A kidney transplant is a surgery done to replace a diseased kidney with a healthy kidney from a donor. The kidney may come from a deceased organ donor or from a living donor. Family members or others who are a good match may be able to donate one of their kidneys. This type of transplant is called a living transplant. People who donate a kidney can live healthy lives with one healthy kidney.
A person getting a transplant most often gets just 1 kidney. In rare situations, he or she may get 2 kidneys from a deceased donor. The diseased kidneys are usually left in place. The transplanted kidney is placed in the lower belly on the front side of the body.
Why Might I Need A Kidney Transplant?
You may need a kidney transplant if you have end stage renal disease (ESRD). This is a permanent condition of kidney failure. It often needs dialysis. This is a process used to remove wastes and other substances from the blood.
- Remove urea and liquid waste from the blood in the form of urine. Urea is made when foods containing protein, such as meat, poultry, and certain vegetables, are broken down in the body. Urea is carried in the blood to the kidneys.
- Balance salts, electrolytes, such as potassium and sodium, and other substances in the blood
- Produce erythropoietin, a hormone that aids the formation of red blood cells
- Regulate blood pressure
- Regulate fluid and acid-base balance in the body to keep it neutral. This is needed for normal function of many processes within the body
Some conditions of the kidneys that may result in ESRD include:
- Repeated urinary infections
- Kidney failure caused by diabetes or high blood pressure
- Polycystic kidney disease or other inherited disorders
- Glomerulonephritis, which is inflammation of the kidney’s filtering units
- Hemolytic uremic syndrome, a rare disorder that causes kidney failure
- Lupus and other diseases of the immune system
Other conditions, such as congenital defects of the kidneys, may result in the need for a kidney transplant.
There may be other reasons for your healthcare provider to recommend a kidney transplant.
Kidney Transplant Vs Dialysis
Dialysis is a process where a machine does the job of filtering and purifying the blood. However, the kidney also performs other functions, like producing hormones to regulate blood pressure and maintain electrolyte balance. A dialysis machine cannot do this. Haemodialysis is a type of dialysis that uses an artificial kidney (hemodialyzer) to filter wastes from blood.
Also, the lifelong cost of dialysis can work out to be expensive. You will also have to go to a dialysis centre regularly to get this done. There are many cities where these centres are not available nearby. Also, dialysis makes your blood super-clean and nutrient depleted and this blood keeps getting more and more toxic until the next dialysis session.
A kidney transplant works out to be more economical than lifelong dialysis. Kidney transplant price in India is much lesser than the cost of dialysis. It also lets you have a normal life as it is natural. Not only this, the survival rate and life expectancy of transplant patients are much better compared to people on dialysis. For example, it was found that the life expectancy of a person in the age group of 40 live 7.3 years on dialysis, but 22 years after a transplant.
After a successful transplant, you can live a normal, healthy life and even indulge in physical activities like swimming, cycling, etc. However, a person on dialysis will not be able to lead a normal healthy life and may not be able to travel to places where there are no dialysis centres. Thus, kidney transplantation is the best treatment option for a person with end-stage kidney disease.
Preparation For A Kidney Transplant
To get a kidney from an organ donor who has died (cadaver), you must be placed on a waiting list of the United Network for Organ Sharing (UNOS). Extensive testing must be done before you can be placed on the transplant list.
A transplant team carries out the evaluation process for a kidney. The team includes a transplant surgeon, a transplant nephrologists (healthcare provider specializing in the treatment of the kidneys), one or more transplant nurses, a social worker, and a psychiatrist or psychologist. Other team members may include a dietitian, a chaplain, and/or an anesthesiologist.
The evaluation includes:
- Mental health evaluation. Psychological and social issues involved in organ transplantation, such as stress, financial issues, and support by family and/or significant others are assessed. These issues can greatly affect the outcome of a transplant. The same kind of evaluation is done for a living donor.
- Blood tests. Blood tests are done to help find a good donor match, to check your priority on the donor list, and to help the chances that the donor organ will not be rejected.
- Diagnostic tests. Diagnostic tests may be done to check your kidneys as well as your overall health status. These tests may include X-rays, ultrasound, kidney biopsy, and dental exams. Women may get a Pap test, gynecology evaluation, and a mammogram.
The transplant team will weigh all the facts from interviews, your medical history, physical exam, and tests to determine your eligibility for kidney transplantation.
If you are to get a kidney from a living family member (living-related transplant), the transplant may be done at a planned time. The donor must have a compatible blood type and be in good health. A mental health check will be done to be sure the donor is comfortable with the decision.
These steps will happen before the transplant:
- Your transplant team will explain the procedure to you and you can ask questions.
- You will be asked to sign a consent form that gives your permission to do the surgery. Read the form carefully and ask questions if something is not clear.
- If you have been on routine dialysis before the procedure, you will get dialysis before the procedure.
- For a planned living transplant, you should fast for 8 hours before the operation, generally after midnight. In the case of a cadaver organ transplant, you should start to fast once you are told a kidney has become available.
- You may get a sedative before the procedure to help you relax.
- Based on your medical condition, your transplant team may ask for other specific preparation.
To Prevent Rejection
To allow the transplanted kidney to survive in your body, you will be given medicines for the rest of your life to fight rejection. Each person may react differently to medicines.
New ant rejection medicines are continually being developed and approved. Your healthcare team will tailor medicine regimes to meet your needs.
Usually several ant rejection medicines are given at first. The doses of these medicines may change often, depending on your response. Because ant rejection medicines affect the immune system you will be at higher risk for infections. A balance must be maintained between preventing rejection and making you very susceptible to infection.
Some of the infections you will be especially at risk for include oral yeast infection (thrush), herpes, and respiratory viruses. Avoid contact with crowds and anyone who has an infection for the first few months after your surgery.
Kidney Transplant Cost In India
The charge of renal transplant varies from the determination and condition of the patient. Along with that, the kidney transplant cost varies from one hospital to another. Most kidney transplant procedures don’t demand any imported material. If we make an estimate, so 5 to 20 lakh, a kidney transplant surgery costs you.
Paired Kidney Matches
Paired kidney donors are a pair of people who want to donate their kidney to a family member or friend, but are not a good match. For example, if patient A is not a good match to donor B, but is a good match to an unrelated patient C. At the same time, patient C’s donor D is a good match to patient A. In such a case, donor D will donate a kidney to patient A and donor B will donate a kidney to patient C. Thus, both patients get a kidney from unrelated donors.
Cadaveric donors are deceased people. They are people who have died as a result of an accident or injury. Either they or their family members have chosen to donate organs after death. When a person is brain dead, the heart still keeps pumping – for hours or even days. As a result, the internal organs are still working and alive, though the person is no more.
If a person is declared brain dead, and has chosen to donate his/ her organs after death, the person’s body is rushed to the operating room and the organs for donation are removed and preserved until they can be transplanted into the recipient. Thus, it is possible for a dead person to donate a kidney that will start working in the recipient’s body.
Life Expectancy After A Kidney Transplant
People in the age group of 40 can have a life expectancy of around 22 years after a kidney transplant, while people in the age-group of 50 have a life expectancy of 16 years. People in their 60s have a life expectancy of 11.5 years after a successful kidney transplant.]
List of Best 10 Kidney Transplant Centres
- Aster MIMS Hospital, Kozhikkode
- VPS Lakeshore Hospital, Eranakulam
- Aster Medicity, Eranakulam
- Metromed International Cardiac Centre, Kozhikkode
- Meitra Hospital, Kozhikkode
- Baby Memmorial Hospital, Kozhikkode
- Iqra Internation Hospital, Kozhikkode
- Amrita Institute of Medical Sciences (AIMS)
- Kerala Institute of Medical Sciences, Thiruvananthapuram
- Lourdes Hospital