kidney failure or untreated kidney disease may eventually affect other vital organs of the body and can cause multiple organ failures and ultimately lead to death. The transplant involves surgical procedures on patient as well as donor, if kidney is donated by a living donor.
Kidney transplant surgery encompasses surgical procedures on both i.e. living donor and recipient of kidney under anesthesia which usually takes 3-4 hours.
Surgery on donor for removal of kidney can be done in two ways:
• Open Nephrectomy – Traditional surgical procedure
• Laparoscopic Nephrectomy – minimally invasive surgical technique
Concurrently, kidney transplant surgery on the kidney recipient is performed under general anesthesia to place the donated kidney and usually takes 3-4 hours.
Kidney transplant in India is performed at various world-class hospitals by highly qualified and skilled doctors.
The kidney transplant becomes necessary when the kidneys cells i.e. nephrons lose around 90% of their filtering ability. Such a patient is said to have reached an end-stage renal disease or renal failure stage. For such patients, a kidney transplant is the best treatment to stay alive and lead a normal life.
Complications of kidney transplant
The significant complications of Kidney transplant surgery, besides delayed graft function i.e. ‘Sleepy Kidney’ including:
- Blood clots and bleeding
- Urine Leak and Urinomas
- Urinary Obstruction
- Peritransplant Fluid Collections that include Urinomas, Hematomas and Lymphoceles
- Urinary Calculi development
- Abscesses and Infection
- Vascular Complications like Renal Artery Stenosis or Infarction resulting from Hyperacute Rejection
- Arteriovenous Fistulas and Pseudoaneurysms, occasionally seen after graft biopsies
- Renal Vein Thrombosis
- Gastrointestinal complications like gastrointestinal hemorrhage due to peptic ulcer
- Failure or rejection of the donated kidney
- An infection or cancer that can be transmitted with the donated kidney
Life after a kidney transplant
Kidney transplant surgery is a sort of new lease of life and produces feeling like getting another chance at life and hence necessitates extreme care of new kidney.
You are required to make changes in life style and:
- Follow strict Diet and exercise regime
- Take prescribed Immuno-suppressants or anti-rejection medication regularly
- Avoid Anxiety, depression and guilt feeling
- Return to work after 4-6 weeks
- Drive after 2 to 4 weeks
- Have sex after 4 to 6 weeks of transplant or until incision is completely healed
- Women to avoid getting pregnant until one year after your transplant
Kidney Transplant Rejection
Since, new transplanted kidney is not part of your original body and hence your immune system body perceives new kidney as a foreign object or tissue and resists by mounting a reaction against it. This may result in causing massive damage to new kidney, termed as rejection of kidney.
Depending on timing, rejection may be:
- Hyper-acute - Occurs within minutes of insertion. It is rare as matching of tissues is done before donation
- Accelerated - Occurs within a few days in patients previously sensitized. It may appear as fever, swollen new kidney and high rise of levels of serum creatinine. High dose steroids are given to treat this but may fail and removal may be needed.
- Acute Cellular Rejection- Occurs in a quarter of all patients usually in 1-3 weeks but can occur up to 12 weeks. It is characterized as fluid retention, rising blood pressure and rapid increase in serum creatinine
- Chronic Rejection- There is a gradual rise in serum creatinine and excretion of protein in urine along with high blood pressure and is not corrected with increasing immunosuppression therapy
Success rate
Although success rate of kidney transplant in India are very high i.e. up to 95% yet varies depending on whether the donated organ is from a living donor or a deceased donor. However, Kidney transplant in India from living donors generally last longer with patients surviving for 15-20 years.
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