WHAT IS KIDNEY TRANSPLANT

Implantation of a donated kidney from a live or cadaveric donor kidney into a person with permanent kidney failure. What are alternatives to Transplant? Peritoneal dialysis – using the lining of your abdominal cavity to draw waste products out of your circulation by putting dialysis fluid into your abdominal cavity. Haemodialysis – filtering the blood by means of a dialysis machine by drawing your blood through vein and filtering it through a dialysis machine and then infusing it back simultaneously

DIALYSIS Vs KIDNEY TRANSPLANT

• Longer life : patients who receive a kidney transplant typically live longer than those who stay on dialysis. A living donor kidney functions, on average, 12 to 20 years, and a deceased donor kidney from 8 to 12 years.Patients who get a kidney transplant before dialysis live an average of 10 to 15 years longer than if they stayed on dialysis. Younger adults benefit the most from a kidney transplant, but even adults as old as 75 gain an average of four more years after a transplant than if they had stayed on dialysis.
• Quality of life: patients who have been on dialysis and then had a transplant report having more energy, a less restricted diet, and fewer complications with a transplant than if they had stayed on dialysis. Transplant patients are also more likely to return to work after their transplant than dialysis patients.
• Financially better: Transplant in the long run comes out to be comparatively cheaper as compared to being on permanent dialysis

Details of the procedure

• Under a general anaesthesia a urinary catheter is placed and incision is made in lower part of tummy(usually right, rarely left).
• The native kidney are not removed unless they are a source of infection or very huge as in Polycystic kidney disease
• Donor kidney blood vessels are stitched to the blood vessels which take blood to and from your leg (Renal artery and vein stitched to iliac artery and vein respectively)
• Donor kidney ureter is stitched with recipient’s urinary bladder or occasoanlly recipients ureter over a plastic tube called DJ stent to allow for healing. It is removed after 3 weeks .
• Donor kidney ureter is stitched with recipient’s urinary bladder or occasoanlly recipients ureter over a plastic tube called DJ stent to allow for healing. It is removed after 3 weeks .
• drain tube is placed around the new kidney and exiting out of tummy near the stitch site to allow for any collected blood or fluid to drain out. Generally removed after 4-5 days.
• Procedure may take 2-3 hours.
• After the procedure you are shifted to ICU for 5-7 days for close monitoring. There are multiple tubings attached for close monitoring and precise infusion of medicines and drugs

OUTCOMES

OUTCOME	CHANCES
Procedure doesn’t cure underlying disease	All
MNeed for long term immunosuppressants with side effectsary	All
Rejection requiring drug treatment	20-30%
Infection of wound or inside the tummy	1-5%
Leakage of urine from joint of ureter and bladder	Less than 1%
Lymphocele (leakage andcollection of lymph around kidney	Less than 1%
Complete non functioning kidney due to rejection or thrombosis	2%
Increase risk of cancers of skin, lymph glands, cervix and breast due to immunosupressants	2%

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POST TRANSPLANT DOS AND DONTS

QUALITY OF LIFE AFTER TRANSPLANT

Quality of life after a kidney transplant is better than being on dialysis. 50% of kidneys continue to function after 10 years.

Take medicines regularly. Stoppage of medicines may lead to rejection

Maintain hygiene to reduce chances of infection

Avoid smoking and recreational drugs

Drink boiled or filtered water o reduce chances of watr borne disease

Eat well cooked healthy diet and avoid eating at unhygeneic places

Wash fruits and vegetables thoroughly and peel off skin to reduce chances of infection

Avoid consuming raw meat meat products .Prefer cooked ones.

Drink boiled or filtered water o reduce chances of watr borne diseasest

Eat well cooked healthy diet and avoid eating at unhygeneic places

Wash fruits and vegetables thoroughly and peel off skin to reduce chances of infection

Avoid consuming raw meat meat products .Prefer cooked ones.

Avoid heavy physical activity or sports activities for three months

Due to increased chances of skin cancers, avoid sunbathing. Use a sunscreen on all exposed skin (SPF 25 or higher) when exposed to sun.

Maintal good dental health

Don’t take any medicine without supervision

Diet

One of the major benefits of a kidney transplant is that you can enjoy a normal healthy diet.

Avoid saturated fats.

Reduce the amount of salt intake

Eat high-fibre foods

Alcohol allowed only in moderation, but it can interact with some of your medications so better to avoid

Avoid grapefruit and grapefruit juice which interfere with some immunosuppressive drugs

Avoid unpasteurized dairy products

Preferably eat home cooked food and always have food at a hygienic place