Recipient preparation and evaluation

What is the preparation required for transplant?

Patients initially might not believe that they need a transplant; they may deny their sickness, expect it to be very easy, feel guilty or be anxious or depressed about the process or costs involved. While most patients have these feelings, it is important to keep the larger picture in mind, seek support from family members, and prepare for the transplant without losing precious time.

The preparation starts with recipient’s evaluation. Once the patient is found suitable for transplantation, potential donors in the family need to be identified. They should have their blood group checked and the one who found compatible should undergo donor evaluation. If the donor is suitable, authorization committee clearance is obtained and transplant scheduled.

Living donors are classified as either a near relative or a non-related donor.

  1. A near-relative (spouse, children, grandchildren, siblings, parents and grandparents) needs permission of the doctor in-charge of the transplant center to donate his organ.
  2. A non-related donor needs permission of an Authorization Committee established by the state to donate his organs. (Authorization Committee (AC): Is a government body that regulates living donor transplantation by reviewing each case to ensure that the living donor is not exploited for monetary considerations and to prevent commercial dealings in transplantation. Proceedings to be video recorded and decisions notified within 24 hours. Appeals against their decision may be made to the state or central government.)

Another alternative in live donations are Swap Transplantations. This is when a near relative living donor is medically incompatible with the recipient, the pair is permitted to do a swap transplant with another related unmatched donor/recipient pair. There is an NGO in Mumbai called ASTRA who can be approached by people who want to find others to do a swap transplant with.

If a suitable family donor is not available, after the recipient evaluation is found satisfactory, the patient is registered on the waiting list for a deceased donor kidney transplant.

Patients should make adequate arrangements for blood required as well as finances well in advance before surgery. While preparing for a transplant, all doubts should be clarified and understood. Patients and the donors are encouraged to meet other patients and families who have undergone the operation and are willing to share their experiences.

Related links:
Pre-transplant recipient (patient) evaluation
Transplant surgery
Post-transplant care

Refrences
www.unos.org
www.clevelandclinic.org
https://www.kidneyresearchuk.org
http://edition.cnn.com/2009/HEALTH/11/13/kidney.disease.diabetes/
http://www.worldkidneyday.org/faqs/about-kidneys-and-kidney-disease/kidneys-and-chronic-kidney-disease/

Fortis Memorial Research Institute Dr. PN Gupta, Paras Hospital