Introduction: Kidney transplantation or renal transplantation is the organ transplant of a kidney into a patient with end-stage renal disease. Kidney transplantation is typically classified as deceased-donor (formerly known as cadaveric) or living-donor transplantation depending on the source of the donor organ. Living-donor renal transplants are further characterized as genetically related (living-related) or non-related (living-unrelated) transplants, depending on whether a biological relationship exists between the donor and recipient.
The decision to have a kidney transplant is an important one. A kidney transplant is not a cure for kidney disease. The decision to have a kidney transplant will mean that you are willing to make a life-long commitment to take care of yourself and your new kidney.
What is a Kidney? In humans, the kidneys are two small organs located near the vertebral column at the small of the back. The left kidney lies a little higher than the right kidney. They are bean-shaped, about 4 in. (10 cm) long and about 21/2 in. (6.4 cm) wide.
The kidneys have a couple of different functions. The main purpose of the kidney is to separate urea, mineral salts, toxins, and other waste products from the blood. The kidneys also conserve water, salts, and electrolytes.
Although humans are born with two kidneys, it is possible for a person to survive with only one. This is because each kidney is packed with renal tissue, which is more than enough for daily use and is quite capable of carrying out the necessary functions all on its own.
What is Kidney Transplantation?
Kidney transplantation is a surgical operation in which the surgeon places a healthy kidney from another person into your body. The donated kidney does the work that your two failed kidneys used to do.
The 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 donated kidney, which makes urine, just like your own kidneys did when they were healthy. The new kidney may start working right away or may take up to a few weeks to make urine.
Why is a Kidney Transplantation Necessary?
When a person has 'RENAL FAILURE', the kidneys do not properly filter harmful waste products; as a result, excess wastes and chemicals start to accumulate in the blood. When this happens, a dangerous accumulation of waste products can occur, causing a condition known as uremia.
Patients with irreversible renal failure have two options of treatment:
Dialysis, where the waste products from the blood are removed artificially
Symptoms of Kidney Failure:
The symptoms of kidney failure vary widely by cause of the kidney failure, severity of the condition, and the other body systems that are affected. Most people have no symptoms at all in the early stages of the disease, because the kidneys are able to compensate so well for the early impairments in the their function. Others have symptoms that are mild, subtle, or vague. Common symptoms of kidney failure and end-stage renal disease include the following:
Puffiness, swelling of arms and legs
Shortness of breath due to fluid collection in the lungs
Feeling of thirst
Rapid heart rate
Urinating less than usual
Urinary problems - Frequency, urgency
Bleeding - Due to impaired clotting, from any site
Loss of appetite
Pain - In the muscles, joints, flanks, chest
Bone pain or fractures
Pale skin (from anemia)
Causes of Kidney Failure:
Following is a list of causes or underlying conditions that could possibly cause Kidney failure includes:
Candidate for Kidney Transplant:
Any patient whose own kidneys have failed permanently is a potential candidate for a kidney transplant. There are several factors in each individual case, which determine whether a kidney transplant or lifelong dialysis is the better form of treatment for that patient. These factors include age, availability of family donors and the presence of antibodies in the patients (this increases the risk of kidney failure after transplantation).
Not a Candidate for Kidney Transplant:
For some people, a kidney transplant may not be an option due to other medical problems. Some of the most common reasons you would not be eligible for kidney transplant include the following:
Significant cardiovascular disease
Active malignancy or history of cancer within the last five years
Alcohol and drug dependency or abuse
Psychiatric (Mental) disorders that are not controlled by treatment
Non-compliance with medication and physician treatment recommendations
Obesity (Overweight patients will be evaluated by the Transplant Surgeon and weight reduction programs may be recommended before the medical evaluation can be initiated or completed.)
Severe liver disease
Severe lung disease
Sources of Kidney:
Cadaver donors: A cadaver kidney is removed from an individual who has been declared as brain-dead from non-kidney related causes, such as an accident or a stroke. Since a cadaver kidney is from a person not related to the patient, the kidney has less possibility of close antigen matching and thus less chances of success.
Living related donors: Very close relatives-parents, siblings (brothers & sisters), children, grandparents may donate a kidney to a near relative. This is because a normal individual has two kidneys and can live safely in good health with one kidney. Kidney donation does not alter the physical capacity or life-style or longevity of life of such a donor.
Emotionally related recipient donor mother kidney donor: In the situation where cadaver donor transplant is not available & living related donors are found unfit, emotionally related kidney donors like spouse (husband/wife) cousins, uncles, aunts, in-laws may donate a kidney and they are called emotionally related kidney donors.
Unrelated kidney donors: When cadaver donors, living related donors, emotionally related donors are not available or are found unfit, then unrelated donor kidney transplantation can be considered. Patients should understand that the chances of rejection are higher.
Kidney Transplant Evaluation:
During a kidney transplant evaluation, a transplant coordinator will arrange a series of tests to assess your treatment options. Tests and procedures performed during the evaluation include*:
Tissue-typing tests (done on blood)
General lab screening for evidence of hepatitis or other viral disease
PSA (Prostate specific antigen) for men over the age of 50
*Depending on a patient’s age and gender, additional tests may be required. After your evaluation, members of the transplant team will meet to review your case. They will decide as a group if further testing is necessary before any decision regarding transplantation can be reached.
Types of Kidney Transplant:
A nephrectomy is the surgical term for the removal of a kidney. A healthy kidney intended for donation is normally removed by one of two procedures.
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. The camera and instruments used in a laparoscopic nephrectomy are used to cut the kidney away from surrounding tissue after clamping off the blood vessels and ureter. The kidney is then removed through an incision below the belly button.
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.
Preparation for Kidney Transplant:
Smokers must stop smoking at least one month prior to surgery and medications containing aspirin should not be taken for three days before the scheduled surgery. Women taking birth control pills are advised to stop taking them one month prior to surgery.
Kidney Transplant Procedure:
Kidney transplant surgery usually lasts three to five hours. The damaged kidneys are usually left in place, with the new kidney being placed in the lower abdomen. The artery and vein of the new kidney will be attached to an artery and vein in the lower part of the abdomen, just above one of the legs. The new kidney's ureter, the tube that links the kidney to the bladder, will be connected to the bladder.
Kidney Transplant Post Operative Care:
The postoperative nursing care of kidney transplant recipient is similar in many ways to the care of any patient who has undergone a major surgical procedure; the emphasis is on maintenance of fluid and electrolyte balance, wound care, pain management, good pulmonary toilet with incentive spirometry, early ambulation, and restoration of normal bowel elimination.
The new kidney usually begins functioning immediately after surgery, but this highly depends on the quality of the organ. Hospital stay is typically for 4 to 7 days. If complications arise, additional medicines may be administered to help the kidney produce urine. Drinking clear liquids and eating solid food can be started from the next day depending on the tolerance power. Kidney recipients are advised to check the blood sugars four times a day after transplantation. Blood pressure should be checked after the first month if there are complaints of blood pressure.
Advantages of Kidney Transplant:
Transplantation is referred to as the "Gift of Life" because it saves lives and restores the quality of life for those who have been sick for a long time. Some advantages that have been found by persons who have had a successful transplant are:
Freedom from dialysis and freedom from the time commitment that it requires
Fewer, if any, diet and fluid restrictions
Feeling better physically
A better quality of life
No longer seeing themselves as chronically ill
Disadvantages of Kidney Transplant:
Kidney transplantation offers many benefits, but it does have some limitations and risks. It is not always the right treatment option for everyone. These limitations include:
Shortage of kidney organs available – the average wait for a deceased donor kidney about 4 years
Risks associated with surgical procedure e.g. infection
Lifetime treatment regimen of immunosuppressive medications, with possible side effects
Patient must satisfy a number of factors to be a possible transplant candidate
Risk of transplant rejection
Legal Status of Kidney Transplant in India:
As per the rules of Government of India, only a relative who is compatible can donate a kidney to the patient. Among the relatives, there is a category called the near relatives which is parents, siblings, children and spouse. People in this category can donate the kidney if they are medically compatible without the permission of the Government. Any other relative not belonging to this category in addition to being medically suitable, the permission from the Government needs to be taken.
Cost of Kidney Transplantation in India:
Among the various healthcare facility, dialysis and kidney transplant is one of the major area that attracts international patients to India. The important reason behind people’s preference to India is the availability of low cost dialysis and kidney transplant. Kidney transplantation in India costs a meager amount as compared to the Western, European and other Asian countries. The success rates match international standards. Indian doctors have a wealth of experience in kidney transplants owing to the large number of procedures done.
Comparison of costs of kidney transplantation among various countries (with donor)
As health care costs are skyrocketing, people are looking for a medical treatment which is a delight to both, their health and their wallet. The cost of kidney transplant in India is still shrinking. The costs have dropped so significantly that it is now cheaper to have a kidney transplant done rather than being on dialysis for more than two and a half years. India is capitalizing on its low cost medical care and highly trained doctors to appeal to the medical tourists. To have a hassle free and quick kidney transplant, India is the best option.
Best Kidney Surgeons in India:
To be recognized as a good kidney surgeon in India, one should have Qualifications as mentioned:
MS in General Surgery
MCH in Urology Surgery
DNB/FRCS/MRCS from International Colleges and Hospitals
International Fellowship and Training Programs
Publications and Paper Presentations in Reputed Scientific and Medical Journals
Wide Clinical Experience
All of our associate doctors / surgeons have trained or worked in some of the best medical institutions in United States, United Kingdom, Europe and other countries across the globe.
Top Kidney Hospitals in India:
Choosing the correct hospital can have a significant impact on the amount of recovery following your Kidney Transplantation. Following are the reasons why one should consider Kidney Hospitals in India for their kidney transplantation;
India offers excellent kidney care and language is not a barrier. You will be able to find foreign-trained kidney surgeons, as well as English-speaking Indian surgeons, without any difficulty.
In India, healthcare centers are of global standards and are well equipped with computerized dialysis instruments, operating rooms, intensive care units, and all other necessary equipments.
These Kidney Hospitals in India are considered among the best in the world to have the most advanced laparoscopic and robotic facilities to conduct precision driven kidney transplantation. The highlights of some of the facilities available at these Kidney Hospitals are:
World class Hospital Infrastructure
Dedicated Anesthesia Team
The Intensive Care Unit
Specialized Equipments etc
Major hospitals in India have special departments for Nephrology and kidney transplant. Indian Cities where top and world renowned kidnry hospitals situated are;
Plan your Kidney Transplantation in India with Tour2India4health: Skyrocketing health care expenses has become an issue of concern world over and people find themselves constrained to make compromises to their personal health. Tour2India4Health Group in India is one of the largest providers of professional healthcare tourism in India. With a large number of world-renowned medical facilities, we have the resources to offer you the finest medical treatment in India, and help you in your speedy recovery. We are experts in providing the ultimate in medical tourism packages.
There are few things more regrettable in life than a botched medical procedure. Keeping this in mind we work hard in bringing together dedicated team of physicians, surgeons, nurses and other healthcare professionals to provide the highest standards of medical treatment to our patients. Service to our patients and their family and the health care needs has always been our highest priority.
Features that make Tour2India4Health the best among other healthcare providers in India are;
Timely execution of your treatment plan
To and Fro transport facilities
Surgery executed under experienced and highly qualified doctors
Facility of top class and world renowned hospitals