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Kidney (Renal) Transplant

Understanding Kidney(Renal) Transplant

Renal Kidney transplant is a procedure for replacing a damaged kidney with a healthy one from a donor. Usually recommended for patients with end-stage kidney disease, the procedure helps patients regain normal kidney function and improve their quality of life. We understand that the idea of undergoing a kidney transplant can be worrying to say the least, which is why  team of Dr Amit Goel ( Best Kidney Transplant surgeon) , nephrologists, and support staff provides thorough guidance and compassionate care at every step. 

A renal transplant, also called a kidney transplant, is a surgical procedure in which a diseased or non-functioning kidney is replaced with a healthy kidney from a donor. The new kidney takes over the work of filtering waste and maintaining the body’s fluid and electrolyte balance, which the damaged kidneys can no longer do. The donor kidney may come from a living donor, such as a family member, or from a deceased donor. Compared to long-term dialysis, a transplant is often considered the most effective treatment for end-stage kidney disease, offering patients the chance to live a healthier and more active life.

A renal transplant is usually advised for patients whose kidneys are no longer able to function adequately, even with medicines or dialysis. Doctors may recommend this surgery in cases of:

 
1. Chronic Kidney Disease (CKD)

CKD is a long-term condition where kidney function gradually declines. In its advanced stages, the kidneys are unable to filter waste effectively, leading to complications such as swelling, weakness, and fluid overload. When CKD reaches its final stage, a transplant becomes the most effective treatment.

 
2. End-Stage Renal Disease (ESRD)

ESRD occurs when the kidneys have lost nearly all their function, usually less than 10–15% of normal capacity. At this stage, dialysis may help temporarily but cannot fully replace the role of a healthy kidney. A transplant offers patients the chance to regain stability and live a fuller life.

 
3. Kidney Failure Due to Diabetes or Hypertension

Long-standing uncontrolled diabetes and high blood pressure are among the most common causes of kidney failure. Over time, they damage the blood vessels in the kidneys, reducing their ability to filter blood. For many patients, a transplant becomes the best option once kidney damage reaches an advanced stage.

 
4. Inherited Kidney Disorders

Some patients develop kidney failure because of genetic conditions such as polycystic kidney disease or certain metabolic disorders. These conditions progressively damage kidney tissue, making a transplant necessary once the disease advances.

 

5. Other Severe Kidney Conditions

Recurrent kidney infections, severe glomerulonephritis, or autoimmune diseases like lupus can also lead to kidney failure. If the damage is permanent and dialysis is not enough, doctors may recommend a transplant.

  • Persistent fatigue and weakness
  • Swelling in hands, feet, or face (edema)
  • Reduced urine output
  • Shortness of breath
  • Nausea and vomiting
  • High blood pressure difficult to control
  • Early intervention is crucial to improve transplant outcomes.

Before transplantation, the patient undergoes a thorough evaluation:

  • Blood and Urine Tests: To assess kidney function and overall health
  • Imaging Studies: Ultrasound, CT scan, or MRI for anatomical assessment
  • Cardiac Evaluation: Ensuring heart health for surgery
  • Compatibility Testing: Blood type and tissue matching with donor
  • Psychological Assessment: Preparing for lifestyle changes and medication adherence

Kidney transplants can be performed using kidneys donated by either living or deceased donors. Both options are available, and patients are guided through the process to ensure the best possible outcome.

  1. Living Donor Kidney Transplant

In this type, a healthy kidney is donated by a living person, often a close relative such as a parent, sibling, or child. In some cases, unrelated but emotionally connected individuals may also donate. Living donor transplants are often preferred because the surgery can be planned in advance, and the donated kidney usually begins working immediately after transplantation.  Laparoscopic Donor Nephrectomy: Donor Kidney is removed from the Donor’s body under General Anesthesia with the Laparoscopic Technique . This is the Gold Standard of Donor Nephrectomy and is considered very safe procedure under a skilled surgeon . The Kidney is delivered from the LSCS (Lower Segment Cesarean) Incision like the one given for Child delivery which gets covered by the donor’s Undergarments. Donor stays in hospital for 3-4 days and can resume normal work after 1 week of kidney donation.

2. Deceased Donor Kidney Transplant

In this case, the kidney is donated by someone who has been declared brain dead but whose organs are still functioning with medical support. These kidneys are carefully matched to recipients through national and regional organ-sharing networks. Although waiting times can vary, deceased donor transplants offer hope to patients who do not have a suitable living donor.

Renal Transplant Procedure: Done by Open technique/ Robotic assisted Kidney Transplant (RAKT) Technique.

Renal transplant surgery involves replacing a diseased kidney with a healthy one from a donor. The procedure is performed under strict medical supervision by skilled transplant surgeons and a dedicated support team. The steps of the surgery are as follows:

 

1. Anaesthesia and Preparation

The patient is given general anaesthesia to ensure complete unconsciousness and absence of pain during the surgery. Vital signs such as heart rate, blood pressure, and oxygen levels are closely monitored throughout the procedure. The abdomen is cleaned and sterilised to prevent infection.

 

2. Making the Incision

A surgical incision, usually 10–15 cm long, is made in the lower abdomen, typically on the right or left side of the pelvis. This provides access to the blood vessels and bladder where the donor kidney will be placed. 

RAKT : In case of Robotic Technique  the Kidney is introduced inside from the LSCS (Lower Segment Cesarean) Incision like the one given for Child delivery in which scar gets covered by the recipient’s Undergarments. 

 

3. Placement of the Donor Kidney

The donor kidney is carefully positioned in the prepared pelvic area. Surgeons ensure it sits in the optimal location for proper blood flow and function. The kidney is placed slightly differently than the original kidneys, which are usually left in place unless causing problems.

 

4. Connecting Blood Vessels

The renal artery and vein of the donor kidney are meticulously connected to the patient’s iliac artery and vein. This restores blood circulation to the new kidney immediately, allowing it to begin functioning right after transplantation.

 

5. Ureter Attachment

The ureter from the donor kidney is connected to the patient’s bladder. This step ensures that urine from the new kidney can drain naturally into the bladder. A temporary stent may be placed in the ureter to support healing.

 

6. Checking Kidney Function

Surgeons verify that blood is flowing properly through the new kidney and that urine output is adequate. Any minor adjustments needed for optimal function are made at this stage.

 

7. Closure of Incision

Once all connections are secure and the kidney is functioning correctly, the incision is closed using sutures or surgical staples. Sterile dressings are applied to protect the surgical site.

Recovery after a renal transplant is a gradual process that ensures the new kidney functions properly and the patient regains strength. This is what you can expect the recovery to be like:

1. Immediate Post-Surgery Care: Patients are monitored in the intensive care unit for the first 24–48 hours. Kidney function, urine output, and vital signs are closely observed. Pain, fluids, and medications are carefully managed to prevent complications such as infection or rejection.

2. Hospital Stay: Most patients remain in the hospital for 7-10 days. During this period, kidney function, urine output, blood parameters and imaging  is regularly done to detect early complications and immunosuppressive medications are adjusted. Patients are guided on medication management, recognising warning signs, and gradually increasing activity.

3. Recovery at Home: After discharge, patients continue recovery under regular medical supervision. Taking medications as prescribed, maintaining a balanced diet, staying hydrated, and avoiding infections are critical for long-term success.

4. Long-Term Recovery: Over the following months, patients regain strength and can resume daily activities. Regular follow-up visits are essential to monitor kidney health and ensure continued proper function.

After the transplant, patients receive comprehensive guidance on recovery, including medication management, infection prevention and dietary recommendations, and gradual resumption of daily activities.

  • Improved quality of life compared to dialysis
  • Greater freedom from dietary and fluid restrictions
  • Increased life expectancy
  • Better energy levels and overall health

While kidney transplantation is generally safe, potential risks include:

  • Rejection of the donor kidney
  • Infection due to immunosuppressive medications
  • Surgical complications
  • Long-term medication side effects

Regular follow-up and adherence to medications significantly reduce these risks.

Dr. Amit Goel and his team operates in Hospital is equipped with modern surgical theatres, diagnostic tools, and monitoring systems including Laparoscopic surgery facilities and Robotic Surgery facility. This advanced infrastructure allows to perform complex renal transplant surgeries with high accuracy and safety, while providing continuous post-operative monitoring and care.

Patients  benefit from end-to-end support, including pre-transplant evaluation, personalised treatment planning, post-operative care, and long-term follow-up. 

With years of experience and rigorous protocols, Dr Amit Goel and his team  has consistently achieved high success rates in renal transplant surgeries. The team focuses on both immediate surgical outcomes and long-term kidney function, giving patients confidence in their recovery and quality of life after the transplant.

The  patient comfort and education is ensured throughout the treatment process. From explaining the procedure and recovery expectations to providing emotional and logistical support,team  ensures that patients and their families feel informed, supported, and cared for at every step.

Frequently Asked Questions

Ques 1. Do we need to remove the Native poorly functioning Kidneys in the Recipient ?

Ans . Native Poorly – Functioning Kidneys are not removed usually . 

They are only removed in certain conditions such as: 

  • Bleeding from native  Kidney
  • Pus in Kidney
  • Stones in Kidney
  • Kidney Tumour Suspicion
  • Polycystic Kidney Disease extending till  the Lower part abdomen giving no space for the Graft Kidney.

Ans. The cost of a renal transplant in India can vary depending on several factors, including the type of donor (living or deceased), the hospital facility, the complexity of the surgery, and the duration of hospital stay. The cost typically includes pre-transplant evaluations, surgery, post-operative care, medications, and follow-up consultations. 

Ans. Recovery after a kidney transplant is gradual. Most patients are able to resume normal daily activities within 2 to 3 months, although complete physical recovery and adjustment to medications may take longer. Regular follow-up visits are essential during this period to monitor kidney function, adjust medications, and address any complications promptly.

Ans. In most cases, a successful kidney transplant eliminates the need for dialysis entirely. However, some patients may require temporary dialysis immediately after surgery if the new kidney takes time to start functioning properly(Delayed Graft Function) . The medical team closely monitors kidney function to determine if dialysis is necessary during the early post-operative period.

Ans. The lifespan of a transplanted kidney can vary depending on factors such as donor type, patient health, and adherence to post-transplant care. Kidneys from living donors often function effectively for 15 to 20 years or longer, while kidneys from deceased donors generally last 10 to 15 years. Maintaining a healthy lifestyle and following prescribed medications can improve the longevity of the transplant.

Ans. After a transplant, following a balanced and safe diet is crucial for recovery and long-term kidney health. Patients are advised to avoid certain foods that may increase the risk of infection or affect kidney function. Adequate hydration and nutrient-rich meals are recommended, and the dietitian provides personalised guidance based on the patient’s condition.

Ans. Yes, with proper care, regular monitoring, and adherence to medications, most patients can return to work, engage in physical activities, and lead an active and fulfilling life. Lifestyle adjustments and healthy habits are essential, but the transplant generally allows patients to enjoy improved quality of life compared to long-term dialysis.

Ans. Many patients are able to have children after a kidney transplant. It is important to consult the transplant team before planning a pregnancy, as some medications may need adjustment to ensure safety for both the mother and baby. Close monitoring during pregnancy is also recommended to protect kidney function and overall health.

Ans. Follow-up visits are frequent during the initial months, usually every week or two, to closely monitor kidney function, adjust medications, and detect early signs of complications. Once the patient stabilises, visits may be spaced to once every few months, though ongoing monitoring remains crucial for long-term success.

Ans. International patients must continue taking all prescribed medications without interruption, maintain regular telemedicine follow-ups, and stay alert for any signs of infection or kidney rejection. Maintaining clear communication with the transplant team and adhering to post-transplant care instructions is essential for successful long-term outcomes.

Ans. Yes, lifestyle choices play a significant role in the success of a kidney transplant. Maintaining a healthy diet, avoiding smoking and alcohol, controlling blood pressure, and following the prescribed medication regimen are all important for protecting the transplanted kidney and ensuring long-term health.

Ans. In certain situations, a second even a third transplant may be considered if the first/second  kidney fails. The feasibility depends on the patient’s overall health, the cause of kidney failure, and the availability of a compatible donor. The medical team carefully evaluates each case to determine the safest and most effective approach.

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