Kidney transplant in India

Overview

Kidney is one of the most vital organs of the human body that performs important function of filtering waste from your blood and excreting that waste out of the body in the form of urine. It also assists in maintaining the body's fluid and electrolyte balance. If the kidney ceases working normally, the waste starts accumulating in the body and it makes you ill and you would need kidney transplant to replace your diseased kidney with a new, healthy kidney.

The new healthy kidney can be sourced from the living person who is willing to donate a kidney or it can be obtained from the dead person or a cadaver.

The basic principle behind kidney transplant from a living donor is that one can lead a healthy and normal even with one kidney which is sufficient for normal functioning of the human body.

Kidney transplant allows the person with renal failure to lead a normal and active life and makes the person free from lifelong reliance on dialysis and associated strict schedule.

However, kidney transplant is not suitable for every single patient with kidney failure. To determine the compatibility and the chances of successful kidney transplant, series of test are performed on both the donor and the patient. The tests include blood group typing, tissue and HLA typing and cross matching.

Causes For Renal Failure

Several disorders can damage the kidneys eventually making your kidneys to stop working completely. The main cause for kidney damage is the end-stage renal disease (ESRD) and kidney failure. Kidney failure can be acute which is caused due to short term severe illness of kidneys or it can be chronic kidney failure, which happens as a result of long term ailments like diabetes, high blood pressure etc.

There are certain risk factors that make people prone to kidney failure and ESRD. These include:

Severe or uncontrolled high blood pressure
Type 1 or type 2 diabetes
Heart disease
Liver disease or liver failure
Vascular disease like renal artery thrombosis, progressive systemic thrombosis etc.
Cancers including renal cell carcinoma, multiple myeloma, lymphoma etc.
Diseases like acute tubular necrosis, acquired obstructive nephropathy
Inherited or congenital kidney disease like polycystic kidney disease, congenital obstructive nephropathy etc.
SLE, injury
Sickle cell anaemia

Candidates

If you are diagnosed with ESRD or if your glomerular filtration rate, that means, the rate of filtering the waste out of the blood by your kidney is less than 15ml/min/1.73 sqm and if there is no other way of restoring the kidney functions, and if you are healthy enough to undergo surgery, you can be a good candidate for the transplant surgery.

Procedure

Evaluation and matching procedure:

Before the transplant, the patient and the donor need to undergo battery of tests like blood group (A, B, AB or O) and HLA (human leukocyte antigen) typing. If the HLA type of the patient matches with the donor, then it is more probable that the patient body will not reject the kidney. Once the matching is done and donor is identified, cross matching of the antibodies is done to make sure that the antibodies will not attack the organ. If the cross matching test comes negative, that means if the patient's blood doesn't show up any antibody reaction after mixing with the donor's blood then the surgeon can proceed with the transplant.

Transplant:

The kidney transplant surgery is a complex procedure performed under general anaesthesia.

As the anaesthesia starts taking effect, the surgeon makes an incision in the abdomen and the diseased kidney is reached. The surgeon then places the donor's kidney in the abdomen by wiring the blood vessels of the kidney to the patient's arteries and veins. This will start the blood flow through new replaced kidney. The surgeon then connects the ureters to the urinary bladder to let the patient micturate normally. Depending on the kidney disease, like, if your kidneys are not triggering any complication, the surgeon will decide to leave the diseased kidney inside your body. If he fears that diseased kidney can cause any problems like high blood pressure etc, then removing them is the best option.

Once the kidney is transplanted, the incisions will be sutured back and both the patient and donor shall be transferred to the ICU.

Recovery

The results of the kidney transplant are satisfying and good. Your new kidney will clean and filter your blood normally and thus you shall get rid of dialysis after the successful kidney transplant. The life expectancy of more than 90% patient who underwent live donor kidney transplant increases by 5 years and of 80% patient increases by more than 10 years.

Expected Results

You will be taken to the ICU immediately after the surgery, where you will be staying for around 24-48 hours following which you will be shifted to the transplant care unit for another 1 week.

Both you and the donor shall experience little pain and discomfort at the site of incision, which would be relieved by medicines. You may also feel numbness due to severed nerves in the area of incision. You will be given medications to subdue your immune system so that it should not reject the new kidney. The surgeon shall also give you antifungal, antibacterial and antiviral drugs for protections against any infection.

Time & Cost

You need to come to India 2-3 weeks prior the scheduled transplant to complete the pre-operative requirements and after the surgery about 7-8 weeks are required. So a total stay of 10-11 weeks is required for kidney transplant in India.

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