Answers About Kidney Questions By Kidney Transplant Physician in Kolkata

Answers About Kidney Questions By Kidney Transplant Physician in Kolkata

Answers About Kidney Questions By Kidney Transplant Physician in Kolkata

  1. Q1. What is kidney transplant?

A kidney transplant is a procedure to put a new, healthy kidney in a person with kidney disease or kidney failure.

  1. Q2. Who needs a kidney transplant?

Those people who have kidney failure or are on dialysis. When the normal functions of kidney like cleaning the blood and removing of extra salt and water are failed patients need external support. This external support keep there body free of harmful toxins. External support can taken from either dialysis (hemodialysis or peritoneal dialysis) or patient can undergo kidney transplant. Both longevity and quality of life are better with kidney transplant as compared to other kidney supports like dialysis. The transplanted kidney will do all the functions for patients as is expected from a patient’s normal kidney.

  1. Q3. Who will give me a new kidney?

As organs are made at birth in womb and they grows in size and function with age, the new organs cant be created in external world. So the people with kidney diseases gets a kidney from either of following source.

  • Living donor – A living donor is usually a family member or friend. They can be related to you, but don't need to be. A living donor can also be someone who is emotional supporter of you. Indian law divides them into two categories
  • Near related donors - they are either parents, siblings like brother and sister, off springs like son and daughter or grandparents.

Far related donors- all relatives other than above mentioned are far related donors.

Unrelated donors- All the donors who are not listed in above categories makes up unrelated donors.

 

The donors are usually motivated for donation from their emotional connect with the patients. In any case of live donor the reward to donor is only empathy, future renal health support in deceased KT program and social respect and support. Any reward outside these boundaries are considered illegal and are exempted form our KT program.

 

  • Dead donor – patients who doesn't have a living donors available they are listed on a central organ waiting list. Whenever a kidney is donated it comes to the common pool or a register maintained by state. As per the written rules a kidney recipient is chosen and kidney is allocated to the patient with kidney disease. It is advisable to keep your name on waiting list as getting a kidney allocated is possible in case some noble family wish to donate their family organs after death.

 

  1. Q4. What needs to done before I undergo a kidney transplant?

 

You need to undergo clinical examination, lab tests and legal process. This part is undertaken to use the available scientific data to ensure that your life will improve both in quantity and quality as compared to other treatment.

  1. Q5. Can you explain the pre-transplant evaluation in detail?


    The detailed workup before transplant entails these steps
  2. Clinical examination and lab tests in a nut shell it helps your doctor to confirm the need of kidney transplant.

  • In this process the kidney failure is confirmed beyond doubt and the need of KT or a new kidney is reconfirmed. There are some disease in which doing a KT is not a good options on long term because the existing disease might harm the new kidney as well therefore some patients may need for these tests too.
    1. Q6. Why do doctors gets so many tests done before KT?


      Doing many test are necessary these tests help your doctor in

    Exclusion of infections and malignancies which might be detrimental to your life and new kidney too
    Matching of blood groups and tissues for as best possible result as could be
    Anatomical workup with the help of CT, USG, ECHO and ECG etc are done to make a blue print of operation before actually starting OT.

    1. Q7. What are the tests doctors will do ?

    This is a sample list of lab work up done. It is though not limited and some times patient may need extra or a fewer tests.



    DONOR EVALUATION PROTOCOL FOR KT RECIPIENT EVALUATION PROTOCOL FOR KT

    A. PHASE -1

    1. Blood Group
    2. FBS, PPBS, HbA1C
    3. Serum TSH
    4. Complete Hemogram
    5. LFT
    6. Lipid Profile
    7. Serum IgG, IgM for CMV
    8. Urine R/E and ACR
    9. USG (Whole Abdomen)
    10. Chest X Ray (PA View)
    11. X ray KUB
    12. 2D Echo and ECG
    13. DTPA GFR

    B. PHASE -2

    1. CT renal vessels
    2. HLA Typing (A,B, DRDP DQ)
    3. T-Cell and B-Cell Cross matching
    4. FCM PRA -> Class – I & II
    5. HLA DSA SAB

    PHASE -3

    1. BT CT, PT aPTT INR
    2. Interdepartmental reviews
    3. Optional
    4. Pap smear
    5. Mamogram
    6. Stool occult blood
    7. Serum PSA
    8. Interdepartmental reviews

    PHASE -1

    1. Blood Group
    2. FBS, PPBS, HbA1C
    3. Blood Urea, Serum Creatinine, Serum TSH
    4. Complete Hemogram
    5. HbsAg, Anti HCV, HIV-I & II by ELSIA method
    7. LFT
    8. Lipid Profile
    9. Serum Na, K, Calcium
    10. Uric acid
    11. Serum IgG, IgM for CMV
    12. 24hrs Urinary Protein and Creatinine Clearance
    13. Urine R/E and ACR
    14. USG (Whole Abdomen)
    15. Chest X Ray (PA View)
    16. X ray KUB
    17. 2D Echo and ECG

    PHASE -2

    1. HLA Typing (A,B, DR)
    2. T-Cell and B-Cell Cross matching
    3. Flow Cytometric Cross matching
    4. HLA DSA SAB
    5. PRA -> Class – I & II

    PHASE -3

    1. BT CT, PT aPTT INR
    2. Optional
    3. Pap smear
    4. Mamogram
    5. Stool occult blood
    6. Serum PSA
    7. Interdepartmental reviews

    1. Q8. What is kidney transplant?

    A kidney transplant is a procedure to put a new, healthy kidney in a person with kidney disease or kidney failure.

    1. Q9. Who needs a kidney transplant?

    Those people who have kidney failure or are on dialysis. When the normal functions of kidney like cleaning the blood and removing of extra salt and water are failed patients need external support. This external support keep there body free of harmful toxins. External support can taken from either dialysis (hemodialysis or peritoneal dialysis) or patient can undergo kidney transplant. Both longevity and quality of life are better with kidney transplant as compared to other kidney supports like dialysis. The transplanted kidney will do all the functions for patients as is expected from a patient’s normal kidney.

    1. Q10.. Who will give me a new kidney?

    As organs are made at birth in womb and they grows in size and function with age, the new organs cant be created in external world. So the people with kidney diseases gets a kidney from either of following source.

    • Living donor – A living donor is usually a family member or friend. They can be related to you, but don't need to be. A living donor can also be someone who is emotional supporter of you. Indian law divides them into two categories
    • Near related donors - they are either parents, siblings like brother and sister, off springs like son and daughter or grandparents.

    Far related donors- all relatives other than above mentioned are far related donors.

    Unrelated donors- All the donors who are not listed in above categories makes up unrelated donors.

     

    The donors are usually motivated for donation from their emotional connect with the patients. In any case of live donor the reward to donor is only empathy, future renal health support in deceased KT program and social respect and support. Any reward outside these boundaries are considered illegal and are exempted form our KT program.

     

    • Dead donor – patients who doesn't have a living donors available they are listed on a central organ waiting list. Whenever a kidney is donated it comes to the common pool or a register maintained by state. As per the written rules a kidney recipient is chosen and kidney is allocated to the patient with kidney disease. It is advisable to keep your name on waiting list as getting a kidney allocated is possible in case some noble family wish to donate their family organs after death.

     

    1. Q11. What needs to done before I undergo a kidney transplant?

     

    You need to undergo clinical examination, lab tests and legal process. This part is undertaken to use the available scientific data to ensure that your life will improve both in quantity and quality as compared to other treatment.

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