Department Of Kidney Transplant

What is a kidney transplant?

A kidney transplant is a surgical procedure in which a functioning kidney from a deceased or living donor is implanted into a person whose own kidneys are no longer able to perform their functions. The kidneys, located on either side of the spine just below the ribcage, are two bean-shaped organs about the size of a fist. Their primary role is to filter waste and excess fluids from the blood, producing urine.

What is end-stage kidney disease?

When the kidneys are unable to filter waste, harmful levels of waste fluids can build up in the body, leading to high blood pressure and ultimately, kidney failure (also known as end-stage renal disease). This condition occurs when the kidneys have lost 90% of their function.

Some common causes of end-stage kidney disease include:

• Diabetes
• Chronic, uncontrolled high blood pressure
• Chronic glomerulonephritis — an inflammation and eventual scarring and inflammation of the tiny filters present in your kidneys (glomeruli)
• Polycystic kidney disease

For individuals with end-stage renal disease, it is vital to remove the waste from their bloodstream in order to survive. This can be accomplished through the use of a machine (dialysis) or a kidney transplant.

What is the best treatment option available for End-Stage Kidney Disease (ESKD)?

Kidney (Renal) Transplantation is the top choice for End-Stage Kidney Disease (ESKD) for the following reasons:

• Improved survival
• Better quality of life
• Cost-effective
• High success rate

Who needs kidney transplantation?

Patients with end-stage kidney disease are carefully evaluated for their suitability for kidney transplantation. Individuals with cancer or active infections are not considered eligible for transplantation. This assessment is done specifically for patients with end-stage kidney disease.

• Old age
• Major lung, liver, or heart disease
• Chronically ill patients like HIV positive patients
• Psychiatric Illness

Who can donate kidneys?

Living Donors:

In India, close relatives of patients are legally permitted to donate organs. This includes spouses, siblings, children, parents and grandparents.

If a family member is unable to donate a kidney due to blood type incompatibility, a swap transplant may be considered, where the donors are exchanged between two pairs.

The medical team will thoroughly evaluate living donors to ensure they have excellent physical and mental health and are free from underlying conditions such as diabetes, uncontrolled high blood pressure, HIV, cancer, hepatitis, and organ diseases related to the kidney, lungs, liver, pancreas, and intestine.

Living donors must be at least 18 years old, compatible with the recipient and evaluated for both psychosocial and medical suitability.

Deceased Donor/Cadaver Donor

A person who is brain dead is considered a deceased donor. Additionally, a person may also be declared dead if their brain has stopped functioning but their heart is still active. This period, which may last for hours or days, provides an opportunity for transplantation of various organs and tissues with the consent of the family.

What is the success rate of kidney transplantation?

In general, kidney transplant success rates are very high. For instance, transplants from deceased donors have a success rate of 85-90% in the first year, meaning that 85-90 out of 100 transplants will continue to function well after one year.
Living donor transplants have an even higher success rate of 90-95%. There is no age limit as the long-term success is good for people of all ages.

What if the donor’s blood group does not match the recipient/transplant candidate?

If the donor’s blood group doesn’t match, then three options are considered for such patients:

• Blood group Incompatible transplantation (ABO)
• Living Donor Paired kidney exchange (LDPE)
• Deceased donor (cadaver) donor listing

What can kidney donors expect?

The process for the donor is the same regardless of blood type compatibility. Special treatments are only required for the patient receiving the transplant.

What Happens During Surgery?

A typical kidney transplant surgery typically takes 3-5 hours. The patient will be under general anesthesia, so they will be unconscious throughout the procedure. The surgeon will make an incision in the abdominal area, just above the groin.

The patient’s own kidneys will not be removed unless they are causing pain or are infected. The donated kidney will be placed inside the abdominal cavity. The surgeon will then connect the patient’s bladder to the ureter, the tube that carries urine from the kidney.

The incision will be closed with sutures and a small drain may be placed in the abdomen to remove excess fluid. The surgeon will also insert a small tube (stent) into the ureter for urination, which can be removed after 6-12 weeks.

What is the recovery period?

After the surgery, patients are typically able to get out of bed and walk around within a day. However, most people will need to stay in the hospital for 5 days or less.

While patients may start to feel better within two weeks, they will need to avoid driving or lifting heavy objects for about a month. Therefore, it’s advisable to take off work for 6-8 weeks.

Since the donated kidney is not the patient’s own, they will need to take special medication every day to prevent the body from rejecting it.

Is it expensive?

The cost of kidney transplant surgery is relatively low. The cost remains consistent across locations, with the exception of the plasma exchange procedure, which may need to be added based on the number of antibodies present in the transplant candidate’s body.