The thought of Renal Transplantation can be devastating and considerably traumatic for most people. These are probably the most dreaded words for those who have been diagnosed with renal disease or have loved ones who have been diagnosed with renal complications. Renal transplants maybe advised by doctors at end stage renal disease. But what does this actually mean and what are its implications?

Dr Sandip Bhattacharya, Nephrologist at The Calcutta Medical Research Institute (CMRI) handles the world class Renal Transplant Unit at the hospital and sheds some light on renal transplants and their implications. He also helps mitigate myths about transplants by answering some frequently asked questions:

 

At what stage is Kidney Transplantation advised?

Doctors will usually advise Kidney Transplantation in individuals in end stage of kidney disease. Kidney Transplantation is a life-extending procedure. The typical patient will live for 10 to 15 years longer with a Kidney Transplant than if kept on Dialysis. The increase in longevity is greater for younger patients, but even 75-year-old recipients gain on an average, four more years of life.

Will I be able to lead a normal life after the Transplant?

Since the first Transplant in the 1950’s medical research and development has facilitated many advancements in the field of renal transplants. India has seen a rising number of cases of kidney transplantation in the last twenty years. Since it is the end stage of a kidney disease, there are a few cautionary restrictions in terms of diet and rigorous physical activity. However, there is not much effect on lifestyle. In fact, it has been seen that lifestyle is more improved in end stage kidney patients who opt for Transplants as compared to those who opt for Dialysis. People generally have more energy, a less restricted diet, and fewer complications with a kidney transplant than if they stay on conventional Dialysis.

Are Transplants very expensive?

At end stage Kidney Disease, one can opt to either continue dialysis or choose Kidney Transplantation. In terms of cost effectiveness, Kidney Transplants are the preferred choice as Dialysis implies regular hospital charges as well as medical costs.

What should be kept in mind for choosing a hospital for this procedure?

The hospital in which one opts to undergo the Transplant should have a qualified and experienced Transplant Team. They should mandatorily have a permit authorised by the health authorities. Moreover, it should have proper infrastructure to facilitate these procedures and proper and hygienic hospital facilities.

Do pre-transplant patients need to follow a restricted life?

The restrictions for pre-transplant patients are the same as those with end stage kidney disease. Further, those who will be undergoing a Renal Transplant are advised to be careful against chest infections, urinary infections and limit water intake. In general they are advised to pay special attention to day- to- day hygiene.

Additionally, smokers must stop smoking at least one month prior to surgery. All medications and supplements must be reviewed by the Transplant Team to determine if they need to be continued prior to surgery. Women taking birth control pills or hormone replacement therapy are advised to stop taking these medications one month prior to surgery.

Who can be a donor?

Any healthy individual can be a donor and can include parents, children, siblings, other relatives and friends. An ideal donor should have a compatible blood type, however with medical advancement even that is not a necessity.
Donors should be in good general health and do not need to be genetically related. Typically, someone who has cancer, diabetes, kidney disease, heart disease, liver disease, sickle cell disease, HIV or hepatitis will not qualify to be a donor. However, these diseases are not all absolute contraindications to donation. Every donor is considered on an individual basis.

Can a spouse be a donor?

As mentioned, a donor does not need to be genetically related. Therefore, if one’s spouse has good general health, they can consider donating to their spouse. In fact, at CMRI we have seen cases of a wives and husbands donating to their spouses.

What are the health risks associated with being a donor and how does it affect lifestyle?

The risks of donation are similar to those involved with any major surgery, such as bleeding and infection. Death resulting from kidney donation is extremely rare. Current research indicates that kidney donation does not change life expectancy or increase a person’s risks of developing kidney disease or other health problems.

A person can lead an active, normal life with only one kidney. Studies have shown that one kidney is sufficient to keep the body healthy. After recovering from surgery, a donor can work, drive, exercise and participate in sports. A donor can continue in all types of occupations. Also, being a donor does not impact a person’s ability to have a child.

When can one return to work after the surgery?

One is likely be able to return to work 2-3 weeks after surgery, depending on the type of work. However, some donors require a longer recovery period if their work requires heavy lifting or other physical demands.