Kidney Transplantation is the process of transferring a healthy kidney into a patient who has end stage kidney disease or CKD Stage V. For this a kidney donor is required and is selected on the basis of various parameters.

• Who need Kidney transplants?

  Kidney Transplant is for people whose kidneys have failed permanently; stopped working completely and are living on dialysis.

• Why kidney transplant is required?

  • It is more efficient than dialysis. Transplanted kidney will remove waste out of the body.
  • The patient will no longer have the restraint of dialysis.
  • Most people with kidney transplants enjoy a normal and a better quality of life
  • People with successful kidney transplant also live longer than those are on dialysis. 

• Who can't get a kidney transplant?

  • Cancer patient
  • Un-correctable heart disease
  • Untreatable psychiatric illness
  • Not going for dialysis regularly and properly or noncompliance with medicine. 
  • Any patient with another condition who is not expected to live very long. 

  Age is not a factor to determine if somebody can undergo kidney transplant or not if the person is otherwise healthy he/she can go for a kidney transplant. 

• When is the best time to undergo Kidney Transplant?

  As soon as possible if the patient is having CKD Stage V or is already on dialysis. Doctors decide the best time of the surgery on the basis of patient history and medical condition. 

• From where does the patient receives the kidney?

  Donor’s kidneys come from either living people or from a person who’s no more living (a deceased donor). In living donor transplantation case, a family member may be the spouse, siblings, parents, grandparents can donate a kidney to the recipient provided the potential donor does not have any prior medical or surgical diseases. 

• Factors should be considered before kidney transplantation

  There are many factors which impact the process of Kidney Transplant, few are listed below:

  1.Blood type compatibility–

  A blood test of both recipient and donor is done to make sure if those are compatible blood groups or not. Which blood group can donate or receive from which one is summarized in the tabulated form below. Also, Rh factor (positive or negative) is not important in kidney transplantation. Kidney Transplant is also done where transplant across Blood Group is possible.  

  Blood Type	Can receive a Kidney from	Can donate to
  O	O	O, A, B, AB
  A	A, O	A, AB
  B	B, O	B, AB
  AB	AB, A, B, O	AB

  2. Crossmatch Compatibility

  In the lab, a sample of recipient’s serum is mixed with the cells of the donor. This is done to check whether the pre-existing antibodies to donor’s antigens are present or not. If the pre-existing antibodies are absent, crossmatch is negative. This test detects antibodies directed against the donor cells. This test is the minimum immunologic requirements for kidney transplantation surgery.

  3.HLA tissue typing

  This test identifies genetic markers, which we have got from our parents. Then comparison is done between recipients and donors genetic markers(Antigens)

• How much time for the Kidney Transplant surgery?

  It will take 4-5 hours to perform the surgery. The surgery for recipient and donor occurs at the same time (simultaneously) by the team of surgeons. 

• What is the procedure of Kidney Transplant?

  The surgery for recipient and donor occurs at the same time.

  Donor’s side (Nephrectomy) 

  Mostly left kidney is the preferred kidney for removal, since it has longer vein than the right kidney from the donor. Still, at times, the right kidney can also be removed in case of any medical/technical difficulty. Donor’s Surgery can be done Laparoscopically also. 

  Recipient’s side

  Doctors made an incision usually on the right side of the abdomen, then the artery and vein of the new kidney is attached to one of the arteries and veins, and then the new kidney’s ureter to the urinary bladder.

• What are the post-surgery complications which the recipient face?

  Complications of post-surgery are listed below:

  • Delayed graft function means a delay in function of the new kidney, a patient might have to resume dialysis after transplant. The patient may even require dialysis till the time transplant kidney starts working.
  • Rejection
  • Infection
  • Onset of Diabetes post transplant. 
  • High blood pressure
  • Weight gain

  Rejection: 

  Our body’s immune system protects us from infections by recognizing them as foreign material. Unluckily our immune system sees the new kidney as foreign material as well and starts destroying it. So, rejection is the most important concern after kidney transplantation surgery. It has been seen in 10-15 percent of patients. However, most of the people don’t lose the kidney to rejection. Rejection cases occurring early after transplantation is usually treatable, with the help of suppressants. 

  Immunosuppressive medication-These are the drugs made to suppress our immune system and transplant for life long. 

• What lifestyle changes should be required after the surgery?

  To stay healthy one should stay away from smoke, alcohol and stick to healthy diet and exercise. Also, a person has to take immunosuppressants for long.

• What are the post-surgery complications the donor face?

  Risk of donating a kidney include a small risk of Hypertension. Some donors may develop proteinuria and very rarely, CKD. 

• What are the precautions donor required for the recovery?

  The donor can experience pain. Painkillers are prescribed for that. Heavy lifting or physical activities are restricted initially. Follow-up visits after 2 weeks to make sure all biological functions are fine. Usually patient recovers in 2 weeks. 

• What is the cost of Kidney Transplant Surgery?

  It depends upon the patient existing medical conditions the cost of Kidney Transplant comes out to be between 6.0-6.5 lacs INR.