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Renal transplant is a surgical procedure, where in a donor kidney from Live related donor or a cadaver donor is surgically transplanted in to a patient of permanent renal failure or End stage renal stage disease. . The kidneys are responsible for filtering the waste from the blood and removing it through the urine. The kidneys are also responsible for maintaining the balance of electrolytes and acid in the body. There can be a build-up of waste in the body if the kidneys stop functioning properly. This would make one fall sick. People with kidney failures undergo dialysis where these metabolic waste is filtered out mechanically. All the patients of end stage renal diseases or permanent renal failure are kept on Dialysis. Once a donor kidney is available for renal transplant these patients are taken up for surgery and renal transplant is done. All transplant in India is strictly monitored by government agencies. Donation, acceptation and facilitation of any organ donation for financial gains strictly prohibited and it is a criminal offence.

Who would be needing a renal transplant?

The renal transplant would be an option if both the kidneys have totally stopped working. The condition is known as the end-stage renal disease (or ESRD). The doctor would be recommending dialysis in this stage. To undergo transplant one should be in good health and be able to tolerate a lifelong, strict medication regimen. Transplant is contra indicated in patients with serious conditions like

• severe cardiovascular disease
• cancer
• stroke
• serious infections like bone infections, tuberculosis or hepatitis
• drug addiction
• excess alcohol consumption
• smoking

If the doctor perceives that patient is a good candidate and you have interest, then that patient would need to be evaluated at a transplant centre. The evaluation would usually involve several visits to assess the psychological, physical and familial condition. The centre's doctors would be running tests on the blood and urine. A complete physical examination would be given to ensure that patient is ready for surgery.

Who would be donating the kidney?

The donors could either be living or deceased people.

1. Living donors - The body is capable of functioning just perfectly with just one healthy kidney. So the family member with two healthy kidneys might choose to donate one of them . A planned donation can be scheduled if the member's blood and tissues match with that of patient. Receiving a kidney from a family member is a good option as it reduces the risk of the body rejecting the kidney.
2. Deceased donors - Deceased donors are also known as cadaver donors. These are acquired from brain dead patients due to accidents. The donor or the family have chosen to donate the organs and tissues. Cadaver kidney would be a good alternative if there aren't any family members who can donate the kidney.

What are the Problems of renal transplant?

Since the renal transplant is a major surgery, the following risks are involved:

• rejection or failure of the donated kidney
• Chances of life threatening infection since they are on immuno suppressant.
• Life long medications and thus the cost involved.
• Constant care against any possible infection.
• Availability of donor kidney

Authored By : Dr. Mahendra Jain