Kidney Transplantation India

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Understanding the Kidney Transplant
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Having a kidney transplant is often the last
ditch effort to save the life of an individual
whose kidneys have failed and no longer process
waste products in the body. Statistics reveal
that a total of about 9,000 kidney transplants
occur every year from cadavers and about 3,000
transplants occur from living related donors.
Living unrelated donors account for 9,000
transplants per year. Sadly, there are more than
56,000 individuals waiting for kidney transplants
at any given period of time.
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The first successful kidney transplant was done
in 1954 in both Boston and Paris. These were
kidney transplants done between identical twins
which don't have problems with rejection. The
biggest problem was tissue typing--finding a
suitable match for the recipient and making sure
that rejection is kept to a minimum. This is why
many donors are relatives who are a good match or
living donors who are a good tissue typing match
for the recipient. Living donors are carefully
evaluated to make sure they are medically and
psychologically able to donate their kidneys for
kidney transplant. The living donor transplant
used to be done via an open procedure but it is
now increasingly done through laparoscopic
surgery, which is easier to tolerate. Kidneys
from living donors have a better success rate
than do kidneys from deceased donors.
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Kidney transplant from deceased donors can come
from those whose hearts are still beating but are
brain dead, as well as from non-heart beating
donors. The kidney can survive on ice for several
hours before transplant so that technically, a
person can be deceased and still donate their
kidneys. The kidney is then kept in a cold
solution prior to donation. The best organs for
kidney transplant come from the brain dead
donors. Doctors judge compatibility for
kidney transplant by assessing the ABO blood type
of the donor and recipient as well as the HLA and
minor antigens. If many of these match, the risk
of rejecting the transplant and further dialysis
is much decreased. In addition, immunosuppressant
are used to keep the immune system in check. In
the US, only about 17 of transplants have no HLA
mismatch whatsoever
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• Because kidneys can be kept cold for several
  hours, the kidney transplant is usually done in a
  different place from where it was harvested. In
  addition, the kidney is also placed in a
  different place from where a normal kidney would
  be. The most common spot for kidney transplant is
  the iliac fossa in the lower abdomen. The blood
  supply must come from somewhere other than the
  renal artery.
• In situations where the kidney transplant
  recipient is a diabetic, the pancreas is also
  sometimes transplanted at the same time in order
  to turn around some of the diabetes the
  individual has. This almost always requires a
  deceased donor although partial pancreas
  transplants in living donors has been done. The
  patient can also receive a kidney transplant
  first, followed by a pancreas transplant at a
  later date.

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In situations where the kidney transplant
recipient is a diabetic, the pancreas is also
sometimes transplanted at the same time in order
to turn around some of the diabetes the
individual has. This almost always requires a
deceased donor although partial pancreas
transplants in living donors has been done. The
patient can also receive a kidney transplant
first, followed by a pancreas transplant at a
later date.
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