Kidney/Renal Transplant

Kidneys are bean shaped organs located just under the rib cage and on the two sides of the spine, and their function is to remove waste, salt, and excess water. Kidneys also maintain blood pressure, hemoglobin levels, and promote optimal bone health. An inability to perform these functions leads to kidney failure. In certain cases, the kidneys may stop functioning completely, which leads to end-stage kidney failure. Patients suffer from different types of kidney failure such as acute or temporary failure, and chronic kidney or permanent kidney failure, which causes permanent damage to the kidney. Dialysis is the chosen treatment strategy for most patients, which sustains them for several years. However, in case of permanent failure of the kidneys, a kidney transplant procedure is recommended. The advantages of kidney transplant include low cost, better life quality, better survival rates, and fewer restrictions on diet. The cost of kidney transplant ranges between 5 and 6 lakhs when the surgery is undertaken in a private hospital. Patients generally incur a post-treatment cost of around 15,000. They are also advised lifelong medication, which typically cost around INR 10,000 per month.

The transplant itself is a surgical process where the surgeon places the new kidney in your abdomen and attaches it to the artery that supplied blood to one of your kidneys and to the vein carrying blood away from the kidney. The ureter is attached to the kidney, which carries urine from the kidney to the bladder.

Causes Leading to Kidney Transplant

Several causes may predict the need for kidney transplant. One of the primary causes is damage to kidneys because of uncontrolled blood sugar in diabetes. Even uncontrolled blood pressure can lead to kidney failure. Patients may suffer from certain hereditary conditions that may damage the kidneys. These conditions include single kidney, kidney cysts, and abnormality of the urinary bladder. Chronic obstruction of urine due to kidney stones or prostate or cervical cancer is a common occurrence among patients suffering from chronic kidney disease. Another cause of kidney failure is chronic recurrent infection, referred to as chronic pyelonephritis.

Organ Donation Challenges and Benefits

Patients who undergo kidney transplant surgery may get a kidney from either a family member or other deceased donors when a family member is not available for donation. Organ donation and transplantation can be a complex process in India. The ratio of donors to recipients is 15,000 donors to 2 lakh patients. The government strategy now focuses on kidneys donated from deceased donors. Another reason for this gap is hesitant family members. Issues surrounding organ transplant have been resolved through several initiatives such as Live Kidney Transplant programme and the programs run by Indian Society for Organ Transplantation.

The physician community undertakes several strategies to improve the chances of successful organ transplant. These include the use of induction agents and immunosuppressive drugs to stop rejection, the use of steroids to address issues related to graft rejection and lower postoperative complications. Other optimizations made to transplant surgery include the use of efficient transplant methods and minimally invasive surgery.

The overall success of organ donation rests with hospitals in terms of early identification of the donor, and their certification and maintenance. On the downside, the transplant registry records more than 21,000 kidney transplants during the period between 1970 and 2015. Further, the number of people who suffer from late-stage kidney disease exceeds 2.5 lakh every year. This rise in the cases of chronic kidney disease is attributed to rising diabetes rates, especially end-stage diabetes.

Typical Procedure for Kidney Transplant

Kidneys remove excess fluid, minerals, and waste from the blood through urine. When kidneys are unable to filter waste, there is a build up of harmful levels of waste and fluid in the body. This accumulation puts a person at the risk of high blood pressure and even kidney failure. In a kidney transplant surgery, the diseased kidney is replaced with a healthy kidney from a donor. Transplanting a kidney eliminates the dialysis.

A physician usually performs a pre-transplant evaluation to determine whether the procedure is technically feasible and also confirms whether there is any active infection. The physician team also checks for any comorbid conditions including advanced stage cardiac disease, age, and liver disease that may have an effect on long-term survival rates. Such an assessment may provide essential information to make the necessary changes to the treatment plan for a kidney transplant. The physician may also consider a combined organ transplant.

As part of the pre-transplant evaluation, the physician takes a detailed history of the patient and performs a physical examination to find out more about the kidney and its chances of recurrence. The cardiologist makes an evaluation for heart disease and the pulmonologist evaluates lung function. These procedures help the care team to determine any risks associated with administering anesthesia. The pre-evaluation is helpful in determining whether there are any active lung diseases such as chest infection and pulmonary tuberculosis. Urologists determine bladder capacity, obstructions with urine flow, blood flow, and the presence of kidney stones. A gynecologist evaluates female patients for cervical cancer by performing a pap smear. A mammography may have to be performed for older women. Finally, a psychological assessment is performed to identify financial, social, and behavioral issues, and the possibility of successful adherence.

During kidney transplantation, the surgeon places the kidney from the donor in the lower abdomen of the recipient and connects the artery and vein of the donated kidney to the artery and vein of the body. Although the transplanted kidney may start making urine immediately, some patients require about a week for their kidneys to start functioning normally.

Due to a shortage of availability of organs, a patient may have to wait until a deceased donor or living donor is available. During this period, it is important to prevent infection. As long as the waiting period lasts, a patient is put on dialysis. Several parameters are monitored by the physician team. These include maintenance of a hemoglobin level between 10-12 g/dl and proper blood pressure control. Patients must take adequate and regular dialysis and keep their weight under check. They are also required to undergo regular check-ups in a month and take regular medication.

Therefore, kidney transplant in India is performed at affordable costs in most hospitals. To raise the chances of positive outcomes, patients must educate themselves about the causes that lead to kidney failure and predict the possibility of a transplant procedure. They must collaborate with the care team to prevent adverse effects and recover successfully.

Fill this form to get a free quote from best hospitals in India

    Get a Free Quote