Kidney Transplant - Guide to take Final Decision

1. Guide for Kidney transplant Complete Guide on kidney Transplant

2. Introduction to kidney transplant The kidneys are two bean - shaped organs located on either side of the spine just below the rib cage. Each one is about the size of a fist. The main function of the kidney is to filter and remove excess waste, minerals and fluid from the blood by producing urine. A kidney transplant is a surgery to place a healthy kidney from a donor into your body. A donor is a living person or a person who has just died, most often a family member. A kidney from someone who has just died is a deceased donor kidney. A kidney from a living person is a living donor kidney. The transplanted kidney takes over the job of filtering your blood. Kidney transplant is done by Nephrologists.

3. Only one donated kidney is needed to replace two failed kidneys, making living-donor kidney transplantation an option. If a compatible living donor isn't available for a kidney transplant, your name may be placed on a kidney transplant waiting list to receive a kidney from a deceased donor. The wait is usually a few years. A kidney transplant is used to cure kidney failure, a condition in which the kidneys can function at only a limited amount of normal capacity. People with end-stage kidney disease need either to have waste removed from their bloodstream (dialysis) or a kidney transplant to stay alive. It is achievable to partially replicate the functions of the kidney using a blood filtering procedure known as dialysis. However, dialysis can be inconvenient and time consuming, so a kidney transplant is the treatment of choice for kidney failurewhenever possible.

4. Different types of kidney transplant are: • Deceased-donor kidney transplant • Living-donor kidney transplant • Pre-emptive kidney transplant Deceased-donor kidney transplant : A deceased-donor kidney transplant is done when a kidney from someone who has recently died is removed with consent of the family and placed in a recipient whose kidneys have failed and no longer function properly and is in need of kidney transplantation.

5. The donated kidney is either stored on low temperature or connected to a machine that provides oxygen and nutrients until the kidney is transplanted into the recipient. The donor and recipient are often in the same geographic region as the transplant center to minimize the time the kidney is outside a human body. • Only one donated kidney is needed to fulfil the body's needs. For this reason, a living person can donate a kidney, and living-donor kidney transplant is an alternative to deceased-donor kidney transplant. • Overall, about two-thirds of the nearly 18,000 kidney transplants performed each year are deceased-donor kidney transplants, and the remaining are living donor kidney transplants.

6. Why Deceased-donor kidney transplant is done? • People with end-stage kidney disease need to have waste removed from their bloodstream via a machine (dialysis) or a kidney transplant to stay alive. • For most people with advanced kidney disease or kidney failure, a kidney transplant is the preferred treatment. Compared to a lifetime on dialysis, a kidney transplant offers a lower risk of death, better quality of life and fewer dietary restrictions than dialysis. • The health risks linked with a kidney transplant include those associated directly with the surgery itself, rejection of the donor organ and the side effects of taking immunosuppressant medications needed to prevent your body from rejecting the donated kidney, which include a higher risk of infection and some types of cancer.

7. What you can expect after Kidney Transplant ? • If your doctor recommends a kidney transplant, you may be referred to a transplant center or select a transplant center on your own. • You will be evaluated by the transplant center to determine if you are accepted as a kidney transplant candidate. Each transplant center has its own eligibility criteria. • If a living donor isn't available for a kidney transplant, your name will be placed on a kidney transplant waiting list to receive a kidney from a deceased donor. • UNOS categorizes deceased-donor kidneys according to how long they are expected to last. First choice to kidneys expected to last the longest goes to those candidates who are expected to need them the longest.

8. Additional factors used in matching deceased-donor kidneys include blood and tissue type matching and how long the candidate has spent on the waiting list. The federal government monitors the system to ensure that everyone waiting for an organ has a fair chance. • Some people get a match within several months, and others may wait several years. While on the list, you will have periodic health checkups to ensure that you are still a suitable candidate for kidney transplantation. • When a compatible deceased-donor kidney becomes available, you will be notified by your transplant center. You must be ready to go to the center immediately for final transplant evaluation. • If the outcomes of the final transplant evaluation are satisfactory, the kidney transplant surgery can proceed immediately.

9. Living-donor kidney transplant A living-donor kidney transplant is done by the removal of a kidney from a living donor and placement into a recipient whose kidneys no longer function properly. Only one donated kidney is needed to replace two failed kidneys, which makes living-donor kidney transplant an alternative to deceased-donor kidney transplant. About one-third of all kidney transplants performed are living-donor kidney transplants. The other two-thirds involve a kidney from a deceased donor.

10. Compared with deceased-donor kidney transplant, living-donor kidney transplant offers these benefits: • Less time spent on a waiting list, which could prevent possible complications and deterioration of health • Potential avoidance of dialysis if it has not been initiated • Better short- and long-term survival rates • A pre-scheduled transplant once your donor is approved versus an unscheduled, emergency transplant procedure with a deceased donor • Living-donor kidneys almost always start working immediately after transplant compared with deceased-donor kidneys that can have delayed function

11. What you can expect After Kidney Transplant? Living-donor kidney transplant usually involves a donated kidney from someone you know, such as a family member, friend or co-worker. Family members are most likely to be compatible living kidney donors. A living kidney donor may also be someone you don't know, a non directed living kidney donor. Both you and your living kidney donor will be evaluated to determine if the donor's organ is a good match for you. In general, your blood and tissue types need to be compatible with the donor's.

12. But even if your donor isn't a match, in some cases a successful kidney transplant may still be possible with additional medical treatment before and after kidney transplant to desensitize your immune system and reduce the risk of rejection. If the living kidney donor isn't compatible with you, your transplant center may offer you and your donor the chance to participate in the paired donation program. In paired organ donation, your donor gives a kidney to someone else whose is compatible. Then you receive a compatible kidney from that recipient's donor. Once you've been matched with a living kidney donor, the kidney transplant procedure will be scheduled in advance. The kidney donation surgery (donor nephrectomy) and your transplant will occur on the same day.

13. Pre-emptive kidney transplant A pre-emptive kidney transplant is a kidney transplant that takes place before your kidney function deteriorates to the point of needing dialysis to replace the normal filtering function of the kidneys. Currently, most kidney transplants are performed on people who are on dialysis because their kidneys are no longer able to adequately clean impurities from the blood. Pre-emptive kidney transplant is considered the preferred treatment for end-stage kidney disease, but only about 20 percent of kidney transplants are performed pre-emptively.

14. Several factors have been associated to the lower than expected rate of pre-emptive kidney transplants, such as: • Shortage of donor kidneys. • Lack of access to transplant centers. • Low rates of physician referrals for the procedure among candidates of lower socio-economic status. • Lack of physician awareness of current guidelines.

15. Why Pre-emptive kidney transplant is done? The benefits of pre-emptive kidney transplant before dialysis for people with end-stage kidney disease include: • Lower risk of rejection of the donor kidney • Improved survival rates • Improved quality of life • Lower treatment costs • Avoidance of dialysis and its related dietary restrictions and health complications

16. What you can expect If your doctor recommends a pre-emptive kidney transplant, you will be referred to a transplant center for evaluation. At the transplant center, your doctor and transplant team will conduct several tests to determine if a pre-emptive kidney transplant is appropriate for you. Variety of factors will be considered, including: • Level of kidney function • Overall health • Any chronic medical conditions that might affect transplant success • Availability of a donor kidney • Ability to follow medical instructions and take anti-rejection medications for the rest of your life

17. If you're approved for a pre-emptive kidney transplant and a living-donor kidney is available, the living-donor transplant procedure will be scheduled. If a kidney from a living donor is not available, you will be placed on a waiting list for a deceased-donor kidney transplant. Why Kidney Transplant is done? A kidney transplant is mostly the treatment of choice for kidney failure compared to a lifetime on dialysis. A kidney transplant can treat chronic kidney disease with glomerular filtration rate (GFR, a measure of kidney function) less than or equal to 20 ml/min and end-stage renal disease to help you feel better and live longer.

18. kidney transplant is associated with: • Better quality of life. • Lower risk of death. • Fewer dietary restrictions. • Lower treatment cost. Some people may also benefit from receiving a kidney transplant before needing to go on dialysis, a procedure known as preemptive kidney transplant.

19. How long do kidney transplants last? • 1 year - about 95%. • 5 years - about 85-90%. • 10 years - about 75%. If you have a kidney transplant that fails, you can usually be put on the waiting list for another transplant. You may need dialysis in the meantime.

20. Recommendedhospitals for Kidney Transplant in India. • Medanta - The Medicity, Gurgaon • BLK Super Speciality Hospital, Delhi • AIIMS, Delhi • Indraprastha Apollo Hospital, Delhi • Rajiv Gandhi Government Hospital, Chennai • Manipal Hospital, Bangalore • Fortis Hospital, Bangalore • Christian Medical College, Vellore • Manipal Hospital, Bangalore • KokilabenDhirubhaiAmbani Hospital, Mumbai

21. Rajiv Gandhi Government Hospital, Chennai MIOT Hospital, Chennai Coimbatore Kidney Hospital, Coimbatore Sri Ramachandra Medical Center, Chennai Rajagiri Hospital, Kerala Baby Memorial Hospital, Kerala Dharamshila Cancer Hospital, New Delhi Columbia Asia Yeshwantpur, Bangalore Wockhardt Super Speciality Hospital, Mumbai Baby Memorial Hospital, Kerala Olive Hospital, Hyderabad Yashoda Hospitals, Secunderabad Primus Super Speciality Hospital, New Delhi Kokilaben Hospital, Mumbai “The approximate cost for Kidney transplant is Rs.10 To 15 Lakhs”

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