Kidney Transplant

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We at Alchemist Hospital, Panchkula provide the best comprehensive treatment for patients suffering from kidney failure. We are the best-known transplant Centre of the region and pioneer in the Swap or paired kidney exchange transplant program catering to the needs of patients from entire north India. When you suffer from kidney failure, you either need dialysis or a kidney transplant to live. Kidney transplant is considered the best treatment option for people suffering from kidney failure because it increases your chances of living a longer and a healthier life. And we at Alchemist Hospital are committed to provide you with best of medical care in experienced hands.

Many research studies prove that patients who had chosen kidney transplant lived much longer than patients on long-term dialysis. A patient after successful kidney transplant may lives upto 15 years longer than dialysis patients. Having a kidney transplant can be a life-changing opportunity. Earlier you get a kidney transplant better and longer life you get.

Benefits of kidney transplant

Kidney transplant surgery is considered safe, and is very successful. On average, living kidney donor transplants last 15-20 years, and deceased kidney donor transplants last 10-15 years. For people with kidney failure, a kidney transplant can increase your chances of living a longer, healthier life.  Because dialysis can only do part of what healthy kidneys do for your body, people who have a kidney transplant usually live longer than those on dialysis.  After successful transplant, your health may be almost as good as a person with healthy kidneys as long as you closely follow your doctor’s advice after the transplant surgery.
Also, when you get a kidney transplant, you may avoid some of the complications that people on dialysis often have, such as bone problems, anemia, stroke, heart disease and recurrent infections related to dialysis

A kidney transplant can improve your quality of life. After your kidney transplant, you have:

  • More energy
  • Fewer limits on what you can eat
  • More free time from not having to go to dialysis
  • More flexibility to travel
  • Greater ability to work and hold a job

Risks with a kidney transplant are the same as with any major surgery. Risk does not mean these things will happen, it means they could happen in few of the patients. Some of the risks are infection, bleeding, or delayed recovery.

Types of Kidney Transplant

You can get a kidney from a person who is alive and willing to donate organ, or someone who has just died (i.e. brain dead or deceased).

1. Living Donor Transplant
A living donor kidney transplant is a surgery to give you a healthy kidney from someone who is alive.
This is possible because a healthy person only needs one healthy kidney to live. A person with two healthy kidneys can donate one kidney to a person with kidney failure. A living donor can be spouse, a family member, a member of the extended family or a close friend or distant relative as guided by the Transplantation of Human Organs Act (THOA).

Kidneys from living donors can sometimes last almost twice as long as kidneys from deceased donors. On average living kidney donor transplants last 15-20 years. How long your kidney will last depends on many factors including your health status before transplant, but the most important is how well you take care of it. To help your new kidney last as long as possible, you must take your medicine every day, as many times a day as your doctor tells you, and at the times your doctor tells you. Skipping your medicine can cause your new kidney to stop working.

2. Paired kidney exchange (Swap Kidney Transplant)

The kidney paired donation transplant enables two incompatible recipients to receive healthy, more compatible kidneys. All medically eligible donor/recipient pairs may participate in the paired kidney exchange program. This is explained in the following example:

Sunil wants to give a kidney to his wife Sunita, but they are not a good match either because of different blood groups or due cross reactivity of tissue matching. Similarly, Pooja wants to give a kidney to her brother Pankaj, but they’re also not a good match due to different blood groups. However, Sunil is a good match for Pankaj and Pooja is a good match for Sunita. So, Sunil donates his kidney to Pankaj, and Pooja donates her kidney to Sunita. That way, everyone who needs a kidney gets one and this is called as

‘Paired Kidney Exchange’.

Paired kidney donation (or paired exchange) is an option when you have a relative who is willing and able to be a kidney donor, but he or she is not a match for you. In a paired exchange, your relative gives a kidney to someone who needs it, and you receive a kidney from the donor/ relative of other patient. Look at the picture below to understand how this works.

3. Deceased donor transplant

Some of the people who have kidney transplants get their new kidney from a deceased donor. A deceased donor is someone who is brain-dead. This person or their family members decided to donate healthy organs at the time of death in order to benefit people who need transplants. No matter how the person died, his or her kidney will only be given to you if it is healthy and likely to work in your body. In our country, efforts are being made to raise awareness about organ donation after death, although this program is well established in most of the western countries.

Finding a Match

Before having a transplant, you will need tests to see if the donor kidney is a match for your body. For the kidney to be a good match, the new kidney will need to be very similar to the other organs and tissues in your body so that your immune system will not attack it.

The job of your immune system is to find anything that should not be inside your body, attack it, and then get rid of it to keep your body healthy. The immune system is meant to protect your body by fighting anything it senses can hurt you, such as bacteria from spoiled food or viruses like the flu. Because the donor kidney comes from another person’s body, your immune system will notice right away that your new kidney is different than the rest of your body, then start to attack the new kidney as if it were a disease. To lower the chances of this happening, your transplant team will make sure that the new kidney comes from someone whose blood type works with your blood type.

There are four basic groups of blood types that people have: type O, type A, type B, and type AB. If your blood type is very similar to that of the new kidney, there is a lower chance that your immune system will try to fight the new kidney.

If your blood type is:

  • O, you can only get a kidney from someone with type O blood.
  • A, you can get a kidney from someone with type A or type O blood.
  • B, you can get a kidney from someone with type B or type O blood.
  • AB, you can get a kidney from someone with type A, type B, type AB or type O blood

Causes and Risk factors for Kidney Failure/ Chronic Kidney Disease

Diabetes and high blood pressure are the two leading causes of kidney disease. They are also considered risk factors, because having either condition increases your risk of getting kidney disease in long-term (especially, if not well controlled).

Diabetes

Diabetes is the #1 cause of kidney disease. Diabetes is a disease that causes your body to have trouble making or using insulin. When your body doesn’t produce or use insulin the right way, too much sugar stays in your blood, which can lead to chronic kidney disease over time and ultimately may lead to End Stage Renal Failure (ESRD).

High Blood Pressure

High blood pressure is the #2 cause of kidney disease. High blood means your heart is working too hard to pump your blood. When blood flows too forcefully through the tiny blood vessels in your kidneys, this can hurt these tiny vessels. Over time, this can lead to chronic kidney disease.

Family History of kidney disease

If you are related to someone who has kidney disease, you are at greater risk, because there are certain genes that can increase your chances of getting kidney disease. Diabetes and high blood pressure also run in families, and can increase your risk of getting kidney disease.

Kidney Stones

Kidney stones are other leading cause of kidney failure in developing countries like India. Especially neglected or improperly treated stones put your kidneys at a higher risk of kidney failure.

Obesity

Being obese puts you at greater risk for the two biggest cause of kidney disease: diabetes and high blood pressure.  This means that being obese puts you at greater risk for kidney disease too.

Smoking

Smoking can cause high blood pressure, which is the second biggest cause of kidney disease. Smoking also causes blockages in your body’s blood vessels. When a blood vessel is blocked, your kidneys cannot get the blood flow they need, and this can cause damage, which can lead to chronic kidney disease.

Past history of acute kidney injury (AKI)

Acute kidney injury is when your kidneys stop working suddenly or temporarily, over a short period of time. People who have had acute kidney injury before are more at risk for chronic kidney disease than people who have never had acute kidney injury.

Heart disease

Heart disease is when your heart isn’t working as well as it should. This makes it harder for the kidneys do to their job. If your kidneys are working too hard, they may become damaged.

  • Recurrent Kidney infections
  • Glomerulonephritis
  • Polycystic kidney disease (PKD)
  • IgA nephropathy
  • Other rare conditions like: ⦁ Lupus nephritis, ⦁ Focal segmental ⦁ glomerulosclerosis⦁ (FSGS), Amyloidosis

Complications of Kidney failure and Long-term Dialysis

Dialysis helps to replace some of the work that your kidneys used to do, but it is not the same as having working kidneys. This means that you need to take extra steps to stay healthy. It also means that you may be at risk for complications of kidney failure. Some of the most common complications of kidney failure include anemia, bone disease, heart disease, high potassium and fluid buildup.
Anemia
Your kidneys help your body, make red blood cells (RBCs) of your blood that impart red color to the blood. As RBC maturation (called as Erythropoiesis) is one of the main function of healthy kidneys, your body is not able to make enough red blood cells when your kidneys are not working properly. This condition is called anemia.
Bone disease and high phosphorus (hyperphosphatemia)
We need adequate amount of functional vitamin D and calcium for good bone health. Vitamin-D formation and Calcium metabolism are another important functions of kidneys. Therefore, healthy kidneys help keep your bones healthy. If you have CKD, your kidneys may not be able to do this important job leading to poor bone health and bone resorption.
Heart disease
Heart disease can cause kidney disease, but kidney disease can also cause heart disease. Heart disease is the most common cause of death among people on dialysis. Patients on dialysis have more than double the risk of dying of heart disease, as compared to patient who has undergone a kidney transplant.
Stroke and Brain attacks
Kidney failure patients on regular dialysis are 10 times more prone to develop brain stroke than general population. This can lead to paralysis and is one of the reasons of death among kidney patients.
High potassium (hyperkalemia) and other electrolyte disturbances
Healthy kidneys filter extra potassium (a mineral found in many foods) from the blood. If you have CKD, you need to limit your potassium because your kidneys may not be able to filter it. High potassium levels in blood can lead to disastrous consequences including cardiac arrest and death if not treated in a timely manner.
Fluid overload and chest complications
Healthy kidneys take out extra fluid (liquid) from your blood. When your kidneys are not working properly, they cannot take out enough fluid. This can cause the extra fluid in your blood to build up in your body.
Having too much fluid in your body can cause problems with your heart and lungs. The extra fluid may accumulate in lungs causing difficulty in breathing and can even lead to lung infections and pneumonia. It can also cause high blood pressure, which can further worsen the underlying problems. Controlling your fluid intake can help prevent these problems and lower your risk for further kidney damage.

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