Kidney Transplant in a Nut-shell.

Renal Transplantation remains the best form of renal replacement therapy providing better quality of life and  survival compared to dialysis.  Live related donor transplant still remains the solution of choice in End Stage Kidney Disease (ESKD) patients with the promise of deceased donor (cadaver donor) transplantation still not fulfilling its promised growth.

 

Who is eligible for Kidney Transplantation ?

Patients whose kidneys have completely failed and no recovery is expected at all ( i.e. Patients with ESKD) have kidney transplant as an option. The other option is to stay on dialysis life-long. These patients are anyways started on dialysis till the transplant workup is done.

However, Kidney transplant can also be done prior to dialysis requirement and is called pre-emptive kidney transplant. Dialysis is no longer required after a successful kidney transplant.

What are the requirements for a kidney transplant ?

A medically fit recipient, a blood group compatible donor, a nephrologist experienced in handling kidney transplant patients, a urosurgeon experienced in performing transplant surgery and most importantly, a multi-specialty hospital recognized for performing kidney transplants.

Who can donate a kidney?

As per the existing Human Organ Transplant Act  1994, any of the first degree relatives of the recipient     ( parents, siblings, children) or the spouse can be an organ donor  provided they are blood group compatible. 

Anyone apart from the above relatives are considered as 'unrelated' by law.

Blood group [ABO] compatibility is the same as that in relation to blood transfusion except that the Rh compatibility is not required for kidney transplant. Blood group ‘AB’ is a universal recipient while ‘O’ is a universal donor.

Who cannot donate a kidney?

Following is a list of conditions which preclude kidney donation.

Absolute

  • Psychiatric disease interfering with ability to consent

  • Active drug or alcohol abuse

  • Evidence of advanced kidney disease

  • Recurrent or bilateral kidney stones

  • Diabetes with kidney involvement

  • Severe Hypertension

  • Malignancy

  • Active infection

  • Chronic active viral infection (hepatitis B or C, HIV)

  • Significant chronic liver disease

  • Current pregnancy
     

Relative

  • Age <18 or >65 years

  • Morbid Obesity

  • Mild or easily treated hypertension

  • Borderline urinary abnormalities

Next : The Surgery & outcomes

 

 

 

 

 
 

Kidney Transplantation