Burjeel Kidney Transplant Centre

Overview

Organ transplantation is considered as one of the most remarkable medical advances of the century in terms of giving a second chance life to patients with end stage Kidney failure. Transplantation is medical procedure in which a healthy organ from a living or deceased person is placed in the body of a recipient ailing due to organ failure. Transplantation of various organs, tissues and cells such as kidneys, hearts, lungs, livers, bone marrow etc are now possible with the availability skilled transplant surgeons and well supported transplant centres with state of art facility.

Burjeel Medical City of Kidney Transplant Program offers state-of-the-art comprehensive adult transplant services. Our experienced clinicians utilise a collaborative approach, working across experts in speciality departments to bring individualised seamless care to patients with congenital problems or chronic conditions. We provide patients and their families the entire spectrum of services starting from pre-transplant monitoring to long term post-surgical care. Pivotal to our organ transplant program is the access to an ecosystem focussed at psychosocial and mental wellbeing support, health education and advanced care, crucial in the patient’s transplant journey to enable a longer and enhanced quality of life.

Importance of Kidneys and what is Kidney Transplant

Dialysis can be painful. It can be a recurring source of muscle cramps, hypertension, hypotension and a wide array of infections and sepsis. More than anything, it can also be physically and mentally exhausting for the patient. It includes frequent insertion of a needle that removes blood and transfers it to a dialysis machine that filters waste products from the blood. It is needed as an external substitute for kidneys and can temporarily perform their functions. However, re-drawing your focus to the word – ‘substitute’’ dialysis is only recommended as an alternate until the patient’s kidney resumes its functioning.

More often than not, the patient’s kidney fails to restore back to its original functionality and needs to be replaced. This means that it is no longer capable of maintaining overall fluid balance, filtering waste materials and/or creating hormones that help produce red blood cells and regulate blood pressure. This is when a kidney transplant is explored as a viable option.

As experienced and recommended by many, a kidney transplant is often the treatment of choice for kidney failure compared to a lifetime on dialysis. It can treat chronic renal (related to kidney) diseases to help patients live longer.

Some of the common causes of end-stage renal disease include:

  • Chronic uncontrolled high/low blood pressure
  • Chronic inflammation and eventual scarring of the tiny filters within the kidneys (glomeruli)
  • Polycystic kidney disease
  • Diabetes

Thus, apart from the obvious benefit of not suffering from a life threatening disease anymore, a patient also achieves:

  • Lower risk of death due to health complications
  • Better quality of life with fewer dietary and lifestyle restrictions
  • Lower and essentially one-time treatment cost

Eligibility for Kidney Transplant

As with any other transplant surgery, after a patient has been selected by a transplant center, his/her candidature is evaluated to determine whether he/she meets the center’s eligibility requirements.

Multiple tests are done including MRI and CT scans, blood tests and a detailed psychological evaluation. The results of such tests are then discussed in detail with the patient and his/her family. Care has to be taken to ensure that no current medications/medical conditions would interfere with the success of this surgery. Also, above everything else, the patient’s willingness to undergo this extensive surgery and his/her commitment to taking utmost care pre and post-surgery has to be measured.

Conditions that may prevent the patient from being eligible for a kidney transplant include:

  • Advanced age, dementia and/ or other mental illness
  • Severe heart disease and alcohol/ drug abuse
  • Active or recently treated cancer
Process & Procedure

Types of Kidney Transplant

Basis availability and severity of the situation, one of the below transplant types is followed:

  • Living donor kidney transplant:
    Such a transplant involves procuring a kidney from a living donor. He/she may be a blood relative or someone close to the patient. Living donor kidney transplant has a much shorter waiting time than the former.
  • Pre-emptive kidney transplant:
    A pre-emptive kidney transplant is a precautionary procedure which is performed before the kidney functioning worsens to the extent of performing dialysis to enhance/substitute the normal functioning of the kidneys.
  • Deceased donor kidney transplant:
    Such a transplant involves transplanting a kidney from an individual from whom at least one organ is recovered for the purpose of transplantation after suffering from brain or cardiac death.
  • SWAP Transplant :
    The SWAP Transplant gives incompatible donors & recipient another way to help the patient receive a transplant with another incompatible Donor & Recipient.

How is a Kidney Transplant performed?

Apart from the obvious complications of a transplant surgery in general, a kidney transplant is a relatively simpler procedure. The new kidney is transplanted to the lower section of the abdomen towards the front side and is connected to the artery and vein that the previous dysfunctional kidney was connected to. It is not necessary to remove the previous kidney and more often than not, it is left in its place. However, if it possesses serious health risks such as cancer or infection, it is removed. The transplant is done under general anesthesia and its duration would vary between 2-4 hours basis the technique used. The new kidney starts working immediately or may take few days.

Post-Surgery Risks & Care

Advancements in medicine and technology have drastically reduced the failure rate of such transplants. However, in some cases, it may not achieve 100% success and some complications may arise.

Some of these complications include:

  • Rejection of the donated kidney
  • Blood clots, infection, leakage and bleeding
  • An infection transfer through the donated kidney
  • Heart attack and other serious worries
  • Medication side effects such as acne, high/low blood pressure, nausea, diabetes and weight gain

Anti-rejection medicines are recommended for the rest of the patient’s life to suppress the immune system from rejecting the donated kidney. It is thus paramount that the patient religiously takes the prescribed medications to avoid any serious complications. Physical activities and exercise are also recommended to ensure a good level of mental and physical health to expedite the healing process.

FAQ’s

Any healthy person over age 18 who has a compatible blood type and compatible HLA tissue typing may be considered as a possible donor. However, individuals with certain medical conditions may not be able to donate. The transplant team closely evaluates these conditions.

The decision to donate a kidney requires careful thought and consideration. The transplant team is available for confidential discussions and questions. Potential donors undergo a thorough evaluation to determine their general health and condition of kidneys. A transplant nephrologist, a physician specializing in kidney care, supervises this medical evaluation and ensures privacy and an objective opinion about the donor's medical suitability to donate a kidney.

Patients who receive a kidney transplant tend to have a higher life expectancy than those on dialysis. If the kidney is from a living donor, it can function for around 12 to 20 years on a average.

To be eligible for a kidney transplant, the patient must have a chronic and irreversible kidney disease that other medical and surgical procedures failed to treat. Patients who are on dialysis or need it in the future also qualify for a transplant. However, if the patients have certain cancers or infections that can’t be cured or unrecoverable heart disease, they won’t be eligible to receive a transplant.

You will need a thorough evaluation by the Transplant Institute staff, in consultation with referring physicians, to determine if transplantation is the best treatment option. Being a good candidate for transplant depends upon your physical health, emotional well-being, and ability to manage medication and care plans.

Kidneys from living or deceased donors both work well, but getting a kidney from a living donor can work faster and be better. A kidney from a living donor may last longer than one from a deceased donor.

To get a deceased donor kidney, you will be placed on a waiting list once you have been cleared for a transplant. It can take many years for a good donor kidney to be offered to you. From the time you go on the list until a kidney is found, you may have to be on some form of dialysis.

No, donating a kidney does not shorten the life expectancy or increase the risks of kidney failure. People can live a healthy and normal life with only one kidney. Generally, the single kidney increases in size to compensate for the absence of the donated kidney. However, donors must talk to the doctors and the transplant team to understand any risks involved with kidney donation.

Sometimes a relative, spouse or friend is able to donate a kidney to a loved one, provided the removal of the kidney will not harm the living donor's health. Here in Burjeel Medical City, we accept till 4 th Degree of your relatives as a Donor(As Per Federal Decree Law No. 5 of 2016) . The donor must undergo a thorough medical evaluation that includes, among other things, blood work to assess tissue compatibility and the likelihood of organ rejection.

Living donation is preferred because it offers patients the best chance for a good quality kidney in the shortest possible waiting time. Once a living kidney donor has been medically cleared to donate, both surgeries (transplant and donation) can be scheduled at the convenience of the donor and recipient.

The patient and the donor has to submit the Legal documents like Identity proofs to prove the relationship of the said donor and Recipient. The detailed documents list can be collected from the Transplant Coordinator.

Yes, Once the donor and recipient relationship are proved with the legal documentation. The transplant coordinator will submit the documents to the Authorization committee for Approval.

Patients may have a living donor who is not able to donate directly to them because of a different blood group, or because of antibodies in the recipient’s blood. These donors can still donate their kidneys via Paired Kidney Exchange/ SWAP Transplantation.

After a new kidney is placed in a person’s body, rejection is a normal reaction. The body treats the transplanted organ as a foreign object and tries to attack it. Therefore, certain medications are necessary to trick the body into accepting the new kidney and allow it to live successfully.

Rejection is a signal that your immune system has identified the new kidney as foreign tissue and is trying to get rid of it. Preventing rejection with immune-suppressing medication is the first priority. The most common sign of rejection is change in kidney function (an increase in creatinine, a waste product), as measured by a blood test. This is why you need frequent blood testing in the first three months after transplantation, and regular testing after that. If a kidney biopsy and kidney ultrasound confirm the rejection episode, then the transplant team will increase the amount of anti-rejection medication or prescribe a different combination of anti-rejection drug therapy. Using medicine, we can successfully reverse most rejection episodes, if we detect it early enough. However, if the episode is severe, it may shorten the overall life span of the new kidney.

You should not smoke after transplant and every attempt to quit prior to the transplant is crucial to extend your life and the life of the new kidney. The transplant team will let you know when you can begin to drive again, return to work or school, and travel. You can decide when to resume sexual activity depending upon how you feel. Postoperative discomfort usually does not interrupt sexual activity for more than a few weeks.

Transplants, with every passing day, need to evolve towards being lower on risk and pain. They need to focus on delivering a higher success level and be as comfortable and meaningful for the patient as can be ensured. Burjeel Medical City works on exactly this philosophy. With their minimally invasive procedure, they focus on minimal incision to mitigate infection related risks. Burjeel Medical City has one of the largest and most comprehensive kidney transplant program in Abu Dhabi with excellent medical care and facilities for pre and post-transplant management. They work closely with patients to determine whether or not a transplant is the most viable option for them. Right from the treatment that a patient and his loved ones receive, to the experts that help patients get their lives back on track, Burjeel Medical City ensures that they become a caring and indispensable part of this life transformational journey. Their team functions in an integrated fashion to ensure a good end result. They leave no stone unturned in keeping all up to speed by doing the right diagnosis, having detailed discussions with the patients and their families to explain the procedure in detail and then performing transplants with international standards of accuracy and success rate. The Burjeel Medical City team that has the best Clinical team, Operating Team and Multi Disciplinary Transplant Support teams like (Infectious Diseases, Nucelar medicine, Histo- Pathology,Interventional Radiologist, Physical medicine and rehabilitation.

For more information about the Transplant, please call 80023 or email us to kidney.transplant@burjeelmedicalcity.com

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Team that Cares

Dr. Venkat Sainaresh Vellanki

Director and HOD - Transplant Nephrology, Consultant Nephrology

Dr. Yassin Ibrahim M. El-Shahat

Consultant Nephrology

Dr. Deepak Pillai

Consultant - Nephrology

Dr. Rehan Saif

Director - Transplant Surgery for Burjeel Abdominal Multi-Organ Transplant Program, Clinical Lead - HPB Surgery, Consultant General Surgery

Dr. Nandakishore S K

Laparoscopic and Endo Urologist

Dr. Rishikesh Ramesh Pandya

Director of Urology and Uro Oncology

Dr. Ramamurthy Ganesan Baskaran

Consultant Anaesthesiology & Transplant Anaesthesia

Dr. Nicholas Wyon

Consultant - Anesthesia / Critical Care Medicine

Dr. Mohammed Zaki Ahmed

Consultant - Interventional Radiologist

Dr. Dima Ibrahim

Specialist - Infectious Diseases

Dr. Ritika Marisse Coelho

Consultant - Pediatric Infectious Disease

Dr. Abdul Rahim Ibrahim Ismail Al Suhaili

Consultant and Director Nuclear Medicine Department

Dr. Rakeshkumar Shah

HOD - Clinical Pathology
Specialist - Clinical Pathologist

Dr. Mahesh Cirasanambati

Consultant - Physical Medicine and Rehabilitation