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Kidney Transplant Surgery

At Wockhardt Hospitals, Our philosophy is to serve and enrich the quality of life of our patients giving them a winning edge to live life to the fullest. The gift of saving a human life is probably the most compassionate deed of all, where you can give or receive a second chance to normal and healthy life.As part of our endeavour to create awareness on different   health issues we would like to provide you information on a life-giving procedure carried out at Wockhardt Hospitals.

Let’s ‘understand the importance and benefits of kidney transplant and its various aspects.

 

1.What is the importance of the Kidney and its functions?

  • The kidneys are two bean-shaped organs situated in the back muscles (on either side of the spine) of the upper abdominal cavity in our body.
  • The main function of the kidney is to filter the blood circulating through your body by removing waste and excess salts and regulate the water fluid levels.
  • They are also responsible for regulating pH, salt, and potassium levels in the body.
  • Produce hormones that regulate blood pressure and control the production of red blood cells.
  • Activate a form of vitamin D that helps the body absorb calcium.

 

2.What are some of the kidney diseases?

a) Chronic Kidney Disease

  • The most common form of kidney disease is chronic kidney disease caused by high blood pressure and diabetes.
  • Kidney failure is the last (most severe) stage of chronic kidney disease.  This called end-stage renal disease or ESRD for short.
  • Other causes include, Autoimmune diseases, such as lupus/SLE and IgA nephropathy ,Genetic diseases ,polycystic kidney disease, Nephrotic syndrome and Urinary tract problems

 

b) Acute Renal Failure:

  • This type of kidney failure is called acute kidney injury or acute renal failure and is of sudden onset. .
  • Common causes of acute renal failure include Heart attack, Illegal drug use and drug abuse, not enough blood flowing to the kidneys, Urinary tract problems. However this type of kidney failure is not always permanent.

 

 

3.What are the common symptoms of kidney failure?

  • Nausea
  • Vomiting
  • Loss of appetite
  • Changes in urine output
  • Fluid retention
  • Anemia (a decrease in red blood cells)
  • Decreased sex drive
  • Shortness of breath

 

4.When is a patient advised for kidney transplant?

A person is advised kidney transplant in the following conditions

 Kidney Failure - Permanent (CKD Chronic Kidney Disease)

 

5. What is the treatment option a patient has for kidney failure?

The three treatment options Renal Replacement therapy.

  • Haemodialysis
  • Peritoneal Dialyses
  • Renal Transplantation for treating kidney failure.

 

6.What is kidney transplant?

  • A kidney transplant is a surgical procedure which allows a person whose own kidneys have failed to receive a new kidney (recipient) from another person.(donor)  A successful kidney transplant can improve many of the complications of kidney failure and is the best solution to patients whose kidneys have stopped working or are close to failing.
  • The functioning kidney is removed either from a living donor or someone who is certified as having brain death.
  • A transplanted kidney performs all the functions of a kidney a person has from birth
  • Patient who are diagnosed with end stage kidney diseases are candidates for kidney transplantation. In other words the kidneys are not functioning optimally.

 

7.What are the types of kidney transplants available?

A) Living donor transplant: Become a Donor Today & Save a Life!

A living donor may be someone in your immediate or extended family, or it may be your spouse or a close friend. In some cases, a living donor may even be a stranger who wishes to donate a kidney to someone in need of a transplant.

Advantages of Live Donor Transplant are as follows:

  • Receiving a kidney from a living donor has shown   to last longer than a kidney from a deceased donor.
  • The operation can be planned to suit your schedule, since it is not necessary to wait for a kidney to become available from a deceased donor.

B) Deceased donor (cadaver donor) is someone who has consented to donating his or her organs upon death. In situations where the wishes of the deceased donor are not known, family members may consent to organ donation.

Speciality Areas
  • Laparoscopic nephrectomy

    This technique is more commonly used today in kidney donor procedures. It involves making several incisions of a couple of inches long in the abdomen. These incisions, called "ports,” allow the insertion of the laparoscope (camera) and other surgical instruments into the abdomen....

     

  • Open nephrectomy

    This procedure opens the abdomen and involves making an incision up to 10 inches long along the bottom of the lower rib to the midriff.A different option for the open nephrectomy starts with an incision further on the back along the side to the front.  However, a portion of the rib may have to be removed.Depending on the technique used, the surgeon will cut...

     

Doctors

FAQs

When is a patient advised for kidney transplant?

A person is advised kidney transplant in the following conditions” Kidney Failure - Permanent (CKD Chronic Kidney Disease

What is the treatment option a patient has for kidney failure?

What is the treatment option a patient has for kidney failure?

  • Haemodialysis
  • Peritoneal Dialyses
  • Renal Transplantation for treating kidney failure.
What is kidney transplant?

  • A kidney transplant is a surgical procedure which allows a person whose own kidneys have failed to receive a new kidney (recipient) from another person.(donor) A successful kidney transplant can improve many of the complications of kidney failure and is the best solution to patients whose kidneys have stopped working or are close to failing.
  • The functioning kidney is removed either from a living donor or someone who is certified as having brain death.
  • A transplanted kidney performs all the functions of a kidney a person has from birth
  • Patient who are diagnosed with end stage kidney diseases are candidates for kidney transplantation. In other words the kidneys are not functioning optimally.

What are the types of kidney transplants available?

  • Living donor transplant: Become a Donor Today & Save a Life! A living donor may be someone in your immediate or extended family, or it may be your spouse or a close friend. In some cases, a living donor may even be a stranger who wishes to donate a kidney to someone in need of a transplant. Advantages of Live Donor Transplant are as follows:
  • Receiving a kidney from a living donor has shown to last longer than a kidney from a deceased donor.
  • The operation can be planned to suit your schedule, since it is not necessary to wait for a kidney to become available from a deceased donor. Deceased donor (cadaver donor) is someone who has consented to donating his or her organs upon death. In situations where the wishes of the deceased donor are not known, family members may consent to organ donation.

What are the investigations required?

 

  1. 1)Glomerular filtration rate (GFR) is the best measure of kidney function and these determine the stages of kidney disease in patients : Stage 5 End Stage CKD (GFR <15 mL/min) – INDICATOR FOR TRANSPLANT
  2. Creatinine levels: when kidneys are working well they remove creatinine from the blood. As kidney function slows, blood levels of creatinine rise is also another indicator.
  3. Basic Renal Function test
  4. Measurement of kidney function(measuring GFR by DTPA Scan)
  5. HLA typing & cross match.

 

What are the benefits of kidney transplant vs dialysis?

The main benefit of successful kidney transplant offers a better quality of life than dialysis. This is because a transplant allows for:

  • Considerably greater freedom (no need to spend time on dialysis),
  • increased energy levels,
  • Less restricted diet.
  • In addition, studies have shown that people who receive kidney transplants live longer than those who remain on dialysis
How does the kidney function improve in Dialysis and KidneyTransplant therapy?

 

Functions of Kidney

Dialysis

Kidney Transplant

A)

Excretion of Excess  volume (Water)

Y

Y

B)

Removal of Urea, creatine, uric acid & other toxins

Y

Y

C)

Removal of Excess potassium and Excess Acid in Blood

Y

Y

D)

Formation of Blood (Red Blood cell Synthesis)

N

Y

E)

Synthesis of Vit D & maintenance of good Bone health

N

Y

F)

Removal of Middle molecules(Uremic toxins)

Y/N

Y

G)

Functioning  through  the day

3 week 4hrs one session

Y

H)

Maintains  good Neurological Health status

Y/N

Y

I)

Maintaining Normal levels of hormonal functions

N

Y

J)

Maintaining Reproductive function for active sexual life

Y/N

Y

Who is eligible for a kidney transplant?

Eligible kidney transplant recipients include patients with:

  • Kidney failure who are either on dialysis or creatinine clearance to less than 20cc/minute
  • A creatinine clearance between 20 - 35 with significant symptoms
  • Progressive renal dysfunction in diabetic nephropathy
  • Polycystic kidney disease with a suitable living donor available.
Who is not eligible for a kidney transplant?

The following conditions may make a patient ineligible for a kidney transplant:

  • Cancers that have occurred within the past five years and cancers that have metastasized
  • Untreated or uncontrolled major psychiatric illness because of medication compliance
  • Progressive renal dysfunction in diabetic nephropathy
  • Non-rehabilitated substance abuse.
Who can be a living donor?

A living donor should be preferably family member, otherwise friend can give as long as they are a medical compatible for you and approval from appropriate government authority is obtained.What is the precondition for a living donor?

  • All living donors must make a free and independent choice
  • They must understand the medical risks to donating a kidney.
  • Living donors will have a number of medical tests to help ensure they are healthy enough to donate
  • Preferably the donor should be a near relative of the recipient (1st relative).
  • If he is not a first relative (non-relational donor), the most important criteria is that the donor must donate the section of his liver ‘Voluntarily’ and “Out of Affection” to be legally compliable.
  • Also a PATIENT who is not having Prior kidney Disease. AND is not Loosing Protein in Urine or has a history of Angioplasty or Bypass surgery
  • Donar must be Neurologically& mentally fit to understand the procedure and indications

PLEASE Understand you can go for kidney transplant also:

A) HIV Positive & having kidney failureB) Having Hepatitis B/C infectionC) Having Diabetes ,Liver Failure along with Kidney failure.D) Your family members Blood Group is not same as youE) What can I do if my & my donor Blood Group Different –1.( Across Blood Group Transfers)2.Swap Transplant (Paired Exchange Transplant):A Swap transplant involves an exchange of organs between two families, who cannot donate the organ to their own family member because of blood group mismatch or positive cross match. This is in a sense ‘paired exchange’. This would minimize this shortfall of organs and increase transplant numbers legally. In this method there is a mechanism for organ sharing between two unrelated donor-recipient pairs. Details of such transplants and requirement are maintained in a SWAP Registry to assist patients and doctors.WHEN IS THE OPTION OPTED FOR?Patients with kidney failure who have a family donor, but the blood groups are incompatible.Patients with kidney failure who have a blood group compatible donor, but their lymphocyte cross-match is positive.Patients with kidney failure who have a suitable donor within the family, but such a donor has tested positive for Hepatitis B or C.Patients who have an elderly donor or a marginal donor with a compatible group can also register to get a donor who is better
How would I be matched for a kidney from a deceased donor?
  • When a transplant team gets an organ offer for one of its patients, it reviews detailed medical information about the donor.
  • The hospital in-charge and the Consultant verifies the recipient’s medical profile and all the details.
  • The recipient is placed on a waiting list of either a hospital or a network of hospitals, in order to effectively connect donors and recipients
  • The team will then decide whether to accept the offer for their candidate. If the offer is turned down for one candidate, it goes to the next person on the transplant waiting list.
  • Kidneys that are likely to function for the longest amount of time are considered first for candidates who are likely to need them the longest.
  • Other factors in matching include how closely the donor’s blood and tissue type matches the patient, how long the candidate has needed a kidney transplant, and how close the transplant hospital is to the donor hospital.
  • The hospital call needy patient as per list provided by ZTCC (Zonal transplant co ordination committee)
  • The recipient is informed about the donor and that the transplant may take place
Is there a waiting time for kidney from a deceased donor?

Yes, unfortunately, there are not enough organs available for everyone who needs a kidney Transplant. Your transplant team will provide this information.

What does the transplant operation involve?
  • The kidney transplant operation involves surgically opening the lower part of your abdomen to place the new kidney inside
  • The kidney will be put into the right or left side of the lower abdomen, just above the front of your hip bone. The blood vessels of the new kidney are connected to your existing blood vessels, and the ureter (urine tube) is connected to your bladder
  • The operation usually takes about three to five hours.
How long is the hospital stay?
  • Donar: 3-5 days
  • Recipient: 7-9 days
What are the signs of rejection of the organ?
  • General discomfort, uneasiness, or ill feeling
  • Pain or swelling in the area of the organ (rare)
  • Fever (rare)
  • Flu-like symptoms, including chills, body aches, nausea, cough, and shortness of breath. Reduced urine output.
How is the antirejection prevented and monitored in the body?( Do we need to add this)
  1. Antirejection medications (also called immunosuppressant) will be given by the doctor like cyclosporine, tacrolimus, sirolimus, or everolimus.
  2. A steroid, such as prednisone, and a third medication, such as mycophenolate or azathioprine
  3. Fever (rare)
  4. Regular check-ups at your transplant center will help find and treat signs of rejection.
What other types of medication will I need to take after the surgery?
  1. In addition to antirejection medications many patients may need to take medications for blood pressure and to prevent infections and stomach ulcers.
  2. Patients will also receive antibiotics for a few weeks or months following transplantation to reduce the risk of common infections
  3. Regular check-ups at your transplant center will help find and treat signs of rejection.
Will I need to follow a special diet?
  1. One advantage of a successful kidney transplant is that there are few dietary restrictions. If you were on dialysis before, you may now be able to eat more of the foods you had to avoid.
  2. Your doctor and dietitian will change your diet as needed
  3. Generally, transplant recipients are advised to eat a heart-healthy diet (low fat, low salt) and drink plenty of fluids.What are the chances that the transplanted kidney will continue to function normally?
  4. A number of factors affect the success of kidney transplantation. Generally, the chances that a transplanted kidney will continue to work correctly are between 89 and 95 percent for one year after the operation.
  5. Continuous research and medical advancement has led to improvements in surgical techniques, preservation of donated kidneys, and antirejection drugs has made transplant successful overall.
  6. In the event that a transplanted kidney fails, a second transplant may be a good option for many patients.
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