Urologic Surgery and Kidney Transplantation Treatment in India

A kidney transplant is a surgical removing of a diseased kidney and replacing it with a healthy kidney from a donor. The kidneys are fist-size bean-shaped organs located on each side of the spine just below the rib cage. The primary function of kidneys is to filter and remove waste, fluid and minerals from the blood by producing urine. When the kidneys lose this filtering ability, dangerous levels of fluid and waste accumulate in the body. This failure can raise blood pressure and result in kidney failure (end-stage kidney disease). The end-stage renal disease occurs when the kidneys have lost about 90% of their ability to function normally.

Common causes of end-stage kidney disease include:

• Diabetes
• Chronic, uncontrolled high blood pressure
• Chronic glomerulonephritis (inflammation and eventual scarring of the tiny filters within your kidneys)
• Polycystic kidney disease

Types of Kidneys Transplant

Deceased donor transplant: When a donor is a dead person who has donated his kidney, it is termed as a deceased donor transplant. Usually, doctors made it sure that the donor and recipient are often in the same region to minimize the time of the kidney outside a human body.

Living donor transplant: Living people who donate one of their kidneys are called living donor. It can be a family member, a friend or even a stranger. Whoever it is, that person will need a health exam to test whether the kidney is a good match.

Pre-emptive kidney transplant: A pre-emptive kidney transplant is a type of kidney transplant that takes place before the kidney function deteriorates to the highest point and felt the need for dialysis.

What can you expect?

Before the procedure

Finding a match

A kidney donor can be deceased or living, unrelated or related to the patient. The transplant team will consider several factors when evaluating whether a donor kidney will be a good match for the patient or not.

Following tests are done to determine whether a donated kidney is suitable:

Blood type: It's preferable to get an organ from a donor of the same blood group as a patient. Blood-type incompatible transplants (known as ABO-incompatible kidney transplants) are also possible. But these types of transplants require additional medical treatments before and after transplant to reduce the risk of organ rejection.

Tissue type: If your blood type is compatible, the next step is a tissue typing test called HLA (human leukocyte antigen) typing. This test compares genetic markers that can increase the likelihood of the transplanted kidney will last a long time. A suitable match means ensures the chances that the patient's body is less likely to reject the organ.

Crossmatch: This matching test involves mixing a small sample of the donor's blood with the patient's blood in the lab. The test determines whether antibodies in the patient's blood will react against specific antigens in the donor's blood.

A negative cross match means they both are compatible and the body of the recipient isn't as likely to reject the donor's kidney.

Sometimes, positive crossmatch kidney transplants are also done, but these types of transplants require additional medical treatments before and after the transplant to reduce the risk of organ rejection.

Some additional factors such as matching the age, kidney size and infection exposure are also considered when the transplant team is finding the most appropriate donor kidney for you.

Living kidney donation

Finding a willing living kidney donor is alternative to waiting for a compatible deceased-donor kidney to become available.

Family members are the most compatible living kidney donors, but living-donor transplants are also successful when the kidneys are donated from unrelated people, such as co-workers, friends or religious congregation members.

Paired donation is also a type of living kidney donation. There may be a case when you have a willing kidney donor, but his organ is not compatible with you. In this case, rather than giving a kidney directly to you, your donor may donate his kidney to someone who is a better match. Then you will receive a compatible kidney from the donor of that recipient.

There are cases when more than two pairs of donors and recipients are linked with a non-directly known living kidney donor to form a donation chain.

If a living donor does not match, then your name will be placed on a waiting list for a deceased-donor kidney. Because of the fewer available kidneys than people are waiting for, the waiting list continues to grow. Usually, the waiting time for this type of kidney is a few years.

Staying healthy

Whether the people are waiting for a donated kidney or their kidney transplant surgery is already scheduled, they need to work to stay healthy. Being active and healthy as you're able will make you ready for the transplant surgery when the time comes. It will speed up your recovery from surgery. To get ready for the surgery, you need to:

• Take your prescribed medications on time.
• Follow your exercise and diet routine.
• Don't smoke.
• Stay involved in healthy activities, including relaxing.

You need to stay in touch with your transplant team and let them know of any significant changes in health. In case you're waiting for a donated kidney, make sure that the transplant team can reach you anytime, i.e. you should update your latest contact number with them. You should keep your packed hospital bag handy, and your arrangements for transportation to the transplant center in advance.

During the surgery

Kidney transplant is performed with general anesthesia. The surgical team monitors the blood pressure, heart rate and blood oxygen level of the patient throughout the procedure.

• The surgeon will make an incision in the lower part of the abdomen of the patient and places the new kidney into their body. If the current kidney of the patient is not causing complications such as high blood pressure, pain or infection, or kidney stones, they are left in place.
• The blood vessels of the new kidney are attached to the blood vessels in the lower part of your abdomen.
• The new kidney's ureter (the tube that links the kidney to the bladder) is connected to your bladder.

After the procedure

• After your kidney transplant, you need to spend several days to a week in the hospital.
• The medical team monitors your condition and watch for any signs of complications.
• Your new kidney will make urine similar to your own kidneys did when they were healthy. This may start immediately.
• However, in some cases, it may take several days, and you need temporary dialysis until the new kidneys begin to function properly.
• Most kidney recipients can resume normal activities within eight weeks after the transplant operation.
• Avoid heavy weight exercises until the wound has healed (usually about six weeks after surgery).
• The patient needs to have frequent checkups.
• After the patient leaves the hospital, close monitoring is necessary for a few weeks. This monitoring will help you to understand how well your new kidney is working.
• The patient may need blood tests several times a week and have your medications adjusted in the weeks following your transplant.
• You'll take drugs called immunosuppressants (anti-rejection medications) that will help your immune system from attacking and rejecting the new kidney.
• Additional drugs can help reduce the risk of other complications, such as infection.

Kidney Transplant Cost

Heart transplant cost in India varies from USD 10,000 to USD 14000.

Factors Affecting the Cost of Kidney transplant:

• The hospital patient is opting for.
• Type of Room: Standard single, deluxe or super deluxe room for the number of nights specified (including meals, nursing fee, room rate, and room service).
• Operating room, ICU
• Fee for the team of doctors (Anesthetist, Surgeons, Physiotherapist, Dietician)
• Medicines

No. of days required

• Total number of days: 40
• Days in hospital: 10
• Days outside the hospital: 30

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