Kidney Transplant Surgery at Fortis Hospital, Bangalore

Importance of Kidneys and what is Kidney Transplant

Dialysis can be painful. It can be a recurring source of muscle cramps, hypertension, hypotension and a wide array of infections and sepsis. More than anything, it can also be physically and mentally exhausting for the patient. It includes frequent insertion of a needle that removes blood and transfers it to a dialysis machine that filters waste products from the blood. It is needed as an external substitute for kidneys and can temporarily perform their functions. However, re-drawing your focus to the word – ‘substitute’’ dialysis is only recommended as an alternate until the patient’s kidney resumes its functioning.

More often than not, the patient’s kidney fails to restore back to its original functionality and needs to be replaced. This means that it is no longer capable of maintaining overall fluid balance, filtering waste materials and/or creating hormones that help produce red blood cells and regulate blood pressure. This is when a kidney transplant is explored as a viable option.

As experienced and recommended by many, a kidney transplant is often the treatment of choice for kidney failure compared to a lifetime on dialysis. It can treat chronic renal (related to kidney) diseases to help patients live longer.

Some of the common causes of end-stage renal disease include:

• Chronic uncontrolled high/low blood pressure

• Chronic inflammation and eventual scarring of the tiny filters within the kidneys (glomeruli)

• Polycystic kidney disease

• Diabetes

Thus, apart from the obvious benefit of not suffering from a life threatening disease anymore, a patient also achieves:

• Lower risk of death due to health complications

• Better quality of life with fewer dietary and lifestyle restrictions

• Lower and essentially one-time treatment cost

Eligibility for Kidney Transplant

As with any other transplant surgery, after a patient has been selected by a transplant center, his/her candidature is evaluated to determine whether he/she meets the center’s eligibility requirements.

Multiple tests are done including MRI and CT scans, blood tests and a detailed psychological evaluation. The results of such tests are then discussed in detail with the patient and his/her family. Care has to be taken to ensure that no current medications/medical conditions would interfere with the success of this surgery. Also, above everything else, the patient’s willingness to undergo this extensive surgery and his/her commitment to taking utmost care pre and post-surgery has to be measured.

Conditions that may prevent the patient from being eligible for a kidney transplant include:

• Advanced age, dementia and/ or other mental illness

• Severe heart disease and alcohol/ drug abuse

• Active or recently treated cancer

Types of Kidney Transplant

Basis availability and severity of the situation, one of the below transplant types is followed:

• Living donor kidney transplant:
  Such a transplant involves procuring a kidney from a living donor. He/she may be a blood relative or someone close to the patient. Living donor kidney transplant has a much shorter waiting time than the former.

• Pre-emptive kidney transplant:
  A pre-emptive kidney transplant is a precautionary procedure which is performed before the kidney functioning worsens to the extent of performing dialysis to enhance/substitute the normal functioning of the kidneys.

• Deceased donor kidney transplant:
  Such a transplant involves transplanting a kidney from an individual from whom at least one organ is recovered for the purpose of transplantation after suffering from brain or cardiac death.

How is a Kidney Transplant performed?

Apart from the obvious complications of a transplant surgery in general, a kidney transplant is a relatively simpler procedure. The new kidney is transplanted to the lower section of the abdomen towards the front side and is connected to the artery and vein that the previous dysfunctional kidney was connected to. It is not necessary to remove the previous kidney and more often than not, it is left in its place. However, if it possesses serious health risks such as cancer or infection, it is removed. The transplant is done under general anesthesia and its duration would vary between 2-4 hours basis the technique used. The new kidney starts working immediately or may take few days.

Post-surgery risks and care

Advancements in medicine and technology have drastically reduced the failure rate of such transplants. However, in some cases, it may not achieve 100% success and some complications may arise.

Some of these complications include:

• Rejection of the donated kidney

• Blood clots, infection, leakage and bleeding

• An infection transfer through the donated kidney

• Heart attack and other serious worries

• Medication side effects such as acne, high/low blood pressure, nausea, diabetes and weight gain

Anti-rejection medicines are recommended for the rest of the patient’s life to suppress the immune system from rejecting the donated kidney. It is thus paramount that the patient religiously takes the prescribed medications to avoid any serious complications. Physical activities and exercise are also recommended to ensure a good level of mental and physical health to expedite the healing process.

Why FORTIS?

Such transplants, with every passing day, need to evolve towards being lower on risk and pain. They need to focus on delivering a higher success level and be as comfortable and meaningful for the patient as can be. Fortis works on exactly this philosophy. With their minimally invasive robotic procedure, they focus on minimal incision to mitigate infection related risks. Fortis has one of the largest and most comprehensive organ transplant programs in India with excellent medical care and facilities for pre and post-transplant management. They work closely with patients to determine whether or not a transplant is the most viable option for them. Right from the treatment that a patient and his loved ones receive, to the experts that help patients get their lives back on track, Fortis ensures that they become a caring and indispensable part of this life transformational journey. Their team functions in an integrated fashion to ensure a good end result. They leave no stone unturned in keeping all up to speed by doing the right diagnosis, having detailed discussions with the patients and their families to explain the procedure in detail and then performing transplants with international standards of accuracy and success rate. Their research team as well is continually focused on finding safer and better, techniques and treatments. The Fortis team that has even pioneered certain procedures in the transplant field have combined experience of X years with an astonishing success rate of X.