Salient Feature Of Kidney Transplant Programme At Max Hospital Saket, New Delhi

• Dedicated team of urology, Nephrology, ICU Staff, pathologist.
• Well equipped laboratory & dialysis center.
• Dedicated trained nurse to look after the OT.
• Isolated & dedicated floor for the transplant patient.
• Most experienced transplant surgeon & nephrologists.
• Dedicated transplant OPD, nurse & dietician.
• Dedicated transplant Co-ordinater & counsellor to help the patient & complete the legal paper work.
• Favored by large number of international patient from Africa, Southern east Asia, central Asia, middle east & Mauritius.

Center Performs

• Live related & cadaver transplant
• Paediatric kidney transplant . Youngest being 4 years old & 10 kg weight.
• ABO incompatible Transplant.
• Donor exchange / swap transplant.
• Re-transplant – 2nd & 3rd transplant.
• Other surgeries related to Kidney transplant.

What Is ABO Incompatible Transplant

Earlier, kidney transplants were possible between a donor-recipient pair having same blood group and with compatible antibodies, else the recipients’ body would reject the kidney immediately. Nowadays, with ABO incompatible kidney transplant Delhi, kidney transplants are done between donor-recipient pairs with different blood groups as well. For example, a donor with blood group A can donate the kidney to a recipient with blood group B or O and in the same way person with blood group B can donate to group O or A. Group AB can be a donor to O or A or B. The Kidney transplant doctor in Delhi does a pre transplant plasmapheresis to remove antibodies of incompatible blood group and treat them with Immunoglobulin & Rituximab.

Kidney Transplantation

Kidney transplantation or renal transplantation is the transplant of a kidney into a patient with end-stage renal disease. Kidney transplantation is typically classified as deceased-donor (formerly known as cadaveric) or living-donor transplantation depending on the source of the donor organ. Living-donor renal transplants are further characterized as genetically related (living-related) or non-related (living-unrelated) transplants, depending on whether a biological relationship exists between the donor and recipient. A person receiving a transplant usually receives only one kidney, but, in rare situations, he or she may receive two kidneys from a deceased donor. In most cases, the diseased kidneys are left in place during the transplant procedure. The transplanted kidney is implanted in the lower abdomen on the front side of the body.

Investigations Before Transplant

• Blood Tests: Blood tests are performed to help determine a good donor match, to assess your priority on the donor list, and to help improve the chances that the donor organ will not be rejected.
• Diagnostic Tests: Diagnostic tests may be performed to assess your kidneys as well as your overall health status. These tests may include X-rays, ultrasound procedures, kidney biopsy, and dental examinations. Women may receive a Pap test, gynecology evaluation, and a mammogram.

The transplant team will consider all information from interviews, your medical history, physical examination, and diagnostic tests in determining your eligibility for kidney transplantation. The potential donor must have a compatible blood type and be in good health. A psychological test will be conducted to ensure the donor is comfortable with the decision.

How The Transplant Will Proceed

• Your physician will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.
• You will be asked to sign a consent form that gives your permission to do the surgery. Read the form carefully and ask questions if something is not clear.
• If you have been on routine dialysis before the procedure, you will receive dialysis prior to the procedure.
• For a planned living transplant, you should fast for eight hours before the operation, generally after midnight. In the case of a cadaver organ transplant, you should begin to fast once you are notified that a kidney has become available.
• You may receive a sedative prior to the procedure to help you relax.
• Based upon your medical condition, your physician may request other specific preparation.

During The Procedure

• You will be asked to remove clothing and given a gown to wear.
• An intravenous (IV) line will be started in your arm or hand. Additional catheters may be inserted in your neck and wrist to monitor the status of your heart and blood pressure, as well as for obtaining blood samples.
• If there is excessive hair at the surgical site, it may be clipped off.
• A catheter will be inserted into your bladder.
• You will be positioned on the operating table, lying on your back.
• Kidney transplant surgery will be performed while you are asleep under general anesthesia. A tube will be inserted through your mouth into your lungs attached to a ventilator.
• The anesthesiologist will continuously monitor your vitals.
• The skin over the surgical site will be cleansed with an antiseptic solution.
• The physician will make a long incision into the lower abdomen on one side.
• The donor kidney will be placed into the abdomen. A left donor kidney will be implanted on your right side; a right donor kidney will be implanted on your left side.
• The renal artery and vein of the donor kidney will be sutured to the external iliac artery and vein.
• The donor ureter will be connected to your bladder.
• The incision will be closed with stitches or surgical staples. A drain may be placed.

After The Procedure

In the hospital, once your vitals are stable, you may be taken to the ICU or your hospital room. Kidney transplantation usually requires a stay of several days. A kidney from a living donor may make urine immediately, but a cadaver kidney may take longer. Until output is sufficient, dialysis may be required. You will have a catheter to drain urine, which is measured to evaluate function. You will receive IV fluids and immunosuppression medications. At home, keep the area clean and dry. Avoid driving or any activity that puts pressure on the new kidney. Notify your physician if you experience fever, redness, swelling, or increase in pain, as these may be signs of rejection or infection.