Kidney transplant is the surgery performed by a trained and well experienced transplant urology surgeon to replace a new fully functional kidney from a healthy donor or a deceased donor to replace the faulty or failed kidneys in a CRF (Chronic renal failure) or end stage renal disease (ESRD) patient.We are associated with Best Nephrologist and Transplant Urology surgeons for Kidney transplant in India for CRF or ESRD patients seeking Kidney transplant in India.
At CMCS Health we have the best Nephrologists and transplant Urology Surgeon in India as our associates and best Indian hospitals for a kidney transplant in India‚ and effective post kidney transplant care for maintenance and sustaining of the newly transplanted kidney.
Understanding Kidney function:
The function of healthy human kidneys is to remove toxins and wastes of metabolites and minerals from the blood. Kidneys also produces certain hormones like calcitriol and erythropoietin .Erythropoietin is responsible for growth and maturation of RBCs. Kidneys also plays a role in maintaining a healthy blood pressure.
Reasons for kidney failure:
The two major causes for kidney failure are prolonged uncontrolled and untreated high blood pressure (Hypertension) and elevated and uncontrolled blood sugar (Diabetes).
The other causes include glomerulonephritis. Glomerulonephritis is a disease that damages the toxins and wastes filtering capacity of kidneys. The exact cause of glomerulonephritis is not known but studies suggest it could be heredity or may be some untreated infections.
Over usage of certain over the counter pain relieving medicines (NSAIDs etc) and severe blood loss or dehydration may also cause kidney failure.
Treatment Options for Kidney Failure:
The first treatment a ESRD (end stage renal disease) or kidney failure patient receives is Hemodialysis. That is artificial filtration of blood by using dialysis machines. But hemodialysis is not a permanent solution and nephrologists and urologists may consider Kidney transplant from a deceased or living donor ( A healthy blood relative ) as a better and stable solution for end stage kidney disease (ESRD) patient.
Kidney transplant procedures can be be done only at hospitals that have license for organ transplant procedures , well equipped operation theaters, properly managed isolation Intensive care units for taking care of patient post successful kidney transplant and minimize the chances of any infection during recuperating post the kidney transplant , trained nursing staff and a well experienced team of transplant urology surgeons , nephrologist and dietician.
The patient and prospective living kidney donor ( a healthy blood relative to recipient ) undergo a battery of diagnostic tests for assessment of feasibility and success of kidney transplant for recipient and safety of kidney donor.
Tests needed for the ESRD or CRF patient before Kidney transplant:
- Blood tests including Protein creatinine ratio, LFT (Liver function test), Urea, Creatinine, Sodium(Na),Potassium (K),Blood sugar( Fasting and Post prandial),HBA1C, Calcium (Ca),Phosphate (Po4),Uric Acid, PTH, Lipid profile,Vitamin D level,T3.T4,TSH and LDH , Complete Hemogram, BT, CT, PT, PTTK , CMV-IGG,EBV(CAPSId)_IGG, for MALE patient PSA (if above 50 years of age) , for Female patient CA-125 and pap smear, Blood group, HBSAG, Anti HCV antibody,HIV1 & 2, HCV RNA qualitative,Anti HBS antibody.
- Cardiology ( Heart function ) tests including ECG,Echo/stress echo,Cardiac clearance from a cardiology ( Heart ) doctor .
- Urine tests including Urine ( SPOT) , urine routine and urine culture.
- Imaging tests including Chest X-ray,Ultrasound-whole abdomen, Color doppler Aorta iliac vessels and carotid.
These tests for donor will help the kidney transplant specialists in assessing the suitability of patient for a successful kidney transplant.
Test needed for the living ( blood related ) kidney Donor :
1. Urine ( SPOT) ,Protein creatinine ratio, LFT (Liver function test),Urea, Creatinine, Sodium(Na),Potassium (K),Blood sugar( Fasting and Post prandial),HBA1C, Calcium (Ca),Phosphate (Po4),Uric Acid, PTH, Lipid profile,Vitamin D level,T3.T4,TSH and LDH.
2.Complete Hemogram, BT, CT,PT,PTTK and urine routine.
3.Urine culture, CMV-IGG,EBV(CAPSId)_IGG, for MALE patient PSA (if above 50 years of age) , for Female patient CA-125 and pap smear.
4.Blood group, HBSAG, Anti HCV antibody,HIV1 & 2, HCV RNA qualitative,Anti HBS antibody.
5. ECG,Echo/stress echo,Cardiac clearance from a cardiologist.
6.Chest X-ray,Ultrasound-whole abdomen,CT (Angio) for renal vessels, DTPA scan etc.
Selecting the right donor is important as it saves big money on dialysis , and staying in India costs till the time we get approval from the government of India appointed organ transplant committee.
The above test for donor are required to lessen the chances of flying in a wrong donor and avoiding time and money for guests till we fly in the right donor.
Once all the tests and investigations for both donor and patient are found to be satisfactory , doctors recommend an HLA matching of both patient and donor to further confirm the success of Kidney transplant.
We inform the patient and attendants about certain documentations required from their respective countries before flying to India for a kidney transplant.
Approval of organ transplant committee:
Once all the investigations and tests for patient and donor are found to be favorable , the treating hospital present the case to an organ transplant committee appointed by government of India for their approval.
After getting an approval from government of India appointed organ transplant committee , a surgery date is given for kidney transplant surgery.
The patient and family members need proper counselling before and after kidney transplant.
Hospital stay for Patient and donor for kidney transplant:
Patient usually remain in isolation KTP ICU for 10 to 12 days , post a successful kidney transplant recuperating his surgery and followup for functioning of newly grafted kidney.
Donor is usually discharged from the hospital after 5 to 7days.
Post Kidney transplant care and management:
Proper and timely follow up of tests your doctors have prescribed. Taking all your post transplant medicines at the accurate time interval prescribed by your doctor. As you are on immunosuppressant medicines to avoid rejection of new kidney by your own body, you should adopt good personal hygiene for not falling with infections.
Tests need to be done for the recipient post successful kidney transplant to ascertain dosing schedule for anti graft rejection medicines and sending those tests reports to doctor for modulating the dosage .
A successful kidney transplant patient lives a perfectly normal life with adequate precautions and timely check ups with the doctor. Some of the medicines will be life long although after three months of transplant the dosage and quantity of medicines are reduced depending on the performance of new kidney and how patients body respond to new kidney.
Cost of Kidney transplant in India:
For kidney transplant in India the normal package is from 13000 USD to 15000 USD. This package includes all the pre investigations for feasibility and success of kidney transplant for patient , investigations for fitness of donor , surgery and hospital stay for both the kidney recipient and donor . In some hospitals some free hemodialysis before the kidney transplant , are also included in the package .
HLA match for recipient and donor and two immunosuppression injections are included or excluded in some hospitals.
Post kidney transplant follow up investigations and immunosuppressive medications are not part of the package.
Frequently asked questions about Kidney transplant in india :
What is success rate for Kidney transplant in India ?
Kidney transplant is a complicated surgery and best treatment option for an ESRD or CRF patient . With an expert urology - Kidney transplant surgeon and the advent of new and very effective anti rejection medicines the success rate for Kidney transplant surgery is above 95 % for most of the patient. Proper follow up with nephrology doctor post a successful kidney transplant and strict adherence to anti rejection medication schedule helps the newly grafted kidney work for a really long time for a CRF or ESRD patient.
What is better , to remain on hemodialysis or go for a KTP ?
Not all ESRD or CRF patient are best suited for a kidney transplant. Patients with extremely old age , overall poor health , severe heart or vascular disease , recently treated or being treated for cancer disease , dementia , poorly controlled medical illness and severe obesity are not best suited for a kidney transplant.
ESRD or CRF patients who are younger , in good overall health otherwise , living a productive and busy life that is hampered by going for a hemodialysis two to three times in a week should always go for a kidney transplant if they have resources . Increased life expectancy , better productivity and much improved quality of life is a big advantage , a kidney or renal transplant offers to such patients.
A thorough assessment of ESRD or CRF patient before the kidney transplant helps the treating doctor in advising the patient if he should remain on hemodialysis or go for a kidney transplant.
How will i get a healthy kidney for a Kidney transplant in India ?
As deceased donor program is still in a very nascent stage and waiting list for pre listed ESRD or CRF Indian patients is long and patient needs to be in close vicinity of the hospital with which he/she is listed for a deceased donor program , makes it almost impossible for foreign medical travelers to India to be enlisted for a deceased donor kidney transplant program.
A living donor kidney transplant is best for a foreign kidney patient seeking kidney transplant in India. As per the government of India guidelines any living donor for a kidney transplant requiring patient needs to be a healthy close blood relative , like a brother or sister , father , mother or grandparents ( below 55 years of age ) , son or daughter or even spouse can donate one of their kidney to ESRD or CRF patient.
For kidney transplant in India,where will i stay in India and for how long ?
Usually a patient need to stay in India for 8-10 weeks for pre kidney transplant analysis and post Kidney transplant follow up including 10 to 12 days stay in hospital after the successful kidney transplant surgery.
At CMCS Health , we arrange a furnished guest house room with individual or shared furnished kitchen or a hotel room depending on requirement , budget and taste of patient. We chose an accommodation for patient , his donor and medical attendant coming to us for a kidney transplant , in a safe and secure place and close to treating hospital.
What tests and follow ups are needed post a successful kidney transplant ?
Initially a complete blood count , Kidney function tests and tacrolimus levels ( Your anti graft rejection medicine ) need to be done on weekly basis and reports need to be seen by the doctor to tailor the anti graft rejection medicines dosage . Gradually it will be increased to 14 days in a month and after that every month for follow up for tapering down the anti graft rejection medicines. You also need to keep a close watch on your blood pressure and blood sugar control as an elevated blood pressure and diabetes are two major reasons for deterioration of kidney function.
How soon can i start an active life post a kidney transplant ?
A person can start an active life after 8 weeks of a successful kidney transplant . Although heavy and strenuous exercises need to be avoided for at least three months like in case of any other abdominal surgery. Your doctor may advise gentle aerobic exercise, such as walking or light chores around the house, from about a week after you get your transplant. Avoid lifting weight of more than 5 to 7 pounds in the first four weeks of your being discharged from hospital post successful kidney transplant.As you are on immunosuppressant medication ( antigraft rejection medicines ) you are prone to acquiring infections easily , so you must avoid going to crowded places and maintain a good personal hygiene to avoid infections.
This is very important and pertinent question for any solid organ transplant patient including the kidney transplant patient. As kidney transplant patients are on life ling immunosuppressive medications ( for graft rejection ) , they are at a higher risk of infections , including the infections preventable with vaccination. In spite of several emerging evidences that certain vaccines are safe for immunosuppressed patients , it remains a fact that most of the vaccines are sub effective in such people. Your transplant doctor can guide you about safety and efficacy of vaccination post kidney transplant.
What kind of foods i can eat post my kidney transplant ?
You were put on certain dietary restrictions when diagnosed with ESRD ( end stage renal disease ) or CRF ( chronic renal failure ) , many of the these dietary restrictions will be eased or completely taken off gradually by your kidney transplant doctors. As you are on immuno- suppressive medication to avoid kidney graft rejection , you should eat properly and hygienically cooked food. Avoid eating outside food , half cooked food , salad bars or buffets and peel off the skin of the fruits before eating.
Gaining weight post a successful kidney transplant is a common problem partially because of food restrictions withdrawal and also because of the feeling of increased hunger due to prednisolone ( Wysolone ) in your post KTP ( Kidney transplant ) medications. A balanced diet and regular physical exercises are needed to avoid being obese post a successful kidney transplant.
You may be advised for adding phosphorus in your diet that you get from low fat dairy products. Potassium levels needs to be monitored , low salt diets to reduce fluid retention and keeping a check on blood pressure , avoid foods high in fat and calories.
When can i resume my intimate life with my partner post KTP?
People diagnosed with ESRD or CKF have decreased libido and sex drive . After a successful kidney transplant a dramatic change is observed in sexual lives of most of the people.
Fertility tend to increase post a successful kidney transplant for both men and women. Men who have had a kidney transplant have fathered healthy children, and women with kidney transplants have had successful pregnancies. It is advisable to talk to your doctor when considering having a child.
Women need to avoid pregnancy at least for one year as some of the post kidney transplant medications may be potentially harmful for the fetus. All pregnancies must be carefully planned with consultation from your doctor and certain medications need to stop six weeks before conception.
It is very important to save yourself from sexually transmitted diseases ( STD) . Using protection during sexual activities is highly recommended.
Do i need to come to India for a follow up post my kidney transplant ?
Usually a kidney transplant patient is advised to come after six months for a review , but it is possible that patient can do follow up tests in his own country and send us the reports , we will discuss the reports with treating doctors and advise him accordingly about his follow up visit to India.
At CMCS Health , we are associated with best kidney transplant hospitals in India for medical travelers seeking kidney transplant in India .