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Kidney Transplant: The Renal Episode

Kidney Transplant

What Is Kidney Transplant?

The part of organ transplantation procedure where kidney functioning well from a donor is placed inside the recipient in need of a kidney owing to a serious renal disease is known as the kidney transplant procedure. The organ transplantation has been practiced since ages taking into account factors such as those of auto rejection, compatibility tests as well as sources of organ donors.

Medical Conditions Requiring Kidney Transplant:

The end stage renal disease (ESRD) mostly calls for a kidney transplant. The conditions included in ESRD are as follows:

  • Polycystic kidney
  • Focal segmental glomerulosclerosis
  • Malignant hypertension
  • Diabetes mellitus
  • Infections with the glomerular filtration rate <15ml/mn/1.73m2
  • Immunosuppressive conditions such as systemic lupus erythmatosus

Signs and Symptoms That Call For a Kidney Transplant:

  • Reduced amount of urine passing (aneuresis)
  • Water retention body leading to swelling in feet, hands, wrists
  • Persistent nausea, drowsiness, weakness
  • Seizures
  • Pain and pressure in chest region

Diagnosis Required Prior To A Kidney Transplant:

Before planning to place kidney from a donor into a recipients body, it becomes an utmost priority to screen the recipient whether he or she will or will not be able to accept the so called foreign body into its system. The tests run are as follows:

  • Testing for the blood type: ut of the four blood groups A, B, AB and O, blood group AB is universal recipient and blood group O is universal donor. The Rh type either – or + however does not bother the process of organ transplant.
  • Human Leukocyte Antigen HLA test: HLA is a protein found on the membranes of white blood cells in the human blood stream. It is used to maintain the immunity and helps distinguish the body between its own and foreign cells. In cases with a positive HLA test outcome indicates that the body has a tendency to produce antibodies against its own tissues. Thus the chances of a transplant failure are quite high.
  • Cross match test: In cases of kidney or for that matter any other type of organ transplant, the body will always treat the organ as a foreign object and begin to destroy it. The body perceives it as an antigen and begins producing antibodies to kill it. However if the recipients blood is mixed with the cells or tissues of the donor in an in vitro method, then an estimation of the response can be made. A cross match is considered positive if antibodies begin to form in the reaction, negative if no antibodies form. A negative cross match test is always a thumps up for an organ transplant procedure.
  • Other serological tests to test for the positivity of sexually transmitted diseases, hepatitis, HIV, cytomegalovirus are also carried out.
  • ABO incompatible kidney transplant: A major advancement in kidney transplant is the introduction of the ABO incompatible kidney transplant. The main aim of the ABO incompatible procedure is to transplant kidney irrespective of the blood group of the donor as well as the recipient. The only test that can be performed on the recipient is that the kidney he or she will be donating is free of any pathological conditions. For this purpose, blood tests, ultrasound imaging or x rays of the pelvic region may be needed for the recipient if at all a need arises.

Types Of Kidney Transplant:

Depending upon the source of kidney origin, transplants can be of the following two types:

  • Deceased donor transplantation: Kidney is taken from the cadavers where the organs are preserved well in formalin. Prior to insertion in the recipient’s body, thorough cleaning procedures are done.
  • Living donor transplantation: Kidney is extracted from a living donor with the consent of the individual. The donor is operated for removing the kidney after running compatibility tests on him or her.
  • Depending upon the genetic compatibility of the recipient-donor, living donor transplantation is further divided as follows:
  • Biologically related: These can be either of the parents, siblings or from the same family or distant relatives who share the same genetic pool. This is the first preference since organ rejection is bound to be avoided if this method is chosen.
  • Biologically unrelated: These are mostly healthy donors of a dissimilar genetic pool who offer to donate kidneys.

Treatment Procedures For Kidney Transplant:

Kidney transplants are performed under general anesthesia with a continuous monitoring of the vitals. During the surgical procedure, the surgeon makes an incision in the lower abdomen and places the new kidney. This is done only after the old one is removed totally and the blood vessels are clutched so as to prevent bleeding. The blood vessels of the new kidney are attached to blood vessels in the lower part of abdomen, just above one of legs. The new kidneys ureter — the tube that links the kidney to the bladder — is connected to bladder. Doctors and nurses monitor the patient’s condition in the hospitals transplant recovery area to watch for signs of complications. The new kidney is expected to make urine in a manner similar to the old one while it was healthy. Often this starts immediately. In other cases it may take several days. Soreness and pain around the site of incision is common to see during such times.

Post Surgery:

Most kidney transplant recipients can return to work and other normal activities within three to eight weeks after transplant. No lifting objects weighing more than 10 pounds or exercise other than walking until the wound has healed. A close monitoring is also needed once the patient gets a discharge from the hospital. This includes weekly blood tests, timely change in the course of medications if need be. Drugs called immunosuppressants (anti-rejection medications) help keep the immune system from attacking and rejecting ther new kidney. Additional drugs help reduce the risk of other complications, such as infection, after the transplant.

After the kidney transplant, the patient may need to adjust diet to keep new kidney healthy and functioning well. The patient may have fewer dietary restrictions than if he or she were receiving dialysis therapy before the transplant, but this may still be need to make some diet changes. A nutrition specialist can be appointed to discuss the nutrition and answer the questions of the patient. Some of the medications may increase the appetite and make it easier to gain weight. But reaching and maintaining a healthy weight through diet and exercise is just as important for transplant recipients as it is for everyone else to reduce the risk of heart disease, high blood pressure and diabetes. A monitoring also is required of how many calories the patient is consuming or limiting food high in sugar and fat.

Some of the tips given below can be helpful:

  • Eating at least five servings of fruits and vegetables each day
  • Avoiding grapefruit and grapefruit juice due to its effect on a group of immunosuppression medications (calcineurin inhibitors)
  • Having enough fiber in your daily diet
  • Drinking low-fat milk or eating other low-fat dairy products, which is important to maintain optimal calcium and phosphorus levels
  • Eating lean meats, poultry and fish
  • Maintaining a low-salt and low-fat diet
  • Following food safety guidelines
  • Staying hydrated by drinking adequate water and other fluids each day.

Exercise and physical activity should be a regular part of the patient’s life after a kidney transplant to continue improving the overall physical and mental health. After a transplant, regular exercise helps boost energy levels and increase strength. It also helps to maintain a healthy weight, reduce stress and prevent common post-transplant complications such as high blood pressure and cholesterol levels. Soon after your transplant, patients are advised to walk as much as they can. Walking, bicycling, swimming, low-impact strength training and other physical activities can all be a part of a healthy, active lifestyle after transplant. But be sure to check in with your transplant team before starting or changing your post-transplant exercise routine.

Complications And Risk Factors Associated With Kidney Transplant:

  • Smoking, alcohol and tobacco consumption pose a great risk for people undergoing a kidney transplant. This mostly results in the form of
  • Obesity follows next in line as a major risk factor
  • Uncontrolled hypertension and diabetes make transplant a difficult option
  • Mental retardation and drug abuse make it difficult for the patient to understand and adapt to the procedures being done on him or her
  • HIV positive is a threat to transplant of kidney owing to the reduced levels of immunity and greater chances of organ rejection

Am I Good Candidate For Kidney Transplant:

You are eligible for a kidney transplant if you fulfill the following criteria:

  • Suffering from chronic irreversible kidney damage
  • You seem to have a good major surgery tolerance, in the sense you do not have any major illness
  • You do not suffer from any autoimmune disorders so that the kidney you will receive shall not face any signs of rejection and further harm the body

Recovery Time:

It will take the patient a minimum of six to eight weeks to recover from the surgery and start with daily routine. A continuous monitoring of the diet, regular exercise and medications is a must for at least a year under the supervision of the nutritionalist.

Success Rate:

  • In about 4 percent of cases, a kidney transplanted from a deceased donor may fail. The signs of failure are well observed in a span of one year.
  • Also if a five year observation period is taken into consideration, 21 percent of cases may show signs of failure.
  • Similarly in about 3 percent of cases receiving kidney from deceased donors, failures can be seen in a span of one year
  • In a five year observation period post the transplantation, 14 percent failures can be seen.

Benefits Of Kidney Transplant:

A kidney transplant will help you in the following ways:

  • Enable the body to form urine timely and expel the waste products from the body
  • Maintain a perfect balance of all that is to be reabsorbed into the body and all that needs to be thrown out via urine
  • Help in restoring the electrolyte balance in the body
  • Prevent water retention, swelling in feet, hands, wrists
  • Prevent dependence on dialysis machines and equipments

Cost comparisons:

A kidney transplant solely will cost you around 2 to 3 lakh in Indian hospitals, with an additional charge of one lakh including the hospital bills. This probably would be the collective amount of just the first day of your stay in hospital in the US/UK!

Why choose India:

The Indian medical tourism immensely focuses on the benefits people will acquire after being treated here. Organ transplantation is a procedure on rise worldwide which is being practiced with utmost care and concern in India. We not only assure a cost effective treatment plan, but also aim increasing the longevity of our highly esteemed clients.

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