Renal Transplant Surgery
Kidneys- a pair of vital organs of the body
The kidneys are a pair of organs located within the abdomen
below the ribs toward the middle of the back. They are made
of a network of millions of tiny units called 'nephrons' which
are the basic functional unit of the kidneys. The nephrons
filter out toxins, excess nutrients and body fluid and excrete
them in the form of urine into the bladder.
Kidneys are essentially blood-cleansing organs and their main
function is to:
- Excrete liquid waste from the blood in the form of urine
- Maintain a balance of salts and other substances in the
body
- Production of a hormone that aids the formation of red
blood cells
Kidney disorders:
Kidney disorders may be caused by congenital defects, by disease
or by lifestyle. Diseases of the kidney and urinary tract
remain a major cause of illness and death in the United States.
A recent analysis showed that more than 300,000 Americans
today have End Stage Renal Disease (ESRD), a condition whereby
the kidneys completely stop functioning.
Common Signs/ Symptoms of Kidney disease are:
- Fluid retention
- High blood pressure
- Disorientation or mental confusion
- Abnormal urine or blood test results
- Headache
- Fatigue
- Shortness of breath
Indications for renal transplant:
- Chronic Renal failure/ End Stage Renal Disease (ESRD)
- End Stage Renal Disease (ESRD) is defined as a drop in
the glomerular filtration rate (GFR) to 20-25% of normal.
A large no of conditions and diseases lead to ESRD. The major
few are:
- Hypertension
- Diabetes Mellitus
- Chronic Glomerulonephritis
- Cystic kidney
- Nephrosclerosis
- Interstitial nephritis
- Renal tumors (Renal cell carcinoma in adults, Wilms tumor
in children)
Renal Transplant:
Once determined that the patient has ESRD, Renal transplantation
becomes the treatment of choice.
Sources of kidney:
The kidney can be procured from the following
sources:
- Deceased-donor (formerly known as cadaveric)
- Living-donor
Living donor Renal Transplants are further subdivided, depending
on whether a biological relationship exists between the donor
and recipient, into:
- Living related
- Living non- related
Renal Transplant Teams associated with Indicure:
Our associate hospitals have a dedicated team of very senior
surgeons for performing the renal transplant procedures. The
team consists of physicians and surgeon specialists who perform
the initial assessments and do the pre-transplant evaluation
thereby ensuring that the patient is a good candidate for
the procedure.
The doctors and all the associated people educate the patient
at all the levels and provide him with psychological support
so that the patient has a smooth transition into the transplant
and the following phases.
Our hospitals feature state of the art equipment and facilities
which are JCI or ISO accredited and we only work with board
certified surgeons. This means that you will receive care
which is recognised by international standards.
The renal transplant team basically comprises of:
- Renal Transplant Surgeon
- Transplant Physician (Nephrologist)
- Anesthetist
- Nurses
- Social Worker
Pre Transplant Evaluation:
On making it definitive that the patient needs a renal transplant,
the transplant specialist gets certain tests done of the patient,
to determine that the rest of the body is functioning optimally.
The extensive battery of tests helps the doctors in identifying
potential problems that may occur later. These pretransplant
tests include:
- Complete medical and surgical history
- Complete blood counts
- Chest X-ray
- Blood Typing
- PFT's or pulmonary function tests
- Ultrasound
- Tissue typing
- PRA ( Panel Reactive Antibody) test
- Mammogram
- PAP smear
- And few others
The transplant procedure:
The kidney transplant procedure is done under general anesthesia.
The surgeon makes an incision in the lower part of the abdominal
cavity and the new kidney is placed near the groin region
of the patient. The surgeons then connect the kidney to all
the vessels and the bladder. A small drain, called a Jackson
Pratt, is also placed into the abdominal cavity to drain any
excess fluid.
Post Operative Care:
The patient is kept in ICU for 1-2 days after the surgery
and in the transplant unit for another couple of days, before
being discharged.
The new kidney generally stars functioning in 3-5 days in
live donor kidneys and 7-15 days in cadaveric donations.
Regular monitoring of the blood levels is done for checking
the proper functioning of the kidney. The patient is administered
Immunosuppressant drugs for the first few days to avoid rejection
of the new kidney by the body.
Outcome of kidney Transplant:
Kidney transplantation is a life-extending procedure. A patient
who has accepted the organ well has chances of living up to
ten to fifteen years longer with a kidney transplant than
if kept on dialysis. The years of life gained are greater
for younger patients.
The most important factor in kidney transplant procedure is
the improvement in quality of life. People generally have
more energy, a less restricted diet, and fewer complications
with a kidney transplant than if they stay on conventional
dialysis.
Family Involvement:
We at Indicure, completely understand that Kidney transplantation
is a family affair, since it is a matter of the life of your
loved one. We strongly believe in involving the family members
intricately in the care process, including decision making
and follow-up lifestyle changes. The team involved in the
transplant explains the kidney patients and their families
in detail about what is happening. They are available 24 hours
a day to answer emergency questions. The doctors and all the
associated people educate the patient at all the levels and
provide him with psychological support so that the patient
has a smooth transition into the transplant and the following
phases.
Top
|
