Dr. V Narayanan Unni, Senior Lead Consultant – Nephrology
Posted on Tuesday, June 27, 2017
A person who has lost over 85% of the function of his/her kidneys is diagnosed to have end stage kidney failure. At this stage of kidney disease, the person cannot lead a comfortable life with medications alone ; he/she would have to undergo the treatment modality known as dialysis or undergo kidney transplantation surgery , if he/she is medically fit for the procedure.
Kidney transplantation is a surgical procedure where a kidney from a living person or a person who has suffered brain death is taken out surgically and implanted into the patient with kidney failure. The recipient has to undergo a series of tests to determine the medical fitness for the surgical procedure ; the person should not have any significant disease of other organ systems ; the usual age limit to undergo kidney transplantation is 65 years. The recipient should be adequately dialysed before he can undergo the transplantation surgery.
The donor can be either a living person or a person who has had a brain death. The best results are obtained when a close /near relative (parents, siblings or offsprings) is the donor. The living donor has to be a healthy person above the age of 18 years and below 60 years, and should have two normally functioning kidneys ; he/she should not have any medical illness which makes him/her a high risk for anaesthesia and surgery. The medical fitness for kidney donation can be ascertained after a detailed medical evaluation.
If there are no suitable living donors available for a recipient, organ donation from a brain-dead person is possible. A person is termed “brain-dead” if his or her brain stem is dead due to a brain injury a result of an accident/ bleeding into the brain/ loss of blood supply to the brain. The person will not come back to life if the brain is dead. Brain stem death is verified by Doctors who are lawfully empanelled to certify the same, based on a set of tests prescribed and followed for the past 50 years. If certified “brain dead”, the person can donate his or her organs to deserving patients. When the donor is no longer alive, it is called a “deceased donor kidney transplant” or “cadaveric kidney transplant”.
The Transplantation of Human Organ Act was passed by Indian Parliament in 1994, making the declaration of brain death and organ donation after brain death legal in our country. The state of Kerala passed this Act in the year 1996.
Kidney transplantation is a highly successful mode of treatment today with a very high rate of success. The success of kidney transplantation, if the donor is a living near relative, is over 98% in most reputed centres across the world. A successful transplantation gives the patient an excellent quality of life and the person is able to return back to his/her normal life quite easily. The survival after kidney transplantation is far superior to the survival on dialysis. Put simply, a successful kidney transplantation gives the patient a second chance at life.
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