A kidney transplant is a surgical procedure of placing a donated kidney from a deceased or a living person inside the person whose kidneys have stopped working. This kidney failure can be the result of a variety of reasons including ageing, diabetes, high blood pressure, or any disease that diminishes the function of the kidney with time
The kidneys are bean-shaped organs that are found one on each side of the spine just under the rib cage. The main function of the kidneys is to filter and remove the waste of the body in the form of minerals and fluids. In short, the kidneys produce the urine as a waste product of the body.
With the loss of kidney function, the waste begins to get accumulated in the body, increasing the levels of these toxins and minerals beyond the harmful levels. This, then eventually results in kidney failure, which is the loss of more than 90% of the function of a kidney. However, kidney transplant is often the last stage of the treatment of end-stage kidney failure as a number of patients often continue their life with Dialysis.
Why is Kidney Transplant Done?
It is a viable option for people who wish to not opt for a lifetime of dialysis. Also, it is a great option for people suffering from chronic kidney disease and end-stage renal failure. The main aim of a kidney transplant is to provide better comfort, longer life expectancy, fewer diet restrictions, and overall reduced risk of treatment when compared to dialysis.
Types of Kidney Transplant
Kidney transplant is categorized into 3 types, based on the type of procedure that is followed during the treatment.
- Deceased Donor Transplant
Deceased donor transplants are when the kidney comes from a person who decided to donate their organs after their death. It is the most common type of kidney transplant and often has a waitlist attached with it.
- Living Donor Transplant
In this transplant, the donor's kidney comes from a living person who is willing to donate one of his kidneys to someone, especially a blood relative, to save their life. A person can live with just one kidney, and by donating a kidney to someone in need, a living donor can save one life.
- Preemptive Kidney Transplant
These are special transplants performed for people with extreme cases before the beginning of dialysis. A rather uncommon form of a kidney transplant, preemptive transplants are performed because of certain benefits that they present.
What to Expect?
You need to make sure that before the transplant, it is important to maintain your healthy and proper body weight to avoid any complications that may arise during the transplant, or may postpone the transplant altogether. This is because our specialized team will evaluate you based on a number of factors, one of which includes your ability and health to tolerate the life-long implications of surgery. You would also be checked for any other medical condition that may hinder with the transplant.
Post this, you will be going through a tests, which may continue for a few days. These tests include:
- Blood tests
- Imaging like X-rays, MRIs, and/or CT Scans
- Physical and psychological evaluation
- Other tests depending on the doctor’s evaluation.
After this evaluation, the doctors will then put you on a priority list, so you can either get a kidney or find a suitable candidate for getting a living donor's kidney.
Before the Procedure
A match for a kidney transplant is determined based on compatibility judged by a number of factors. The major aim is to find a kidney that will match with the receiver's body type and blood type, and will not face rejection from the body's immune system. For this purpose, the doctors follow a few specific guidelines and tests that include:
- Blood Type: A matching or compatible blood type is important as it reduces the risk of organ rejection.
- Tissue Type: Tissue typing or HLA matching (human leukocyte antigen) is the next step. This compares the genetic markers that match to increase the likelihood of success of a transplant. This also ensures that the kidney will last longer.
- Crossmatching: Crossmatching is the process off mixing your blood with the donor's blood in order to determine whether the antibodies will react to the antigens in the donor's blood. This again has to do with organ rejection, which means a negative crossmatch is desirable.
As mentioned earlier, it is important to maintain your health before the transplant in order to not face any complications during the procedure. Apart from that, staying healthy is an important step towards ensuring that your body will be able to take the load of the procedure, and will recover faster after the transplant. For ensuring this, you must:
- Take prescribed medications
- Follow diet and exercise as guided
- Get involved in healthy activities
- Don’t smoke
Your doctor and our team will stay in touch with you so they can keep you updated and monitor your progress. In the meantime, it is advised that you stay ready for the transplant, pack a separate bag and keep it handy. We will make all the travel arrangements and take care of all other logistics and formalities involved in the process.
During the Procedure
Kidney transplants are done with general Anaesthesia, meaning that you will not be awake at the time of the procedure. The surgeon makes an incision in the lower abdomen and places the new kidney in your body, attaching the blood vessels and the ureter of the new kidney into the body. Unless the old kidneys cause a problem like high blood pressure, kidney stones, pain or chances of infection, they are left in place inside the body.
The surgeon will then close the incision and send you to recover into the intensive care unit.
After the Procedure
After the completion of the transplant, you should expect to wake up in the ICU as this is where the doctors and their team will monitor you for any complications or rejection. This is how your recovery period will go like:
- ICU: You will spend some days in ICU where the new kidney will begin to work for you just like the old ones used to when they were healthy. This may either start immediately or may take some time. During this time, you may be put on temporary dialysis to help the body in cleaning up.
- Hospital Stay: You will continue recovering in the hospital for a few more days, where soreness and pain around the incision site may continue to bother you.
- Recovering From Home: People usually take about 8 to 10 weeks to return to their usual activities. Lifting a weight higher than 5 Kgs is not advised, while exercises other than walking are not recommended until the incision has healed.
- Diets, schedules, and appointments: You will also be provided with a diet plan, exercise schedule, and check-up schedule with our partner doctors in your own country.
- Medication: You will be instructed to take medicines for the rest of your life in order to supplement your system, and suppress your immune system from attacking your new kidney.
We are known to the world around to provide the services of some of India’s best and top doctors for patients arriving from all over the world. With world-class hospitals and highly experienced doctors at your service, you can get the best care in the world for kidney transplant services.
Kidney Transplant’s Pre-conditions:
- It is preferable that the donor should a first degree family member with the same or compatible blood group. Other relatives can also be considered but with proper documents and DNA typing to support their relationship.
- The donor should be mentally and physically fit
- He/She should be between the age group of 18 and 60 years
- The donot should not be suffering from chronic diseases such as HIV, Severe Hypertension, Hbs Ag, Diabetes etc
- The donor and the attendant should be near relatives.
Necessary Formalities to be completed in India:
Step1: Obtaining No Objection Certificate from the respective embassy in Delhi. Furnish the following documents at the Nigerian Embassy:
- A letter on the hospital’s letter head telling that the patient is undergoing the treatment
- Old medical reports and health records
- A small summary of the case or medical history of the patient (if referred)
- An affidavit from the local government authority stating that the patient and the donor are relatives (mandatory for all Foreign Patients).
- 10 photographs each (patient and donor)
- Salary slip or bank statement of both patient and donor as the Income proof
- The consent from the next of kin of donor on a stamp paper that should carry donor’s and kin’s photograph, duly pasted. In case the donor is a cousin, it is necessary for the next of kin to be present at the Transplant Authorization Committee.
- Birth certificate or marriage certificate etc as proof of relation
Step 2: The patient is required to go to the SDM office along with the donor and the relative for getting the affidavit of donor, attested by him. Following documents are needed at the SDM office:
- A letter on the hospital’s letter head telling that the patient is undergoing the treatment.
- NOC from the Embassy
- Affidavit patient
- Affidavit donor
- Affidavit relative
Step 3: Notary attests the affidavits of the patient and the relative. This takes a time of a day or two.
Step 4: After the affidavits get attested, these documents are taken to the Authorization Committee of the hospital for approval. At the same time, the concerned doctors conduct some important tests on the patient and the donor. All this takes around 2 week’s time.
Kidney transplantation is a procedure that places a healthy kidney from another person into your body. This one new kidney takes over the work of your two failed kidneys.
A surgeon places the new kidney inside your lower abdomen and connects the artery and vein of the new kidney to your artery and vein. Your blood flows through the new kidney, which makes urine, just like your own kidneys did when they were healthy. Unless they are causing infection or high blood pressure, your own kidneys are left in place.
Benefits of Kidney Transplant
A successful kidney transplant can benefit the patient drastically. The patient will be able to get back to its normal lifestyle after the surgery and can go for a normal diet and opt for more fluid intake. After transplant the patient need not to depend on dialysis. Anemia which is a common problem with kidney failure might also be corrected. The success rate depends on the type of organ transplanted, by the number of organs transplanted and the type of disease that caused the organ to fail. For single organ transplants the success rate is 80 % to 90 % of and a 5-10 year survival rate.
Post Transplant Care
Your body's immune system is designed to keep you healthy by sensing "foreign invaders," such as bacteria, and rejecting them. But your immune system will also sense that your new kidney is foreign. To keep your body from rejecting it, you'll have to take drugs that turn off, or suppress, your immune response. You may have to take two or more of these immunosuppressant medicines, as well as medications to treat other health problems. Your health care team will help you learn what each pill is for and when to take it. Be sure that you understand the instructions for taking your medicines before you leave the hospital.
If you've been on hemodialysis, you'll find that your post transplant diet is much less restrictive. You can drink more fluids and eat many of the fruits and vegetables you were previously told to avoid. You may even need to gain a little weight, but be careful not to gain weight too quickly and avoid salty foods that can lead to high blood pressure
You can help prevent rejection by taking your medicines and following your diet, but watching for signs of rejection-like fever or soreness in the area of the new kidney or a change in the amount of urine you make-is important. Report any such changes to your health care team.
Even if you do everything you're supposed to do, your body may still reject the new kidney and you may need to go back on dialysis. Unless your health care team determines that you're no longer a good candidate for transplantation, you can go back on the waiting list for another kidney.
Side Effects of Immunosuppressants
Immunosuppressants can weaken your immune system, which can lead to infections. Some drugs may also change your appearance. Your face may get fuller; you may gain weight or develop acne or facial hair. Not all patients have these problems, though, and diet and makeup can help.
Immunosuppressants work by diminishing the ability of immune cells to function. In some patients, over long periods of time, this diminished immunity can increase the risk of developing cancer. Some immunosuppressants cause cataracts, diabetes, extra stomach acid, high blood pressure, and bone disease. When used over time, these drugs may also cause liver or kidney damage in a few patients.