Kidney Transplantation | Organ Transplant
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    Kidney failure or End Stage Renal Disease (ESRD) is best treated by means of a kidney transplantation. Prior to doing this transplant intensive knowledge about the procedure and the outcome is required for the patients, living donors as well as family members. If the donors are within the family, the family members are intricately involved in the care process, including decision making and follow-up lifestyle changes.

    Kidneys for transplantation come from two different sources – living donors or non-living (cadaveric) donors. Living donors are usually immediate family members or sometimes spouses. Cadaver kidneys are obtained from persons who have donated their kidneys/organs before their death. 

    The kidneys functions to serve the body in the following ways 


    • To remove waste products and water from the blood 
    • Maintain control on blood pressure 
    • Maintain the fluid content in the body 
    • Helps to produce red blood cells (RBC) 
    • Produce Vitamin D to keep bones strong and healthy 
    • Control the amount of potassium, calcium, magnesium and phosphorus in the blood 

    Symptoms 


    Symptomatic indication of kidney disease appear slowly over a long period of time. As a reason one tends to overlook most of the indications. 

    Typical symptoms are the following. 

    • Swelling in parts of the body because of excess fluid retension leads to a condition known as edema. Typical indications are swelling in the hands, ankles, feet, or face. Fluid also can get collected in the lungs causing difficulty in breathing
    • A decrease in production of a hormone called erythropoeitin, leading to a low red blood cell count. This causes Anemia leading to headache and lack of concentration due to lack of oxygenated blood to the brain. This could also lead to dizziness and lack of proper sleep
    •  Abnormal urine or blood count can occur due to excess fluid retension. The frequency of urination may be less or more, in certain cases changes in presuure or difficulty in urinating will be there. There could also be traces of blood in the urine
    • Loss of appetite and distaste can occure due to build up of waste in the blood. Skin irritations like rashes or an itchy skin can occure due to waste build up in the blood. This can also lead to cramps or sore in the leg and could lead to a nerve damage
    • In addition to the symptoms above high blood pressure can occur. This is due to more water and salt content in the blood thus increasing the pressure in your blood vessels
    BRIEF ABOUT THE PROCEDURE

    Tests

    This procedure demands a lot of mecical tests, the transplant surgeon will decide on the tests that you will need. People with diabetes will need more tests for their heart. 

    Apart from a physical examination, a Chest x-ray, electrocardiogram (EKG or ECG) and an Ultrasound with Doppler examination to determines the quality of the iliac vessels may be done. 

    Dental Evaluation, Blood tests, Blood typing, Pulmonary function test, Upper gastrointestinal test (to ensure the patient's esophagus and stomach are disease free), Lower gastrointestinal test (to ensures that the patient is free of intestinal abnormalities), Renal function test, serum & creatinine tests, tissue typing, viral tests etc are the typical tests done. 

    A Mammogram and Pap smear would be done in addition to the above for female recipients. 

    Histocompatibility tests may include Crossmatch Testing, Tissue Typing and Panel Reactive Antibod. These would determine how your body will respond to the transplant organ. 

    Procedure 

    The procedure is done under general anesthesia and takes approximately 5 hours. 

    In a Kidney transplantation procedure a healthy kidney is placed into the body to perform all of the functions that a failing kidney cannot. The diseased kidneys are not removed unless one has uncontrolled hypertension, repeated infection and backup of urine into the kidneys. 

    The kidney is placed commonly in the right or left iliac fossa. In certain cases the the kidney is placed extra-peritoneally by creating and dissecting a pocket between thkidney transplante peritoneum and the abdominal wall. The bladder is expanded with 200 to 300 ml of saline containg antibiotic. A midline incision is done from the pubic bone to 5 cm above the umbilicus. The new kidney is positioned and the blood vessels and urinary bladder are attached. The vein and artery of the new kidney are attached to your vein and artery. 

    The new kidney usually begins functioning immediately. Normal functioning levels in the case of liver from a iving donor typically requires 3 to 5 days. In the case of a Cadaveric donor, it may require 7 to 15 days. Four to seven days hospitalisation would be required after surgery. 

    Kidney transplants are a life extending procedure and typically add ten to fifteen years of life to the recipient. In younger patients life gained is much more. 

    Risks and Complications 

    Transplant rejection, Infections and sepsis, Post-transplant lymphoproliferative disorder, Imbalances in electrolytes including calcium and phosphate which can lead to bone problems are among the few complications that can occur. Side effects of medications may include gastrointestinal inflammation and ulceration of the stomach and esophagus, hirsutism (excessive hair growth in a male-pattern distribution), hair loss, obesity, acne, diabetes mellitus, hypercholesterolemia etc.

    • Living donor

    This involves removing a kidney from a healthy living donor and implanting it into a recipient

    The donor, who may be a blood relative, spouse or friend, will have extensive medical and psychological evaluations to ensure the lowest possible risk

    Their health must also be stable enough to undergo transplantation with excellent chances of success

    • Deceased Donor
    In deceased donor kidney transplant, the donor may be a victim of an accident or head injury. The donor's heart is still beating, but the brain has stopped functioning. Such a person is considered legally dead, because his or her brain has permanently and irreversibly stopped working. At this point, the donor is usually in an intensive-care unit.
    The identity of a deceased donor and circumstances surrounding the person's death are kept confidential.

    RELATED ARTICLES

    The other Organ Transplant Procedures are:

    • Lung Transplantation
    • Bone Marrow Transplantation
    • Cornea Transplantation
    • Heart Transplantation… etc
    HOSPITALS FOR KIDNEY TRANSPLANT

    Few Major Hospitals for Kidney Transplant are:

    DESTINATIONS FOR KIDNEY TRANSPLANT

    Thailand, Malaysia, Singapore, Turkey and India are the most cost effective locations that offer up to almost 80% savings in comparison to the US.

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