Kidney Transplantation

Kidney Transplantation has become the most accepted mode of treatment for patients with terminal Chronic Kidney Disease (CKD) throughout the world as the quality of life and longevity is much better as compared to long term dialysis. Since the first successful human kidney transplantation between two identical twin donor recipient pair in USA in 1958 thousands of patients underwent this procedure with an excellent outcome. The programme was started at few centers across India in '70s and presently more than 4000 such operations are carried out every year in the country. Though more than 100,000 terminal kidney failure patient need kidney transplantation every year in India the number of transplant performed are very few. Besides the cost of such treatment lack of human organ for transplantation is the biggest hurdle to provide this treatment to every needy patient. Shortage of human organ for transplantation is a global problem and even in most developed countries where 80 percent of the organ transplanted are from cadaver donors, the average waiting period for a cadaver transplantation is about five years. In India more than 95 percent of the transplanted kidneys are from living donor and remaining from cadaver donors as awareness about organ donation after death is very low in general population. The government is also making effort to create awareness about organ donation and thus increase the number of cadaver donors in the country and in coming years we may start seeing the results.

In kidney transplantation, one kidney from another human being (whether living person or cadaver) is implanted into the patient's body by a sophisticated surgical technique. The new kidney works like patient's own kidney and most of the time they start producing urine immediately after transplantation. Within a reasonable period of time (normally less than a week) the Urea, Creatinine level return to normal and the patient experience a tremendous feeling of well being and start eating normal diet with virtually no food restriction. All patients are immediately put on immunosuppressive drugs to prevent rejection of the transplanted kidney. During first 48 - 72 hrs patient are kept under close observation and they are regularly monitored for blood pressure, temperature, pulse, urine output etc. and blood and other investigations are done at frequent intervals to monitor the progress. Normally the donor is discharged after 5-6 days of surgery and the recipient 10-12 days after surgery and they are monitored regularly on outpatient basis. During the operation some tubes are left in the operated area and they will be removed by the surgical team at an appropriate time. An urinary catheter is kept in the bladder for about a week to closely monitor the urine output.