Kidney Transplant in India

According to the Urology Care Foundation, a kidney transplant is one of the most common organ transplants performed today. 

When a person has kidney failure or end-stage kidney disease, they may require a kidney transplant. This procedure is a life-saving choice for those in need.

If you have kidney failure and cannot have a kidney transplant for some reason, dialysis can help you sustain life.

During the dialysis process, harmful and waste substances are removed from the blood to maintain your health

If you are looking forward to getting detailed information, you can find it in this article, including stages, procedures, and more.

Why Kidney Transplant is Performed?

A person may need a kidney transplant if they have end-stage renal disease (ESRD) or are in a later stage such as 3B, Stage 4, or Stage 5.

Compared to a lifetime on dialysis, a kidney transplant can treat chronic kidney disease (CKD) or end-stage renal disease, allowing you the freedom to feel better and live a longer life.

How Is the Kidney Transplant Procedure Done?

The kidney Transplant procedure replaces the affected kidney with a new one, which can be from a deceased or living donor. Before processing the transplant procedure, the patient will go through tests, and then the transplant procedure will be started.

Here is the procedure that will be followed:

Before the Surgery

• The process of organ transplantation involves several steps, including the review of medical reports and the analysis of individual cases by the transplant team.
• The recipient and the donor must undergo a pre-transplant work-up, including tests and assessments to determine compatibility.
• After the donor's eligibility is assessed by the transplant team, the patient must submit all the necessary documents to the transplant committee for approval.
• The committee then reviews the case and gives their approval, which can take 2-4 weeks after submission of the necessary documents.
• Once approved, the patient undergoes the transplant.

During the Surgery

• The operation takes 3-4 hours to complete. 
• The procedure will begin with anesthesia administered by the surgeons, who will then enter the tube into the patient's mouth and lungs. 
• The tube will be attached to the ventilator so that the patient can breathe. 
• They will now clean the operation site and create a large incision in the lower abdomen. 
• Following this, the surgeon will transplant the donor's kidney into the patient's belly. 
• The donor's kidney is placed on the lower right or left side of your abdomen where it’s surgically connected to nearby blood vessels. Placing the kidney in this position allows it to be easily connected to blood vessels and your bladder. The vein and artery of your new kidney are attached to your vein and artery. The new kidney's ureter is attached to your bladder to allow urine to pass out of your body.
• After that, they will close the incision, insert a drain, and apply a bandage or dressing to the location.

After the surgery

• After surgery, a patient needs to rest for 1-2 days.
• If the patient gets the kidney from the living donor, it will start working after surgery.
• If a patient gets a kidney from a deceased donor, it will take to start working, which can be 2 – 4 weeks, and might need dialysis till the kidney begins to work.

Diagnose and Evaluation for Kidney Transplant

In India, there are various tests available that should be done before kidney transplantation, and if you want to learn the names of the tests, the list is given below:

Determine the Donor and Recipient Compatibility

This test is to check if the patient is healthy, and for that, a donor goes through a series of blood tests: these tests consist:

Pre-Transplant Work-Up For Donor

1. Blood Tests:

• Blood grouping
• CBC with ESR
• RFT extended
• LFT
• Lipid profile
• PSA( if applicable)
• PT/APTT
• FBS/PP
• HbA1c
• HbSAg
• HIV
• HCV
• CMV IgG and IgM
• TSH,T3,T4
• HLA Typing for organ transplant 

2. Urine tests:

• Urine r/m
• Urine c/s
• 24 hrs urine for creatinine/protein

3. Radiology Tests:

• ECG
• 2D Echo/Stress Echo(>40years)
• Chest X-ray PA view
• USG Whole abdomen/Pelvis
• DTPA Renal scan
• CT-Renal angiogram 

4. Clearance for kidney transplant:

• Gynecology clearance (if applicable)
• Psychiatry clearance
• Cardiology clearance
• PAC Clearance
• Blood Donation-2

Pre-Transplant Work-Up For Recipient

1. Blood Tests:

• Blood typing and screening
• CBC with ESR
• KFT extended
• LFT
• Lipid profile
• PSA( if applicable)
• PT/APTT
• FBS/PPHbA1
• HbSA
• HIV
• HCV
• HCV RNA Qualitative
• TSH,T3,T4
• CMV IgG and IgM
• X-ray Pelvis AP
• CDC T & B cross-matching
• Flow crossmatch
• HLA typing for organ transplant

2. Urine tests:

• Urine r/m
• Urine c/s

3.  Radiology Tests:

• ECG
• 2D Echo/Dobutamin stress Echo (>40years
• Chest X-ray PA view
• USG Whole abdomen/Pelvis
• USG color Doppler pelvic arteries and veins

4. Clearance for kidney transplant:

• Gynecology clearance (if applicable)
• Cardiology clearance
• Psychiatric clearance
• PAC Clearance
• Blood Donation

Types of Kidney Transplant

There are four types of kidney transplants given below is detailed information:

1. Deceased-Donor Kidney Transplant

A deceased donor kidney transplant is performed when a kidney from someone who has recently died is removed with the consent of the family and replaced with the recipient whose kidney has failed and no longer functions properly.

2. Living-Donor Kidney Transplantation

A living donor kidney transplant involves a donated kidney from someone who is alive and He/She must be a family member as they are mostly compatible living kidney donors.

3. Preemptive Kidney Transplant

This process is done when the kidney function declines. Dialysis takes the place of the kidney for regular filtration activity, which is an early stage of kidney transplantation for end-state illness.

4. Robot-Assisted Kidney Transplant

RAKT, Robot-assisted kidney transplantation is a process with minimally invasive techniques that get robot support to process kidney transplants. However, the surgery is performed by experts with extensive training and experience in robotics and transplant surgery.

Who are the Candidates?

• Patients with end-stage illness are eligible.
• Individuals whose kidney renal illness increased.
• Individuals with long-term kidney illness and are type 1 diabetic will carry out kidney-pancreas transplants.
• The health of the patient and donor will be measured before surgery.

List of Best Hospitals for Kidney Transplant in India

• Indraprastha Apollo Hospital, Delhi
• Medanta - The Medicity Hospital
• BLK Max Super Speciality Hospital
• Amrita Hospital, Faridabad
• Manipal Hospital Dwarka

Best Surgeons for Kidney Transplant

• Dr. Sandeep Guleria
• Dr. Rakesh Kapoor
• Dr. Sanjay Gogoi
• Dr. Shafiq Ahmed
• Dr. Dinesh Khullar

Complications

• Blood clots and bleeds.
• Leakage or obstruction of the tube that connects the kidney to the bladder (ureter).
• Infection.
• Failure or rejection of a donated kidney.
• An infection or cancer is transmitted from the donor.
• Death, heart attack, or stroke.

Conclusion

End-stage kidney illness is a severe health issue that needs treatment before time. Experienced doctors perform this procedure to replace the kidney from the living or deceased donor to give them a new life. Still, on the other hand, it has complications or risks as well, so before processing for the surgery, consult the doctor.

Medically Reviewed By

Dr. Aryan Malhotra

Dr. Aryan Malhotra is a highly respected and compassionate medical professional with a strong academic background. He holds an MBBS and MD degree from DTMU University in Georgia. Driven by a deep sense of duty, he is dedicated to providing exceptional care to his patients.