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Kidney Transplant
- Days In Hospital 5 days
- Outside Hospital Stay 15 days
- Success Rate 75%
Minimum Cost
$ 7000
Maximum Cost.
$ 15000
Overview of Kidney Transplant in India
A kidney transplant is a surgical procedure in which a diseased kidney is replaced with a healthy kidney. The kidneys are the organs that are just below the ribs on each side of the spine. They help in removing waste products from the body through urine. When the kidneys do not function normally due to disease, waste products begin to build up in the body potentially resulting in life threatening situations. When the function of the kidney drops to 90% then in this case, the surgical procedure is performed and the kidneys are donated from a deceased or healthy person through this process of kidney transplant.
Dialysis is therapeutic option for patients, but it needs to be done two times a week. The only permanent treatment of kidney disease is kidney transplant. Kidney transplant is also preferable to dialysis because of the low risk of death, lower treatment costs and better quality of life for the kidney disease patients. A kidney donor can be a closely related relative to the patient or may be completely unrelated from the patient. Since a kidney donor who is a closely related relative has a greater chance of not failing due genetic similarity, this is an advantage. If the transplant of the kidney fails, then the patient may need to continue with dialysis or possibly require a subsequent transplant of the kidney.
What is a Kidney Transplant?
A kidney transplant is the surgical process of inserting a viable kidney from a donor into a person with kidneys that do not function well anymore. The purpose of the kidney transplant operation is to restore kidney function in patients with end-stage renal disease, or ESRD, or advanced chronic kidney disease. The kidneys, the body's organs of filtration, affect how the body detoxifies itself (by filtering waste products and excess fluids from the blood), regulates blood pressure, and maintains electrolyte balance in the system. Failure of the kidney results in the dysfunction of these vital bodily functions, resulting in the accumulation of toxins, or waste products, in the body, and may lead to death.
Kidney transplants are one significant type of treatment to improve a patient's quality of life by allowing for a return to normal activities without the need for dialysis, a treatment that artificially detoxifies the blood. A kidney transplant can be performed with a deceased donor or a living donor. A kidney transplant is often deemed the best option for patients with advanced kidney disease.
Living Donor Kidney Transplant
In this type of kidney transplant, a healthy kidney from a close relation or friend is donated to a person with end stage kidney disease. The donor needs to have the same blood type as the patient and have the same genetic make-up. Living donor kidney transplant is usually preferred because it has a higher rate of success and a longer survival period than a deceased donor kidney transplant. For a living donor transplant, the donor needs to be coordinated with the patient for this type of transplant.
Deceased Donor Kidney Transplant
In this type of transplantation, the kidneys come from a deceased person. Medical professionals will obtain consent from that deceased person prior to their passing. The kidneys are matched with the recipient according to their blood type, tissue matching, and waiting period in the kidney transplant queue. Deceased donor kidneys are the most common type of kidney transplanted, however the success rate for kidney transplant from a deceased donor is less than that of a living donor kidney transplant.
Preemptive Kidney Transplant
During preemptive kidney transplantation, the healthy kidney is replaced with the damaged kidney prior to the necessity of dialysis or the kidneys becoming to end stage kidney disease (ESKD). Preemptive kidney transplantation is considered the best treatment option for patients with ESKD and a suitable living donor. Some of the benefits associated with preemptive transplantation include better long-term outcomes, avoidance of dialysis, improved quality of life, and better circulation/heart health. Not all patients qualify for preemptive transplantation since the transplant must occur with a suitable living donor and there must be coordination in a timely manner.
Types of Kidney Transplant:
There are many clinical circumstances and test results that could make a patient suitable for a kidney transplant. These include:
End-stage renal disease (ESRD): This is the most common reason for a kidney transplant. A patient with ESRD may have lost about 90% of kidney function, and requires either a kidney transplant or dialysis to survive.
Chronic kidney disease (CKD): Patients with advanced chronic kidney disease such as stage 4 or stage 5, can be candidates for a kidney transplant. Advanced CKD may occur due to diabetic nephropathy, renal injury related to hypertension, or polycystic kidney disease.
Acute kidney injury (AKI): In certain situations, patients experiencing a abrupt and severe decrease in kidney function due to conditions such as severe dehydration, sepsis or drug related toxicity may be considered candidates for a kidney transplant assuming their kidney function fails to recover and subsequently progresses to ESRD.
Congenital Kidney Disorders: A proportion of patients are born with structural abnormalities of the kidneys which lead to chronic failure. These patients may be evaluated for a transplant at an early age.
Recurrent Kidney Disease: Patients who have had actual kidney transplants or failing kidneys that have undergone rejection or complications may be candidates for a second transplant.
Other Medical Conditions: Certain autoimmune disorders, like lupus or vasculitis, may affect the kidneys in a way that requires transplantation.
Before a patient is placed on the transplant list, a full and complete evaluation, including laboratory blood tests, imaging studies and assessment of comorbid health will be conducted. The comprehensive evaluation will determine the patient’s suitability for the procedure and potential risks.
Procedure:
The process of preparing for a kidney transplant can vary based on individual circumstances and specific transplant centers. Below is an overview of what renal transplant patients can expect when they begin the preparatory phase.
Initial Evaluation: The first step is an in-depth assessment by a transplant team consisting of nephrologists, surgeons, and others in the field. This initial assessment evaluates the patient's health, and kidney function. and determines fitness for the procedure.
Medical Tests: The evaluation will likely be ordered to have reliable information on the patient’s general health, kidney function and incidental findings. Medical tests generally include a battery of tests, including blood tests, imaging studies, such as ultrasounds or CTs and possibly a kidney biopsy to assess kidney function, establish a diagnosis and background for any observed change.
Psychosocial Assessment: A mental health assessment is typically a part of the transplant preparation process, aimed at identifying psychosocial issues that could impact the patient in the transplantation experience and initiation of coping mechanisms and plans.
Education: Patients will learn about the transplant process and what to expect before, during, and after the surgery. It is necessary to understand the process, as well as the proper care of the kidney after the transplant.
Lifestyle Changes: Patients may be asked to make lifestyle changes, such as a healthier diet, an end to smoking, and possibly more activity. Lifestyle changes can result in better overall health and improved recovery.
Finding a Donor: If the patient will not get a kidney from a living donor, they will be placed on a waiting list for a kidney from a deceased donor. The transplant team will discuss how the matching process takes place and what to expect while waiting.
Medications Pre-Transplant: Patients may be asked to start certain medications prior to transplant to help prepare their bodies for the new kidney. Some medications may assist with current medical problems and decrease the risk of complications.
Surgery Preparation: Patients should plan for transportation to and from the hospital on the day of surgery and have a support system in place for post-operative recovery since this may be difficult.
Pre-Operative Instructions: Patients will be given specific pre-operative instructions regarding fasting, medications, and what to bring to the hospital. It is imperative for the surgical process that you follow these instructions.
Kidney Transplant Procedure - Step-by-Step Process
Familiarity with the kidney transplant of the procedure can ease anxiety and prepare patients for what to expect. Here is a step by step overview:
Before the Procedure: The day of surgery, patients will arrive to the hospital, check in and meet the surgical team, who will review the procedure and answer last minute questions. A IV (intravenous) line will be started to give medications and fluids.
Anesthesia: Prior to the surgery starting, patients will receive general anesthesia, which means you will be unconscious and pain free during the procedure.
Surgical Procedure: The surgeon will start the operation by making an incision in the lower abdomen, accessing the area where the kidney will be placed. If it is a living donor, the kidney will be inserted placed into the abdomen or if it’s a deceased donor kidney, it will be inserted and with the surgical team will connect the blood vessels and the ureter (the tube that carries air from the kidney to the bladder).
Monitoring: The surgical team will monitor vital signs during the entire surgery to ensure everything goes well. The length of the surgery on average is between 3-5 hours.
Post-Operative Management: Patients will be transferred to a recovery room where they will be monitored closely as they awaken from anesthesia and will start on their pain management plan. Patients will receive fluids and medications via IV.
Patient Hospital Stay: The majority of patients will stay an estimated three to seven days at the hospital, based on their recovery process. During the patients stay, the overall kidney function, medications and any potential complications will be monitored by health care providers.
Follow-Up Appointments After Discharge: After patient discharge, regular intervals of follow-up appointments will help to monitor kidney function and make any changes to medications if needed. Blood will be drawn to check kidney function and any signs of rejection or infection.
Long-Term Health Management: Patients will be on long-term immunosuppressive medications, to decrease the risk of organ rejection. It is imperative that patients are compliant with their medication and follow-up appointments for their long-term health.
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Cost of Kidney Transplant in India
The cost of kidney transplant in India usually ranges between 13000 USD - 20000 USD. This cost can vary according to the type of kidney transplant. It may also vary in different hospitals of different cities in India.
|
Different Cities |
Min (USD) |
Max (USD) |
|
Ahmedabad |
6,600 |
9,900 |
|
Chennai |
11,000 |
16,000 |
|
Bangalore |
11,000 |
15,500 |
|
New Delhi / NCR |
11,000 |
15,000 |
|
Mumbai |
13,000 |
20,000 |
Top Hospitals in India
Indications of Kidney Transplant:
Kidney transplants are generally suggested for those who have symptoms of kidney failure or have been diagnosed with diseases that compromise the kidney function.
Typical symptoms that may prompt the book a transplant include:
- Chronic fatigue and weakness;
- Swelling in the legs, ankles, or feet due to fluid build-up,
- Nausea and vomiting;
- Decreased appetite and weight loss;
- Itching and dry skin;
- Changes in urination, like decreased amount of urine or dark-colored urine.
Usually, the recommendation to carry out a kidney transplant is initiated when the kidney function deteriorates to a critical level, often defined as a glomerular filtration rate (GFR) of less than 20 mL/min. Kidney function at this level is often associated with:
- Substantial health risk
- Cardiac risk
- Reduced life span
A kidney transplant is also indicated for patients who:
- Have been on dialysis for a prolonged period and are experiencing dialysis-associated complications.
- May be referred for a transplant evaluation prior to being on dialysis due to a progressive kidney disease, which is likely to become more serious over time.
Risk Factors:
As with any surgery, kidney transplants have risks and complications. Patients should be aware of them, so they can make a fully informed decision. Below is a list of some common and uncommon risks important to be aware of with kidney transplants:
Common Risks of Kidney Transplantation:
- Rejection: The body may see the new kidney as foreign and seek to reject it. This is one reason immunosuppressive medications are important.
- Infection: Immunosuppressive medications increase the risk of infections, especially early after the transplant.
- Bleeding: Some bleeding may occur at the time of surgery, or after the procedure, and may require further intervention.
- Blood Clots: There is always a risk of developing blood clots in the legs or lungs during recovery.
Less Common Kidney Transplant Risks:
- Failure of the Organ: In rare instances, the transplanted kidney may fail, and the patient may need to restart dialysis or get another transplant.
- Cancer: The long-term use of immunosuppression drugs has increased the risk of a few cancers occurring, especially skin cancer or lymphoma.
- Heart Problems: Some patients with existing heart disease may have a heart attack or may have a stroke.
- Graft Versus Host Disease (GVHD): Although very rare with kidney transplants, GVHD occurs when the donor's immune cells attack the recipient’s body.
Long Term: The patient must remain vigilant regarding their health, and call their doctor if anything new or unusual happens. The patient will need to see his/her healthcare providers regularly to monitor kidney function and overall health.