying health problems.

Dialysis patients can suffer from sudden falls in blood pressure, and they must always be on the lookout for signs of infection.

Without a kidney transplant, dialysis patients must continue with the treatment for the rest of heir lives.

A kidney transplant gives the patient a much better freedom of lifestyle - greater independence and general quality of life - no need to go to a medical centre for dialysis or receive dialysis in the home.

Patients with other underlying health issues like heart disease may not be able to withstand the stress of transplant surgery, so dialysis is the only option to stay alive.

Dialysis patients must take great care in lifestyle e.g. no smoking, minimum alcohol and avoid excess weight.

Many of the points raised here apply to the advantages and disadvantages of other transplant procedures.

---

Key points Source of information is based on textbooks & syllabus-specifications for students taking the AQA GCSE, Edexcel GCSE and OCR GCSE level biology examinations (~US grades 9-10).

Key points about kidney problems and treatments e.g. transplants versus dialysis and their advantages and disadvantages

What Are Kidney Problems?

The kidneys filter waste products (like urea), excess water, and ions from the blood.

If they stop working properly, waste builds up, leading to serious illness or death.

Causes of Kidney Failure:

• Infections

• High blood pressure

• Diabetes

• Genetic conditions

• Physical injury

---

Treatments for Kidney Failure

There are two main treatments:

1. Dialysis

• A machine filters the blood to remove urea, excess ions, and water.

• Acts as an artificial kidney.

How It Works:

• Blood is passed through a partially permeable membrane.

• Dialysis fluid contains:

  • No urea → urea diffuses out of the blood.

  • Normal glucose and ion levels → only excess ions/glucose diffuse out.

• Blood and fluid flow in opposite directions (counter-current) to maintain a concentration gradient.

Advantages:

• Life-saving for people waiting for a transplant.

• Available to all patients (no donor needed).

• No need for immunosuppressant drugs.

Disadvantages:

• Time-consuming (3–5 hours, 2–3 times a week).

• Expensive long-term.

• Requires strict diet (low salt/protein).

• Only a temporary solution.

---

2. Kidney Transplant

• A healthy kidney from a donor is surgically implanted.

• Replaces the function of the failed kidney.

Advantages:

• Long-term solution.

• Patient can lead a more normal life (fewer dietary restrictions).

• Cheaper than dialysis in the long run.

Disadvantages:

• Risk of rejection (immune system attacks the new kidney).

• Requires immunosuppressant drugs for life.

• Surgical risks (infection, bleeding).

• Shortage of donors.

• Transplanted kidney may only last 8–10 years.

---

Comparing Dialysis and Transplants

---

Why This Is Important in Human Biology

• Shows how the excretory system maintains homeostasis.

• Highlights the role of diffusion, osmosis, and selective permeability.

• Demonstrates the interdependence of body systems (circulatory, endocrine, immune).

• Encourages understanding of organ donation, medical ethics, and healthcare decisions.

---

Exam Tips

• Use key terms: urea, dialysis, transplant, immunosuppressants, homeostasis, diffusion.

• Be able to compare dialysis and transplants using a table or bullet points.

• Understand the advantages and disadvantages of each treatment.

• Explain how dialysis uses concentration gradients to remove waste.

---

Keywords, phrases and learning objectives for this part on kidney transplants and dialysis

Kidney problems can arise from several causes e.g. genetic, high blood pressure, diabetes or from an infection.

After kidney failure transplants versus convenient dialysis must be considered and lack of kidney donors is a constant problem - the donated kidney must be matched with the recipient patient, otherwise rejection is highly likely.

Know there are problems with having a kidney transplant e.g. rejection of donated kidney by the recipient's immune system and why patients must adjust their lifestyle e.g. preferably no alcohol, no smoking and possibly restrictions on diet - avoid being overweight..

Be able to evaluate the advantages and disadvantages of treating kidney failure by dialysis or kidney transplant.

---

WHAT NEXT?

TOP OF PAGE

INDEX of biology notes on homeostasis: Kidney structure and function - osmoregulation

INDEX of all my BIOLOGY NOTES

BIG website, try using the [SEARCH BOX], maybe quicker than the many indexes!

Basic Science Quizzes for UK KS3 science students aged ~12-14, ~US grades 6-8

Biology * Chemistry * Physics for UK GCSE level students aged ~14-16, ~US grades 9-10

Advanced Level Chemistry for pre-university age ~16-18 ~US grades 11-12, K12 Honors

Find your GCSE/IGCSE science course for more help links to all science revision notes

email doc brown - comments - query?

---

Explaining importance of advantages & disadvantages of kidney transplants & dialysis in GCSE level biology, What you need to know about advantages & disadvantages of kidney transplants & dialysis for GCSE level biology, Explaining use of advantages & disadvantages of kidney transplants & dialysis knowledge in GCSE level biology, Examples of advantages & disadvantages of kidney transplants & dialysis explained when studying GCSE level biology, What is the significance of advantages & disadvantages of kidney transplants & dialysis in GCSE level biology, describing explaining theory of advantages & disadvantages of kidney transplants & dialysis when studying GCSE level biology, exam revision notes for advantages & disadvantages of kidney transplants & dialysis, online help for understanding advantages & disadvantages of kidney transplants & dialysis in GCSE biology, what do I need to learn about advantages & disadvantages of kidney transplants & dialysis? what do I need to know about advantages & disadvantages of kidney transplants & dialysis for GCSE biology exams, how to prepare for questions on advantages & disadvantages of kidney transplants & dialysis in GCSE biology examination? advantages & disadvantages of kidney transplants & dialysis for syllabus-specifications for students taking the IGCSE/GCSE level biology examinations, summary revision notes key points on advantages & disadvantages of kidney transplants & dialysis for students studying AQA igcse/gcse biology notes on advantages & disadvantages of kidney transplants & dialysis, Edexcel gcse biology notes on advantages & disadvantages of kidney transplants & dialysis,  OCR 21st century GCSE biology notes on advantages & disadvantages of kidney transplants & dialysis, OCR gateway GCSE biology notes on advantages & disadvantages of kidney transplants & dialysis, WJEC gcse biology notes on advantages & disadvantages of kidney transplants & dialysis, CCEA gcse biology notes on advantages & disadvantages of kidney transplants & dialysis, CIE Cambridge igcse biology, notes on advantages & disadvantages of kidney transplants & dialysis useful for US grade 9-10 biology student courses

---