Cadaver Kidney Transplantation - what you should know and how to register for cadaver kidney transplantation

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Kidneys for transplantation come from a living donor or a deceased (cadaver) donor. Deceased donors are people who have been declared brain-dead and whose organs are kept viable by ventilators (artificial lung support) until organs can be retrieved for transplantation eg: Road Traffic Accident / bleed in the brain. For Solid organ donation (heart, lungs, liver, pancreas, kidneys) requires artificial compactable fluid to be circulated & cooled after these organs are retrieved. This is possible only in brain death where the functioning of these organs are be supported for some time till retrieval .

One kidney will be allotted to the first patient in that hospital. The 2nd kidney will be allotted to the patient in the Government Hospital and if not used - to a patient in the private hospital to group (All Kerala Basis) Government of Kerala has now taken up the task of promoting deceased organ donation and transplantation in Kerala through an organization-KNOS-Kerala Network for Organ Sharing and has done more than 490 Cd Tx . For more details : http://knos.org.in.

This online registry is for organ recipients waiting for transplantation from various hospitals in Kerala, authorized to undertake transplantation of organs.

Chronic Kidney Disease (CKD) Pts on Dialysis can register for CADAVER TRANSPLANTATION at Lekeshore hospital

Requirements for Registration :

• Open a file in concerned hospital and be in dialysis.
• A negative PRA report.
• Clearance from treating doctor for fitness/cardiac clearance in elderly /Diabetic Patients.
• Raise a DD in favor of KNOS for Rs 2000/-.payable at Trivandrum.
• Registration form to be filled.
• Some may need Nephretomy of deasesed kidney prior to trasplant surgery.

Kidney transplantation surgery at Lakshore hospital is @11lakhs. Cadaver Transplant charges will be lesser. But retrieval charges brain death organ donation is shared by the recipients of Kidneys/ Liver / Heart.

For details contact

Preparations for Receiving a Kidney from a Deceased Donor (Cd Tx)

Laboratory Tests

• Once a brain dead person is identified in the Central Zone (Kottayam ,Alleppy , Cochin ,Trichur and Kollencherry ),Kidneys along with other organs are allotted by KNOS (Kerala Network of Organ Sharing).
• When this happens in a "non transplanting center "one kidney will go to Medical College .The other kidney will be distributed according to the zonal priority.
• When this happens in a "transplanting center "like Lakeshore one kidney is for the patient in that hospital according to the seniority seen in the KNOS website .The other kidney will go to Medical College (MCH) and if they decline ,it will be given to the Private hospital doing transplant as per list.
• When a brain death case is notified , you will be informed when your turn comes .It is better to give 2 phone numbers to the hospital.
• Keep your finance ready. Cadaver transplantation may cost @ 9-10 lakhs . This amount can be put as FD (Fixed deposit) in your bank in your name, so that the interest of this FD can also be utilized by you. Financial help can be sought form various agencies/NGOs and approval can be made .Release of these funds can be done once the transplant is over.
• You have to proceed to the hospital and report to the dialysis unit .If you had dialysis on that day it is good .If not you will need dialysis to remove excess fluid and reduce Urea, Creatnine . That is why it is very important to undergo regular 3/week dialysis and be well dialyzed!
• Preliminary test, coagulation profile, viral markers, X-ray, ECG will be done in anticipation of a good cross match result.
• Once the cross match comes (Cx) negative, the person going to receive the kidney will be started on Immunosupressive medications .The medicines used are Mycept ,Tacrolimus and Steroids .
• For one kidney ,3 persons will be selected and Cx will be done .Whoever is the luckiest with lowest Cx will be selected for the transplant.
• In addition to the above immunosuppressive medicine other injections are used depends on the Cx .They are Inj Simulect/ Inj Rituximab .
• Retrieval charges as per the bill form the hospital where brain death is declared are shared by the recipients ie, 2 kidneys, liver and heart.
• Plasma pheresis is a procedure like dialysis whereby the antibodies in the blood are removed and thereby reduces the chances of acute rejection. This may have to be done if the Cx is borderline positive or PRA is elevated.

For Transplant Please note:

• Age 12 -- 65 can be considered, we have done 66, with 84 % success, since 2012 -2013
• Male kidneys are supposed to be bigger in size than that of females but the number of nephrons (functioning unit) is the same.
• Recipient fitness is more important.
• Immunological factors like Negative PRA ,low Cx, Good surgical technique favor good outcome.
• All biochemical and sonological test like those of a live related donor are performed to assess the donor kidneys.
• Upto 7-8 hrs harvested kidney after perfusion (special fluid used to clean inside the kidney )can be stored in the ice .
• We have done 66 cadaver transplatation in the last six years through KNOS with 84.5% results.
• If cross match is positive or if you are not selected you may have to return .Don't get frustrated .
• It is better to stay somewhere near the hospital when your turn is likely to come or nearby town so that you can reach the hospital within 1 hour.
• It is better to update your fitness every 3 months. This will help in processing the Tx faster. If you have any infection anywhere please inform .Immunosuppressive medications are known to flare up your infection.
• There is a possibility that many people in your front in the queue may not accept the kidney on that day due to various reasons like—like having infection ,finance not ready , out of station, Cx positive ,Tx already done etc. So you must be mentally and financially be prepared when a cadaver kidney is offered to you by KNOS suddenly.

GOOD LUCK !!!!!!!

Contact to reduce confusion :

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Ms. Amee Mob: 9497397201 Mr. Justine Mob: 9995616706 Ms Razeena Mob: 9605898288