KIDNEY TRANSPLANT
Introduction to Kidney Transplant
When the kidneys fail, treatment is needed to replace the work they can no longer do. When a patient gets a kidney transplant, a healthy kidney is placed inside the body to help it function better.
Need for Kidney Transplant
When the kidneys lose the filtering ability, harmful levels of fluid and waste accumulate in the body, which can raise the patient’s blood pressure and result in kidney failure (also known as end-stage renal disease). Common causes of end-stage renal disease include:
People with end-stage renal disease need to have waste removed from their bloodstream via a dialysis (haemodialysis or peritoneal dialysis) or a kidney transplant to stay alive. Kidney patients of all ages—from children to seniors—can get a transplant.
Haemodialysis
Patients need dialysis when they develop end stage kidney failure – usually by the time they lose about 85 to 90 percent of their kidney function. When the kidneys fail, dialysis keeps the body in balance by:
- Removing waste, salt and extra water to prevent them from building up in the body
- Keeping a safe level of certain chemicals in the blood, such as Potassium, Sodium and Bicarbonate
- Helping control blood pressure
Peritoneal Dialysis (PD) is a treatment for kidney failure where a special sterile fluid is introduced into the abdomen through a permanent tube that is placed in the peritoneal cavity. The fluid circulates through the abdomen to draw the impurities from surrounding vessels in the peritoneum, which is then drained from the body. Peritoneal dialysis can be carried out at home, at work or on trips but requires careful supervision.
Kidney Transplant evaluation process
The evaluation process for a transplant is very thorough. Here are the tests a patient has to undergo before it is decided that they are fit for a transplant.
It looks at the heart’s rhythm and will show if there are any abnormalities
Any issues in a patient’s medical and surgical history could complicate the surgery
This is done to make sure the patient does not have infections, cavities, or gum disease as they can cause problems post-surgery
The purpose of the psychosocial exam is to make sure the patient is emotionally prepared for the surgery, post-transplant care, and living with a new kidney
Used to check the function of your heart, kidneys, liver, thyroid, and immune system. Patients will also be checked for problems with blood sugar control and electrolyte balance
These include blood typing, tissue typing and cross-matching to ensure a suitable match to the patient’s kidney
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Living on Dialysis
If the kidneys have failed, patients will need to have dialysis treatments for their whole life unless they are able to get a kidney transplant. Life expectancy on dialysis can vary depending on the other medical conditions and how well the patients follow their treatment plan. Average life expectancy on dialysis is 5-10 years; however, many patients have lived well on dialysis for 20 or even 30 years.
One of the reasons for the short survival is that many patients with kidney failure are relatively elderly. The benefit of transplant is far greater in younger patients and a living donor kidney transplant provides more benefit than a deceased donor transplant.
Legal Requirements
The primary legislation, Transplantation of Human Organs ACT, was passed in 1994. As per this act, there are certain guidelines to be followed for receiving a transplant depending on the country of residence of the receiver or the state of life of donor. For more information, visit Legalities section of our website.
The Kidney Transplant Process
If a patient is on a waiting list for a deceased donor kidney, they must go to the hospital as soon as they receive notification that a kidney is available. If a family member or friend is donating the kidney that the patient will receive, they need to schedule the operation in advance.
Complications of Kidney Transplant
Kidney transplantation can treat advanced kidney disease and kidney failure, but it is not a cure. Some forms of kidney disease may return after transplant. Kidney transplant surgery carries a risk of significant complications, including:
- Blood clots
- Bleeding
- Leaking from or blockage of the tube (ureter) that links the kidney to the bladder
- Infection
- Failure of the donated kidney
- Rejection of the donated kidney
- An infection or cancer that can be transmitted with the donated kidney
Life After Kidney Transplant
After surgery, patients will probably feel sore and groggy when they wake up. However, many people who have a transplant report feeling much better immediately after surgery.
Success Rate and Life Expectancy of Kidney Transplant
As medicine progresses, so does the life expectancy of patients undergoing kidney transplant. There have been great strides taken in the last decade or two, which have increased the success rate and the life expectancy of patients.
Choosing the ideal kidney transplant centre
It is imperative that patients learn about different transplant centres around them before zeroing in on any one of them. A few things to keep in mind while choosing a transplant centre are:
- The centre/hospital’s reputation, mortality rates, technological expertise and team of doctors
- Whether the centre/hospital accepts your insurance coverage
- Locational advantage of getting to and from the patient’s home
- Whether the transplant/centre has particular expertise in living donor transplants or deceased donor transplant
- Consult more than one doctor and/or patients who have undergone a transplant in the centre and learn about their experience
- The amount of experience the centre/hospital have in dealing with transplant cases
Analysing cost of a Kidney Transplant
It’s important to consider the cost of any major surgery before a patient opts for it. Patients who opt for dialysis may need to spend almost Rs.25000 a month on 7 – 10 sessions.
It is suggested that patients check their insurance plans to check the coverage of Dialysis procedure as well as the transplant. The average cost of a kidney transplant ranges between 7 – 10 lakhs. This includes pre-transplant evaluation, the surgery itself and post-transplant recovery period. The costs generally depend on:
- Organ Recovery and Transport Charges
- Cost of dialysis before the transplant
- Hospital Infrastructure and Technology
- Expertise of skilled surgeons, their teams and use of advanced techniques
- Length of stay in the hospital and category of room opted
- Any health complications
- Recovery and Rehabilitation
- Post-transplant Medication
Patients who don’t live in the vicinity of the hospital and/or have travelled from another city for the transplant also need to keep in mind the cost of stay in the new city. Most patients and their families opt to find a house on a short-term lease in close proximity to the hospital. These costs can add up over the course of a few months.
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