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Wednesday, April 16, 2008

Kidney Transplant

We offer a complete range of investigations, medical
procedures and surgeries at our hospitals. The treatment
procedures listed below is a partial list only. To enquire
about treatment for your condition, please click the link
at the bottom of this page.

About kidney transplants

What is a kidney transplant?

A kidney transplant is a surgical procedure in which
a person whose own kidneys have failed receives a new
kidney to take over the blood purification function.
The surgery is classified as a major one but advancements
in medicine have greatly improved the success rates and
the acceptability of donors who would some years ago
have been rejected.

Kidney donations come from two sources: living
donors and non-living donors. A living donor may be
a family member, close friend or even a stranger
who wishes to donate a kidney to anyone in need of
a transplant.( In India donations byunrelated living
donors require special approvals from the government).
Deceased donor kidneys usually come from people
who have willed their kidneys before their death.

How is donor-patient kidney compatibility
tested?


What blood tests are performed to determine if a
person is a compatible kidney donor?

Blood type

A simple blood test is performed to verify the blood
type of the donor and the patient. Given below is a
compatibility table:

Donor blood type

Patient blood type
A
A or AB
B
B or AB
AB
AB
O
Any blood type: A, B, AB or O

Tissue typing

Tissue typing is a blood test that evaluates the
compatibility between the tissue of the donor and
the patient.

The human leukocyte antigen test, also known as
HLA, is a test that detects antigens (genetic markers
in white blood cells that trigger antibody production).
The HLA test is used to verify tissue compatibility typing
of tissue recipients and donors

Siblings (brothers and sisters) usually have the best
chance of being a perfect match (6 of 6 antigens).
Recent developments in anti-rejection medications
have cut down the occurrence of rejection in kidneys from
unrelated donors

Crossmatching

Blood samples of the donor and the patient are allowed
to mix in the laboratory. If the interface does not result
in any cell damage, compatibility is indicated. On the other
hand, if cells begin to die, the conclusion is non-compatibility.

If the blood tests indicate compatibility, the potential
donor is examined to verity that his physical condition
does not preclude the donation. Counseling is also
provided.

What are the risks of kidney transplantation?

As with any surgery, the common risks are bleeding,
infection, or breathing problems. The patient could be
more prone to infections, as immune-suppression
medication taken after transplantation lowers the
body’s defence against infection. The specific risk is organ
rejection.

What is kidney rejection?

Kidney rejection is caused when the body’s immune
system recognizes the transplanted kidney as a ‘foreign’
object and activates the body’s defence mechanism.
The degree of rejection depends on a number of factors
including the extent of mismatchbetween the donor and
the patient’s tissues.

Rejection is overcome by taking medications every day.
Anti-rejection medications have possible side effects
(high blood pressure, weight gain and a susceptibility to
infections and tumors) because the body's immune system
is suppressed. The side effects usually are manageable for
most patients.

The kidney transplant procedure

Kidney transplant surgery usually lasts three to five hours.
The damaged kidneys are usually left in place, with the new
kidney being placed in the lower abdomen. The artery and
vein of the new kidney will be attached to an artery and vein
in the lower part of the abdomen, just above one of the legs.
The new kidney's ureter, the tube that links the kidney to the
bladder, will be connected to the bladder.

The transplanted kidney may function immediately. In some
cases the kidney begins to work only after a week or so.
Soreness or pain around the surgery site is common..
The recovery time in the hospital is usually about seven days.

We advise patients from outside of India to come prepared
for a 10-12 week stay, post-discharge, in the city where the
transplant is done. This is to facilitate routine dressings initially
and for monitoring thereafter.

What are the chances of a successful kidney transplant?

With proper matching and appropriate medication, the
chances of a successful transplant are good. A successful
kidney transplant gives the patient strength and vitality.
The patient canreturn to a close to normal diet and
food intake. A more normal lifestyle and more independence
in day to day activities is possible.

Are kidney transplants done in India?

Yes, kidney transplants are done exceptionally well
at many hospitals in India. The success rates match
international standards. Indian doctors have a wealth of
experience in kidney transplants owing to the large
number of procedures done. We offer kidney transplants
at five leading centres in India.

Can you find a kidney donor for us in India

Sorry, we take on only those cases where the donor
is organised by the patient’s family. Preferably, the donor
should be a close relative of the patient. Siblings,
parents, children and spouse come under the category of
'close relatives'.

In cases where the donor is not a close relative,
government permission is required and is given only if it
is established that there is no commercial angle whatsoever
to the donation.

In view of various ethical and legal issues involving the
sale of kidneys, we do not take on the responsibility of
organising kidney donors.

Costs
Hospital costs : The total cost of the kidney transplant
would be $ 13,000 to $ 30,000 depending on the ward
category, extent of treatment, complications, etc.
Hospital stay would be about 8 days for the donor,
15 days for the patient. The cost includes all hospital
costs from the time of admission of the patient and the
donor till the time of their discharge after the transplant.

Accommodation outside the hospital : The patient will
need to stay in an apartment near the hospital for about 2
weeks before the surgery and for about 8-10 weeks after
the transplant. Accommodation in a furnished apartment
starts at about $ 600 a month.

Four steps to get a kidney transplant done in India

1. Identify a donor from your country, preferable a relative

2. Please investigate donor-patient compatibility in your
country or a neighbouring country if possible. If not you
can send us samples for HLA typing ( couriers may have
restrictions). If this also is not possible, you will need to
come to India forinvestigations

3. Once compatibility is confirmed, both the patient and
donor will be investigated for operability

4. Transplant will take place after the above confirmations
and completion of documentation relating to the donation of
kidney ( We will need Government permission in cases where
the donor and patient are not closely related)

Summary

1. Medically speaking, we can organise a kidney transplant
procedure at one of the best hospitals in India. The success
rate is at world class levels.

2. There are no legal issues if the donor is a close relative

3. In cases where the donor is not a close relative, Govt.
permission is necessary but may or may not be given
depending on the circumstances of the case.

4. We do not organise donors for kidneys

5. The total cost of the kidney transplant would be
$ 13,000 to $ 30,000 depending on the ward category,
extent of treatment, complications, etc

6. Hospital stay would be about 8 days for the donor,
15 days for the patient.

7. The patient will need to stay in an apartment near the
hospital for 2 weeks before the surgery and for about 8-10
weeks after the transplant. Accommodation in a furnished
apartment costs start at about $ 600 a month.

* The above costs are an approximate range and
may vary slightly
from case to case

We offer a complete range of investigations, medical
procedures and surgeries at our hospitals. The treatment
procedures listed above is a partial list only. To enquire about
treatment for your condition, please click here.

Via: http://www.aarexindia.com










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