Kidney Transplantation

Why Kidney Transplant ?

India is the capital of kidney diseases in the world. Kidney failure is a crippling disease severely affecting not only the patient himself, but also the entire family.

Dialysis is an expensive treatment modality and most patients in India cannot afford long term dialysis.

Contrary to common perception, transplantation, in the long run,  is a  less expensive option than dialysis, giving better rehabilitation.

Options for patients with End Stage Kidney Disease (ESKD)

Once the kidneys have completely failed or the functions have fallen to less than 10% of the normal, patients need some form of treatment which will replace the kidney functions. The options at this stage are one, Dialysis and second, Kidney Transplantation.

Dialysis aims to remove the toxins which accumulate in the body as a result of kidney failure. This means that it takes care of the ‘excretory’ functions of kidney.

There are several ‘synthetic’ functions of the kidney viz. production of vitamin D, synthesis of hormone (Erythropoietin) that maintains hemoglobin levels in blood and production of several substances that help in regulating blood pressure.

These synthetic functions are not replaced by dialysis. Moreover, dialysis replaces only 10 to 15 % of  excretory function of a normal functioning kidney.

Therefore, kidney transplant is a more complete solution since a normal functioning kidney is placed inside the recipient which carries out both the excretory as well as the synthetic functions to its maximum potential giving almost 50 to 60 % functions of  normal functioning kidneys.

Are Kidney Transplants ever successful ?

A common misconception in the patient is that kidney transplant usually does not succeed. Nothing can be farther from the truth !survival

Kidney transplantation is a well established programme all across the world. Success rates are uniform across all centres and are consistently above 95% patient survival (see graph) and 90% graft (the new kidney) survival at one year.

Simply put, there is less than 5 to 10% chance of a failure !!
It is a chance worth taking for a better life.

Quality Of Life improves after Transplantation

When on dialysis, the patient depends on the family for moral, emotional and even economical support.

He may lose his job partly or completely. After transplant, the roles revert back to normal.

Patients who are hooked to dialysis machines three times a week are freed of that after a successful transplant. That means they have that much more time to be productive at workplace and share more responsibilities at home.

Patients feel more energetic, efficient and hopeful and can even participate in recreational activities and certain sports.

But then, Kidney Transplants are very Expensive !!

Not at all ! Immediate cost for the transplant surgery may be high, but when you calculate long term expenses after transplantation, they gradually come down after one to two years ( since the doses of the expensive medications are reduced), whereas the cost of dialysis remains same or may actually go up given the inflation rates !!

So, at the end of five years, transplantation is actually cheaper by a substantial amount !! Add to it the survival advantage (see graph above), and the therapy becomes invaluable !!

So, having seen the above advantages, it is only rational to choose kidney transplant over dialysis as the treatment option for patients with ESKD. It gives freedom from dialysis, improves quality of life, enhances survival chances and best of all, is less expensive in the long term !

Next: Kidney Transplant in a Nut-Shell

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