Question 1

1) What is a Kidney Transplant?

Accepted Answer

Kidney Transplant is a surgical procedure to place a healthy kidney from a donor into a person whose kidneys no longer function adequately.

Question 2

2) When is a Kidney Transplant needed ?

Accepted Answer

The main function of kidneys is to filter and remove excess wastes material and metabolites, minerals and fluid from the blood by the production of urine in nephrons.

When kidneys lose this filtering ability, harmful fluid and waste accumulate in, that raises blood pressure and results in end-stage renal diseases.

Common causes are:

Diabetes
Polycystic kidney disease
Uncontrolled high blood pressure
Chronic glomerulonephritis

People with end-stage renal disease need to have wastes removed via a machine called dialysis or a kidney transplant surgery to stay alive.

Question 3

3) What are types of kidney transplant?

Accepted Answer

Types are:-

Deceased-donor kidney transplant
Living-donor kidney transplant
Pre-emptive kidney transplant

Question 4

4) Why kidney transplant is preferred instead of dialysis ?

Accepted Answer

A kidney transplant is preferred for kidney failure as a kidney transplant can treat chronic kidney disease with glomerular filtration rate (GFR, which is a measure of kidney function) less than or equal to 20 ml/min.
Kidney transplant promises following benefits over dialysis,

Better quality of life
Lower risk of death
Fewer dietary restrictions
Lower treatment and maintenance cost

Question 5

5) Am I eligible for Kidney Transplant?

Accepted Answer

Under the following conditions, one is not eligible for receiving kidney donation,

Advanced age
Severe heart disease
Active or recently treated cancer
Poorly controlled mental illness
Dementia
Alcohol or drug abuse

Question 6

6) What are the complications of Kidney Transplant Surgery?

Accepted Answer

Kidney transplant surgery carries the following risks,

Blood clots
Bleeding
Leaking from or blockage of the ureter
Infections
Rejection of the donated kidney
An infection or cancer that can be transmitted with the donated kidney
Death, heart attack and stroke

Question 7

7) What are the chances of survival of kidney transplant?

Accepted Answer

Kidney transplants are very successful. Over 94 per cent of transplants are working an year later however one needs to consult a nephrologist to assess their medical condition and suitability for undergoing this procedure.

Question 8

8) What are pre-diagnostic measures before transplant?

Accepted Answer

Medical tests used by a nephrologist to assess your health before a transplant can include,

A physical examination
Blood tests
X-rays of the heart and lungs
Ultrasounds and other imaging of the heart.
A surgical review of arteries, veins and bladder
Periodic tests of anti bodies.

Question 9

9) How to prepare for a kidney transplant?

Accepted Answer

When preparing for kidney transplant, maximizing your general health and fitness will make you suitable for a transplant and aids your recovery.

You should also consider maintenance of your:

Recommended dietary and fluid restrictions
Schedule for dialysis
Obesity increases the risk of complications during surgery

Question 10

10) What happens during Kidney Transplant?

Accepted Answer

During surgery, the new kidney is placed in position. If the patient has large kidneys, one may be removed to make space for the transplant. Usually kidneys are not removed.

The operation usually takes about two to three hours. The new kidney is connected to urinary bladder so urine can flow and a catheter is placed inside the bladder for up to five days.

The catheter and other tubes are removed after about four days.

Question 11

11) What happens after Kidney Transplant Surgery?

Accepted Answer

You will be in hospital for about a week, depending on how quickly you can recover from the surgery.
Blood tests and scans will be taken regularly.

The tests will start daily and then reduce to weekly after around three to six months, according to how long it takes for the kidney to work properly.

You will be prescribed medications by your nephrologist. These stop your body from rejecting the kidney, but these medications can sometime make you prone to serious illnesses.

Before you decide to have a transplant, it is important to understand risks involved. So talk to your nephrologist about any complications involved.

Question 12

12) Why a live donor kidney transplant is considered more beneficial?

Accepted Answer

In comparison to dialysis, kidney transplant recipients:

Live longer,
Have better health,
Have less restriction on diet and water,
Have more time and energy,
Have better quality recipient

In comparison to a deceased donor kidney transplant, live donor kidney transplant:

Has less rejection,
Has a higher success rate,
Eliminates the long dialysis waiting time.

Question 13

13) Who can be a live donor?

Accepted Answer

A live donor must be:

Biologically related to the recipient.
At least 21 years of age; donors older than 65 years can be considered on a case by case basis
Free from the following conditions:

a. Cancer
b. Diabetes
c. Heart disease
d. Hepatitis B or C
e. HIV infection or AIDS
f. Kidney disease

Question 14

14) How are the surgeries performed?

Accepted Answer

The operation involves removal of the kidney from the donor and then transplanting it in the recipient.

Step 1: Removal of the kidney from the donor.

i. Open surgery, through a loin incision; or
ii. Laparoscopic surgery (‘key hole’ surgery), where a camera and tiny instruments are inserted into the abdomen through very small cuts (0.5 to 1.5 cm). These are used to separate the kidneys after which the kidney is removed through a second incision of about 5-7cm at the lower abdomen. As the second incision does not involve cutting muscles at all, this method results in faster recovery for the donor.

Step 2: Transplant

An incision is made in the front lower quadrant of abdomen of the recipient. The new kidney is placed and the incision is closed. The recipient’s own kidneys aren’t usually removed.
The donor is usually discharged within three days after surgery; while the recipient can be discharged within 7 to 10 days.

Question 15

15) What is the cost of Kidney transplant surgery in India ?

Accepted Answer

The cost of Kidney transplant surgery varies across different cities and hospitals in India-

Cost of Kidney Transplant Surgery in India
CITY	COST
Cost of Kidney Transplant Surgery in Mumbai	INR 600000- INR 900000
Cost of Kidney Transplant Surgery in Bangalore	INR 580000- INR 850000
Cost of Kidney Transplant Surgery in Delhi	INR 580000- INR 850000
Cost of Kidney Transplant Surgery in Chennai	INR 550000- INR 820000

Question 16

16) Do patients from abroad come to India for kidney transplant surgeries?

Accepted Answer

Yes, from recent decade, patients from abroad come to India for transplant surgeries due to following
reasons,

Top and Qualified Doctors: India has top and qualified doctors, specialists.
Low Cost: For international patients, these treatments are relatively inexpensive making it affordable.
Visa: The government of India is also encouraging the medical tourism by providing M-VISA to foreigners which is why it is quite easy to get a medical visa.
Medical Tourism Facilitation: The ISO certified companies provides medical treatment or procedure packages & services along with arrangement of hotel, food, visa & transportation.

Question 17

17) What are the advancement in the technology used in a kidney transplant surgery?

Accepted Answer

With the advent of better immunosuppressive agents to stop early rejection, there has been a shift from using high-dose steroids to prevent graft rejection.

Minimally invasive methods for managing transplant surgery complications have been possible due to the advances made in the field of urology.

As per the Indian law and amendments to it in 2011, there has been there is a provision of “required request” available to the intensive care doctors to ask for organ donation in the event of brain death, making kidney transplant more feasible.

Kidney Transplant

The signs/symptoms observed which indicate kidney failure or end stage kidney disease are –

Kidney Transplant from one of the best multi-speciality hospital: DR L H HIRANANDANI HOSPITAL, Powai, Mumbai

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