Kidney transplant- A New Lease of life
Kidney failure is a debilitating condition for the patient and the family. Patients with renal failure are able to survive due to long term dialysis. Dialysis is a process of cleaning the blood of impurities and is done by circulating the blood through a dialysis machine. This is done in a shift of four hours thrice weekly. However, patients on dialysis need to do this process on a long term basis and the only permanent solution is a Kidney transplant. During this process a new kidney from a donor is transplanted into the patient body so that this can replace the function of the patients damaged kidneys.
How big is this Problem and what are the solutions
An estimated around 1.8 lakh persons suffer from renal failure every year, however the number of renal transplants done is around 6000 only. This shows that is a big gap between demand and supply of the organs. The first successful Kidney transplant in India was done in CMC Vellore in 1971 and since then, for many years, Kidneys were taken from live donors and transplanted to patients with kidney failure. However this was unregulated till theTransplantation of Human Organs Act (THOA) 1994 was enacted to provide a regulation of removal, storage and transplantation of human organs for therapeutic purposes and for the prevention of commercial dealings in human organs. This act has been now adopted by most of the states and is now provides a framework and guidance for removal of organs from one person for transplantation into another. This also defines the concept of Brain Death and paved the way for harvesting organs form a deceased person.
The evolution of Cadaver transplantation
The organ transplant act is a big way forward and has opened up the ability to remove organs from a brain dead person and use them for the good of the humanity. The act and the associated regulations strictly define the roles of various health care professionals and the process for harvesting organs. This also opened up other forms of organ transplants like Liver, Pancreas, Lung and Heart transplants. Today, Cadaver donation and cadaver organ transplant one of the major procedures done in most hospitals. In Telangana, this has been further streamlined by the establishment of Jeevandan scheme which regulated the distribution of organs between different hospitals in a smooth and transparent process.
Kidney Transplant operation – How is it done and implications
In most patients with kidney failure, the original damaged kidneys need not be removed. The new kidney to be transplanted is placed in the right or left lower abdomen and the blood vessels and ureter are connected to the patients vascular system and urinary bladder respectively. This is a complex and critical operation and takes about 2-4 hours. The technique of operation has now been established and can be done with little or few complications. However the major challenge that remains is the control the patients immune system so that the new kidney is not damaged by the patients white blood cells or antibodies. A lot of research has gone in to understand the immune mechanisms involved and a large number of drugs have been developed over the years to improve the immunological tolerance and improve the graft survival. The patient need to be on immune suppressive medications life long and needs regular monitoring to check the function of the newly transplanted kidney treat any complications accordingly.
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