Nephrology and Kidney Transplant

RBH specialises in Renal Sciences with latest equipment, renowned doctors and trained para-medical staff. RBH has an enviable success rate in the areas of Urology, Nephrology & Kidney Transplant Surgery. The state-of-the-art Nephrology unit is well equipped to facilitate Kidney Transplants and round-the-clock Dialysis. Treatment with the latest diagnostic and therapeutic technologies and ensuring comprehensive care for kidneys, makes RBH a dependable and specialised hospital.

Nephrology Services
  • Vascular Access for Haemodialysis
  • Intervention Radiology – Angioplasty / Stent for Haemodialysis access dysfunction
  • Peritoneal Dialysis – Laparoscopic Placement of CAPD Cath Lab
  • Haemodialysis Conventional & Recent Modifications
  • Single Cabin Dialysis Service for Isolation Patients / Private Patients / Corporate Executives
  • Bed side Dialysis for ICU / Unstable Patients
  • CAPD, SLED, CPRT & Plasmapheresis facilities

Kidney Transplant Services
  • Specialist Kidney Transplant Registrar, Coordinator
  • Dedicated Kidney Transplant ITU Beds and specialized Nursing Team
  • Pre-operative procedures
    • PCR-based HLA typing
    • Cross match (CDC), DSA Screen
    • Virtual cross match (Luminex)
    • Donor-specific antibody (Luminex)-Single, Antigen, Cross match
    • Monitoring of BK virus
    • Adenovirus in transplant
  • Minimal Access Live Donor Nephrectomy
  • Adult &Paediatric Transplant, ABO incompatible Transplant
  • USG guided Real-Time Renal Transplant Biopsy
  • Surgical and medical management of Delayed Post Transplant Graft Dysfunction

The Benefits of Kidney Transplant

It is important for a kidney transplant recipient to feel healthy physically and emotionally. The need for time-consuming dialysis treatments no longer exists and the recipient can go back to normal diet without any fluid restrictions. Also, both energy and endurance of the recipient is expected to increase rapidly, thus improving quality of life. Re-joining work and re-starting travel and recreational activities will help improve the emotional status too. Kidney transplant recipients have a higher life expectancy than those on dialysis.

Living Donor Program

While the number of patients nationally in need of kidney transplant continues to rise, very few deceased donor organs are available, creating a long waiting time for those awaiting kidney transplant.Hence, many people choose to help a family member, loved one or a friend by donating one of their healthy kidneys.

New anti-rejection medications allow ESRD patients to successfully receive kidneys not only from blood relatives, but also from unrelated individuals, such as spouse or friends.

Any potential living donor in our programme will receive counselling on the possible risks and complications, and undergo a thorough evaluation to ensure that there are no abnormalities that would increase the risk of surgery for either the donor or the recipient.Since the 1980s, techniques have been developed to safely overcome this barrier by reducing antibodies before transplantation, enabling an increasing number of patients to receive kidney transplants around the world.

The result of blood group incompatible kidney transplants arenow comparable to live donors blood group compatible kidney transplants. World-wide, 1 year survival is about 90to 95%.

Laparoscopic Donor Nephrectomy

RBH surgeons have extensive experience and expertise in performing minimally invasive surgery to remove a donor’s kidney (laparoscopic donor nephrectomy) for a kidney transplant, as an alternative to open surgery.

In laparoscopic donor nephrectomy, surgeons perform the procedure through one or more small incisions in the abdomen. Laparoscopic nephrectomy results in quicker recoveryleading to a shorter hospital stay and less pain compared to open surgery. Many kidney donors return to normal activities or job within a few weeks of donating a kidney.

What is ABO incompatible transplantation

About 30% of potential live donors for kidney transplantation are found to be blood group incompatible. This means that antibodies in the patient with kidney disease will reject the kidney of the donor because of different blood group type.

In earlier days, in such cases, the kidney would have immediately rejected the transplant. The table below shows blood group incompatibilities.

How is the patient prepared for an ABO transplant?

A discussion with the doctor, and assessment of the ABO antibody levels, helps in planning when you will need to come to hospital for appointments and for treatments.

Immunoadsorption is used to remove blood group antibodies from the blood in a process resembling a haemodialysis session which is dependent on the amount of antibody present. Most people require 2 – 4 sessions, but some people require a lot more.

The blood group antibodies will be monitored during this process and the transplant will proceed only if the antibody levels are sufficiently low. Occasionally (in about 1 in 10 cases), it may not be possible to reduce the antibodies.Anti-rejection medications can be started 4-6 days before transplantation.

Sometimes high levels of antibodies come back after transplantation and further sessions of immunoadsorption are required.