Kidney Transplant FAQ's

Q1. What is Kidney Transplant?

Renal/kidney transplant is a surgical procedure that involves the replacement of the diseased or dysfunctional kidney with a healthy kidney.

Q2. What are the Indications for Kidney Transplant?

Kidney transplant is required mainly in the case of kidney failure. Symptoms of kidney failure are:

1. High blood pressure
2. Fatigue
3. Nausea and vomiting
4. Abnormal sweating
5. Excessive thirst

The other indications that suggest that a patient might need a kidney transplant include:

1. Severe metabolic imbalance leading to diseases like Gout, Diabetes mellitus
2. Kidney infections
3. Presence of tumors, such as renal cell carcinoma and Wilm's tumor
4. Kidneys have become unresponsive to medical or surgical treatments
5. Trauma resulting in permanent damage to the kidney

Q3. Who can be the Donor? 

Living Donor

Any individual between 18-60 years of age can be a donor. Donors don't need to be genetically related. All that is required is a perfect match between the kidneys of the donor and the recipient.

Besides this, the blood group and the tissue type of the donor and the recipient should be compatible and all cross match tests should be negative. In case the blood group and the tissue type are incompatible, then kidney exchange, also known as Paired Donation is done where in the donor and the recipient are paired with another donor and recipient who too are incompatible with each other.

Deceased Donor

Deceased Donors can be classified into two categories:

• Brain-dead Donors
• Donation after Cardiac Death donors

A Brain-dead/Beating-heart donor's heart pumps blood to maintain the circulation. This helps surgeons to operate while blood is being delivered to the rest of the body. "Donation after Cardiac Death" donors are operated immediately after death to recover the organ.

Q4. Is there any Legal Documentation Required?

Yes, legal documentation is required for both the donor & recipient. You should discuss the legal requirements with your doctor.

Q5. What to do if we don't have a Donor?

If a recipient is unable to find or get a donor, he/she must seek immediate help from the authorized organizations that collect and curate data about potential donors by registering himself/herself with the respective organization. Such organisations can help the recipient find a suitable donor within the stipulated time frame.

Q6. Will a Living Donor Experience any Side Effects?

Though in a majority of cases the donor might go on to lead a healthy life, there can be a few complications in some circumstances. The living donor might suffer from side effects, which include internal bleeding, chronic pain, hernia, hypertension, cardiac problems, infections, obesity, nerve damage and pancreatitis.

Q7. Can the Donor Survive on One Kidney? 

Kidney donation does not interfere with the donor's body activity. The donor can live a long and healthy life after donation with one kidney performing all the functions adequately. However, annual blood and urine tests should be performed and care must be taken to protect the kidney from injury.

Q8. What all Precautions should the Donor take Pre & Post Operation?

Pre-operation:

• Avoid consumption of tobacco, alcohol or any other harmful substance
• Follow a balanced diet and regular exercise regime to keep the weight in check
• Maintain oral health through sound dental care

Post-operation:

• Following the prescribed medication and diet and limit the intake of salts, proteins and sugar
• Avoid lifting heavy objects for a few weeks until your incisions are healed completely.
• Patients can take a shower. Bathing in a bathtub, Jacuzzi or swimming in a pool is forbidden for 15 days after the operation as it can cause infection.

Q9. Can Kidneys be Retrieved from Non-Heart Beating Donors? How they are Different from Heart Beating Donors?

Kidneys can be taken from non-heart beating/Cardiac Death donors. To prevent the ischaemic damage, in-situ cooling preserves the kidneys. The normal retrieval process follows this. In heart beating/brain-dead donors a continuous blood circulation is maintained in the body, which makes the retrieval, process a little less complex.

Q10. Who does the Kidney Transplant? Where can it be Done? How Long does the Transplant Surgery take Place?

A transplantation surgeon under the supervision of a nephrologist performs the kidney transplant procedure. The procedure is performed only at hospitals. This surgery takes about three hours.

Q11. How much Time will it take to Recover?

Recovery time depends on the patient's health and the method of surgery used. Open surgery causing a large incision generally takes about 8 weeks to recover. In case of a laparoscopic surgery involving small incisions, the recovery period is about 4 weeks.

Q12. What can be the Complications of Kidney Transplant?

1. Rejection: in this case the immunity system of the body identifies the new transplanted kidney as a foreign object or an invader and hence rejects it. This can cause serious damage to the kidney. Immuno-suppressive medications prevent the risk and rate of rejection.
2. Infection: Post operation, bacterial infections involving the urinary tract are very common. The immuno-suppressive medications prevent rejection, but leave you at an increased risk for infections. To prevent infection, antibiotics should be taken for the first 3-6 months after your transplant.
3. Urine Leak: If the bladder becomes full before the incision in the bladder gets healed, the ureter can pull away from the bladder causing the urine to leak out.
4. High Blood Pressure: The immuno-suppressive medications might lead to an increase in the blood pressure which in turn may damage your heart and other organs. Additional medicines might have to be taken to control the blood pressure.
5. Diabetes: Some immuno-suppressive medications can also increase the blood sugar level in the body.  Proper diet and adequate exercise can help in maintaining optimum blood sugar level.
6. Kidney Stones: Sometimes kidney stones get transplanted along with the donor kidney. This calls for kidney stone treatment.

Q13. How Different is Life after Surgery? What is the Diet One should Prefer?

One can lead a normal and healthy life even after surgery. However, patients need to take care of their transplanted kidney and the following points need to be kept in mind:

• Quit Smoking: Smoking doubles the risk of a kidney failure.
• Stop Alcohol and Drug Intake: Alcohol being high in calories causes weight gain. Drugs, on the other hand lead to a drastic increase in the blood pressure. Both cause serious damage to the kidney.

Although the dietary restrictions are not much, a few changes in the diet are advised. In order to control your weight and blood sugar level, avoid foods high in sugar and fat content. Intake of salt should be limited, as high levels of sodium can increase your blood pressure. Taking 5-6 small meal servings unlike the conventional heavy 3 meals is also advised. Low-fat dairy products should be consumed to maintain the desired calcium and phosphorus levels. The diet should be rich in fiber content. The intake of water should be kept more than 7-8 glasses in a day to keep the body hydrated. Regular kidney function tests should be performed to make sure that the transplanted kidney is functioning properly in the body.

Q14. What is the Estimated Total Cost of Surgery?

The cost of a kidney transplant surgery ranges from Rs.300000 to Rs.700000 in Indian hospitals, depending on the procedure to be carried out and the availability of kidney donor.