Transplant or Dialysis during permanent kidney failure – Dr Vernekar Ritesh

Kidneys are significant organs that contribute to your overall well-being. But when kidneys function at only below 10 to 15 percent of their normal capacity, they cannot effectively do their job, such as remove waste or excess fluid from your blood.

End stage renal disease (ESRD) is the last stage (stage five) of chronic kidney disease (CKD). When kidney diseases develop into ESRD, dialysis or a kidney transplant is necessary to live for permanent kidney failure.

Kidney diseases are on the rise in India thanks to the alarming prevalence of diabetes & unawareness in general public.

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Dialysis is done in two ways

CAPD(Continuous Ambulatory Peritoneal dialysis)

Hemodialysis, and in India more than 95% of the patients are on hemodialysis.

Transplant can be done from a LIVE donor, and this constitutes 95% of the transplants while the cadaver (Brain Dead) donor these constitute only 5% in India.

Deceased (or Cadaveric) Donor: This is a kidney which comes from a person who is brain dead and the family has given permission for the kidneys to be donated for transplant.

Living Related Donor: A kidney which comes from a blood relative such as a parent, brother or sister.

The organ allotment is according to waiting list as per Zonal Coordination Committee of Karnataka for Transplantation, constituted by the Government of Karnataka.

Patients always ask which is better Transplant or Hemodialysis ?

Transplant offers much better quality Life & has better survival rate than hemodialysis also expenses involved in transplant is much less than hemodialysis if we consider the entire life span.

Who can be a live DONOR?

As per HOTA(Human Organ Transplant Act) “anyone can be a donor provided there should be no monitory transaction between the 2 parties ”

LIVE RELATED DONOR-

The state authorization committee which permits transplants gives regional(local) hospital authority to go ahead of transplant in cases of first degree relatives (parents, siblings, children) also wife & grandparents.

Second degree relatives (cousins, half siblings, aunts, uncles, nephew, niece) for this, the transplant permission is with state authority committee and it has been seen that getting a permission in such cases is very difficult and rare these days.

Third degree relatives (far relatives) friends who come forward as donors with emotionally involved with recipient in such cases it’s very very difficult sometimes impossible to convince state authority & permission is generally deprived.

The COST of transplant for live transplant is in the range of 4-8 lakhs depending on the hospitals. In Belagavi the Kidney transplant can be done in the above range.

Donors are usually discharged by day 5, recipient by day 8-10 and both are not kept in an ICU.

First year post transplant the expenses are about 6-10lakhs, Second year 80 thousand to 1 Lakh and Third year 40-50 thousand thereafter 25-30 thousand per year.

The cost involved post transplant is mainly the expenses of anti-rejection medicines & blood tests/scans involved in post transplant care.

Anti-rejection medicines are reduced every 1-2months slowly but a small doses are kept lifelong.

The SUCCESS/SURVIVAL rate in India is at par with the west 1yr survival rate is > 90%, 5yr survival rate > 75%, 10yr rate > 65%

Complications such as rejections & infections, reported early to transplant physician these complications can be reasonably managed if reported in time.

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