A patient having Chronic Kidney Disease or End Stage Renal Disease is advised to undergo kidney transplantation. The advantage of transplant over dialysis is kidney transplantation is better in terms of quality of life, longevity of the patient and also cost in the long run
What is kidney Transplantation?
A kidney transplantation is surgically transferring a functioning kidney from a person (called the donor) to another person whose kidneys are not working (called the recipient) is called renal transplantation. Transplant of Kidney from a live donor is called live renal transplantation and kidneys taken from a dead person (who is certified brain dead) is called cadaveric renal transplantation*
- Please note that kidney for cadaveric renal transplantation is taken within a time limit since donor has been declared dead
- Criteria for Kidney Transplant
- Recipient diagnosed with ESRD (End Stage Renal Disease)
- Patients diagnosed with ESRD but cannot undergo Kidney Transplant
- Patients with reversible causes of renal dysfunction
- Patients with severe cardiac dysfunction, lung disease, cancers
- Patients with chronic infections‚ HIV, HbsAg +ve with active and advanced disease (Some of these patients are accepted if they are otherwise well and the family accept the higher risk of morbidity in such cases)
- Patients with active Vasculitis, SLE, or any infection which could flare up in the post transplant period.
Who can be the donor?
- Should have normal kidney functions, no proteinuria and no focus of severe infections in the Genito-urinary tract
- Should have a compatible blood group with the recipient as in blood transfusion
- Should be between 25-60 years of age
- Should have no Hypertension, Diabetes , significant cardiac disease or Lung disease, multiple kidney stones, disseminated cancer
- No Viral infections –HbsAg, HIV,HCV,CMV should be negative
- Should be mentally and physically fit and willing to donate the kidney Donation.
Transplantation across blood group is possible?
Yes but very rarely, this type of transplantation is called ‘Transplantation across Blood –Groups’. In this method the preformed antibodies are removed by plasmapheresis and special medicines are given to the recipient to prevent antibody formation. Some centres also remove the spleen. The levels of antibodies are monitored in the post transplant period and necessary steps taken to keep them down, to prevent rejection. This form of transplant involves a lot of cost and generally the rates of rejection are high, but with technological improvement, the results are improving.
Post transplant follow –up: It is of utmost importance to know that the recipient has to be on lifelong immunosuppressive medicines (medicines which prevent the rejection of the kidneys). He also has to be under the regular follow up of a nephrologist so that any problem of the transplant kidney can be picked up quickly.
During each visit, the nephrologist monitors the functioning of the transplanted kidney and tries to adjust the dose of immunosuppressive medicines to keep the side-effects of these medicines to a minimum.
He will look for any new-onset infection or a malignancy, which are quite common in these patients. Metabolic complications post transplant, like Diabetes, hypertension, hyperlipidemia , obesity and Coronary artery disease have to be actively searched for, to prevent deaths and morbidity in these patients.
The current recommendations suggest that the patient should visit the nephrologist or the transplant team 2-3 times per week after discharge in the immediate post transplant period. The visit dates are extended gradually if the patient is stable and is expected to come for follow up every month till the first three months. Later they come every 2-3 months or as directed by their doctor.
About the Liver
The liver is a marvellously resilient and vital organ that plays an indispensable role in nurturing and protecting your body everyday with clockwork precision. It has several key functions to perform – it helps filter and dispose off toxic materials from the blood, feeds your body the energy it needs to function, wards off viruses and infections, produces blood-clotting factors, regulates sex hormones, cholesterol levels and vitamin and mineral supplies in your body. Merely the tip of the iceberg, for the liver performs over 500 and odd functions, far more than any other organ in your body!
The need of the hour is to fully understand the critical role the liver plays in sustaining complete health. The liver supports almost every organ in the body and is vital for survival. It is tremendously important to understand the indispensable and central role that the liver plays in maintaining overall good health and vitality – only by doing so can you identify activities that help or harm this vital organ and do all you can to help protect it.
There are further advantages to be had from understanding your liver better – one, it helps you know exactly what must be done to keep it healthy and two, you will be able to actually cut down your risk of developing not only liver disease but other related health conditions such as diabetes and heart disease.
The process of caring is dual. Your liver depends on you to take care of it . . . so it can, in its turn, do a better job taking care of you. It is an efficient multi-tasker and performs manifold functions – serves as your body’s engine, pantry, refinery, food processor, garbage disposal, trouble shooter and “guardian angel.” As you can see, a healthy liver is the key to achieving a healthy life. The trouble lies in the fact that this indefatigable worker carries out its work silently, often there’s no hint of trouble and any damage is usually far advanced by the time it makes its presence felt. Currently, there is no artificial organ or device capable of emulating all the functions of the liver. This heightens the importance of maintaining the continual good health of your liver.
What are the diseases that affect the liver?
The liver is an important organ that supports almost every organ in the body and is vital for survival. Because of its strategic location and multidimensional functions, the liver is also prone to many diseases. Although the mere mention of liver disease is typically linked to alcohol or drugs, the sober truth is that there are over 100 known forms of liver disease caused by a variety of factors and affects everyone from infants to older adults.
What is Liver Cirrhosis?
Cirrhosis is a prevalent liver-related condition that most people are acquainted with. Liver cirrhosis is a term that refers to a group of chronic diseases of the liver in which normal liver cells are permanently damaged and replaced by scar tissue. When scar tissue develops in the liver, the amount of normal liver tissue decreases and the liver is unable to function normally. Liver cirrhosis is a serious condition, for the liver is a very important part of the digestive system. Cirrhosis blocks the flow of blood through the liver and prevents it from working as it should. Liver damage cannot be reversed, and unfortunately, cirrhosis does not always produce symptoms in its early stages. As the disease progresses liver function is increasingly diminished. It is the end stage of many different forms of liver disease and is known to cause a number of other health problems, including variceal bleeding, ascites and hepatic encephalopathy