विवरण
Compared to continuing on dialysis, kidney transplantation is linked to improved quality of life and mortality. As a result, for the majority of patients, it is the best treatment for kidney failure. General nephrologists and internists frequently look after kidney transplant recipients after the first six months following the procedure, during which time transplantation nephrologists normally take care of the patient. Drug interactions are frequent and often lead to toxicities, rejection, and graft damage. Long-term immunosuppression-related infections and cancers may be difficult to diagnose and cure.
सारांश
- The speaker discusses the critical need for organ transplantation, emphasizing the organ shortage and the role of healthcare workers in educating the public about organ donation. The presentation will cover transplantation protocols and showcase a case study to illustrate the process from beginning to end. Organ transplantation involves replacing a sick organ with a healthy one, with ongoing research into artificial organs like kidneys and pancreases.
- Organ transplantation encompasses various types, including autotransplants, allotransplants (between individuals), and xenotransplants (across species). Donors can be living (related or emotionally motivated) or cadaveric (brain-dead, beating or non-beating heart). The major challenge with cadaveric organs is convincing families to consider donation. Waiting times for transplants can be extensive, especially in countries without central programs.
- The first successful kidney transplant in India was at KM Hospital, Bombay. Common challenges in transplantation include public and professional attitudes, religious beliefs, legal aspects, reporting brain death, hospital infrastructure, and trained transplant coordinators. The Ramachandra protocol is used to request organs from brain-dead patients.
- Post-transplant, the body may reject the organ. Rejections can be hyperacute (immediate), acute (within seven days), or chronic (any time post-transplant). Relative contraindications for organ donation exist, such as HIV (now a relative contraindication) and severe sepsis. Cold ischemic time is the time from organ removal to cold storage, while delayed graft function occurs when the transplanted organ doesn't start working immediately.
- Kidneys are typically placed in the right iliac fossa and require anastomosis of the artery, vein, and ureter. Surgical complications include delayed graft function. Rejections are classified as T-cell mediated (easier to treat) or antibody-mediated (difficult to treat). Immunosuppression is used to prevent rejection, involving induction agents (injections) and maintenance drugs (steroids, antimetabolites, CNIs).
- Challenges with deceased donors include fluctuating blood pressure. Immunosuppression drugs have side effects like severe reactions, reduced blood counts, GI issues, new-onset diabetes, and infections. The first three months post-transplant involve intense immunosuppression. Efforts to increase organ donation include educating family members, unconventional donor sources, and exploring xenotransplantation.
- The Human Organ Transplantation Act aims to prevent commercial dealings in organ transplantation and recognize potential donors. Religious barriers are often rooted in fears of mutilation or unequal access to organs. Programs like Moan Foundation and Jeevandan are successful models for promoting deceased donor transplantation.
- A case study involves a young man with severe hypertension and kidney failure due to IgA nephropathy. His mother is considered as the donor with preliminary investigations including blood work, ultrasound, and glucose tolerance tests. The mother and son share the same blood type, facilitating a blood-group compatible transplant.
नमूना प्रमाण पत्र
वक्ताओं के बारे में
Dr Satyanarayana Garre
MBBS, MD, DNB( Nephrology) Apollo hospitals Hyderabad
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