Kidney transplant is the treatment of choice in End Stage Renal Disease (ESRD) or Chronic Kidney Disease Stage 5 (CKD V). Compared to dialysis, survival is better after transplantation. This advantage is irrespective of age, sex, gender, ethnicity and with diabetic or non-diabetic kidney disease.
Herrick
twin brothers were the
world's first successful kidney transplant pair. The transplant was carried out
by Dr Murray on December 23rd 1954, at The Peter Bent Brigham
Hospital Boston USA. In India first successful renal transplantation was done
in 1971 in Vellore.
A kidney transplant is a surgery in which a healthy kidney
from a donor is placed into the body of a patient whose own kidneys are no
longer working properly. The new kidney takes over filtering waste, removing
extra fluid and helping the body maintain balance.
In most kidney transplants, the patient's own failed kidneys
are not removed — they are left in place. The donated kidney is placed in the
lower abdomen, close to the bladder.
Benefits of Kidney Transplant
A successful transplant offers many benefits compared to
long-term dialysis:
Better energy levels and appetite
Freedom from regular dialysis sessions / hospital visits
Fewer food and fluid restrictions
Better ability to work, study, travel and spend time with
family
Improved emotional well-being and mental health
Better long-term survival outcomes
Who Can Get a Kidney Transplant?
Not every patient with kidney failure is automatically
suitable. The transplant team conducts a thorough evaluation to check whether
the patient can safely undergo surgery and take lifelong medicines afterwards.
The evaluation considers:
Heart health and overall fitness for surgery
Diabetes control and blood pressure management
Absence of active serious infections
Cancer history, reviewed where relevant
Liver/ chest condition
Weight and nutritional status
Blood group and tissue compatibility with the donor
Reliability in taking medicines on time
Family, emotional and financial support available
Tests and Evaluation Before Transplant
Before a transplant, both the patient and the donor require
detailed evaluation. These tests help doctors minimise risks and plan the
safest treatment.
Blood group
Haemoglobin, Kidney function tests including electrolytes, Urine
tests
Blood pressure, diabetes and heart health checks
Imaging for kidney structure / function/ blood supply
Infection screening (viral, bacterial)
Cancer screening where indicated by history
Tissue matching and crossmatch tests
Psychological and social support review
For deceased donor transplant, patients are evaluated first
and then placed on a waiting list if found suitable
In case of transplant across incompatible blood groups
further testing including isoagglutinin antibody titres is done
Donor Evaluation and Safety
Many families worry about whether the donor will be safe. A
donor is never accepted simply because the family is willing. Doctors first
carefully check whether donation is truly safe for the donor. The donor's
safety is considered equally as important as the transplant recipient's success
• A donor must be medically fit and emotionally prepared
before donation is approved
• Donation must be completely voluntary and free from
pressure or coercion
• Doctors explain all surgical risks, recovery expectations
and long-term precautions to the donor
• Most healthy, well-evaluated donors live entirely normal
lives with one kidney
• Donors are advised to continue periodic health check-ups
after donation
Life After Transplant
After a kidney transplant, patients must take anti-rejection
medicines (immunosuppressants) every day, for life. In addition regular check-up
including blood & urine tests are done to check kidney function. The
following precautions are recommended:
Take medicines exactly as prescribed — same time every day
Never skip a dose, even when you feel completely well
Never stop or change medicines without consulting your
transplant doctor
Attend all follow-up appointments and blood tests on
schedule
Inform your team before starting any new medicine, herbal
product or supplement
Carry your medicine list at all times and keep spare
supplies when travelling
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