Kidney & Pancreas Transplant
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The kidneys are organs whose function is essential to maintain life. Most people are born with two k
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Best liver transplant surgeonDue to shortage of cadaver liver there is a long waiting list to get a cadaver liver. Many patients are too unwell or have tumour in their liver and they may not be able to wait long for cadaver liver. Many patients die waiting for a cadaver liver.Pancreatic TransplantA pancreas transplant is surgery to implant a healthy pancreas from a donor into a patient with diabetes. Pancreas transplants give the patient a chance to stop taking insulin injections. Description The healthy pancreas is taken from a donor who is brain dead, but is still on life support. The donor pancreas must be carefully matched to the patient who is receiving it. A portion of the first part of the small intestine, called the duodenum, is transplanted with the donor pancreas. The healthy pancreas is transported in a cooled solution that preserves the organ for up to 20 hours. The patient's diseased pancreas is not removed during the operation. The donor pancreas is usually placed in the right lower part of the patient's abdomen. Blood vessels from the new pancreas are attached to the patient's blood vessels. The donor duodenum is attached to the patient's intestine or bladder. The surgery for a pancreas transplant takes about 3 hours. However, the operation is usually done at the same time as a kidney transplant in diabetic patients with kidney disease. The combined operation takes about 6 hours. Why the Procedure is Performed The pancreas makes a substance called insulin. Insulin moves glucose, which is sugar, from the blood into the muscles, fat, and liver cells, where it can be used as fuel. In people with type 1 diabetes, the pancreas doens't make enough, or sometimes any, insulin. This causes glucose to build up in the blood, leading to high blood-sugar levels. High blood sugar levels can cause many complications, including: Amputations Blindness Heart disease Kidney damage Nerve damage Stroke A pancreas transplant can cure diabetes and eliminate the need for insulin shots. Because of the risks involved with surgery, however, most people with type 1 diabetes do not have a pancreas transplant soon after they are diagnosed. A pancreas transplant is major surgery, and people with diabetes have a high-than-normal risk of heart disease and other complications. People who have had a pancreas transplant will need to take several medicines for the rest of their lives. These medicines have serious side effects. Because of these risks, pancreas transplant is rarely done alone. It is almost always done when someone with type 1 diabetes also needs a kidney transplant. Pancreas transplant surgery may NOT be done in patients who also have: A history of cancer HIV Infections such as hepatitis, which are considered to be active Lung disease Obesity Other blood vessel diseases of the neck and leg Severe heart disease (such as heart failure, poorly controlled angina, or severe coronary artery disease) Smoking, alcohol or other lifestyle habits that can damage the new organ The doctor may also recommend against a pancreas transplant if the patient is not able to keep up with the many follow-up visits, tests, and medications needed to keep the transplanted organ healthy. Risks The risks for any surgery are: Bleeding Breathing problems Heart attack or stroke Infection or abscess Reactions to medications Scar formation The risks for pancreas transplant include: Blood clots (deep venous thrombosis) Clotting (thrombosis) of the arteries or veins of the new pancreas Development of certain cancers after a few years Inflammation of the pancreas (pancreatitis) Leakage of fluid from the new pancreas where it attaches to the intestine or bladder Rejection Outlook (Prognosis) If the transplant is successful, you will no longer need to take insulin shots, test your blood-sugar daily, or follow a diabetes diet. There is evidence that the complications of diabetes, such as diabetic retinopathy, may not get worse -- and may even improve -- after a pancreas-kidney transplant. More than 95% of people survive the first year after a pancreas transplant. The risks for organ rejection are about 1% each year. The quality of life after a pancreas transplant has improved. Almost all patients find that managing daily life is a lot easier and more satisfying.Liver Transplant and SurgeryAll About Liver Transplant A few facts about liver transplantation Only cure for advanced stages of cirrhosis Can be done by donation by a brain dead person or by a close relative with matching blood group Done in time, it carries 80% success rate Close follow up is essential after transplant Life can be completely normal after transplant Who needs a Liver Transplant? According to international guidelines, any patient suffering from liver cirrhosis who is assessed to have a life expectancy of less than a year should be considered for a transplant. Severity of liver disease is graded from A to C. Usually all Grade C and most grade B patients are candidates for transplant. Any patient with any of the liver failure symptoms listed below should seek specialist opinion so that liver experts can assess whether a transplant or drug treatment is more suitable for them. In any case, the better the condition of the patient at the time of transplant, the better are the results of surgery. In patients who are critically ill in ICU, malnourished, have active infection, or other organ damage such as kidney impairment at the time of the operation, the results of transplantation are dismal. Therefore, timely transplant is of essence in obtaining good results. A timely transplant done on a patient who is in a reasonable condition, with a good donor liver has around 80% chance of success. In most instances, the above causes initially result in Hepatitis which can usually be treated. However, if the offending factor is not removed or treated on time, cirrhosis develops and then it is usually too late to change the course of the disease. Symptoms of liver failure due to cirrhosis Black stool Blood vomiting Water in the abdomen (ascites) Drowsiness and mental confusion Excessive bleeding from minor wounds Jaundice Kidney dysfunction Excessive tiredness Low hemoglobin and other blood counts Top Pre-transplant evaluation (Liver Transplant Assessment) The liver specialist usually suggests this evaluation once he has diagnosed end-stage liver disease. Recipient evaluation is done in three phases and normally takes 5-7 days in hospital. To establish definite diagnosis, determine the severity of liver disease and the urgency of the transplant. To determine the fitness of the patient for a transplant. The other systems such as heart, lungs, kidneys, blood counts are tested and the presence of any infection is ruled out. The liver specialist then decides how successful the surgery is likely to be depending on the status of the patient and the cause and severity of liver disease. The final phase entails the psychological and mental preparation of the patient. The patient and the family are counseled about the procedure, hospital stay, the likely course after surgery, follow up and aftercare. After evaluation, the patient is either placed on the waiting list for cadaveric donation, or , if there is a willing and blood group matched family donor available, he/she is evaluated for donation and a transplant is scheduled. While on the cadaver waiting list, the patient follows up with the Transplant Team until a suitable liver becomes available. If the patient's condition shows signs of deteriorating, we normally suggest the family to consider living liver donation.Pancreas Transplant & Multi Visceral TransplantatiWhat is multivisceral transplantation? Multivisceral transplantation having more than three abdominal organs replacement such as stomach, duodenum, pancreas, small intestine, and liver. The transplantation is based on patients need. The pancreas lies behind the lower part of the stomach. The main function of the pancreas is to create insulin. Insulin is a hormone responsible to regulate sugar (glucose) absorption into the body. If the pancreas is unable to create enough insulin, then sugar level increases to an unnatural level resulting in diabetes. A pancreas transplant is used to overcome this condition. Pancreas transplantation is for people who suffer from chronic diabetes and also have renal failure. It is aimed to ‘cure’ diabetes and in the long run, it will protect the transplanted kidney from being affected by diabetes and even reverse neuropathy and prolong their life. Small bowel transplantation is for people with bowel failure from either surgical cause or medical cause. Bowel failure means bowel is unable to absorb nutrients from food. Sometimes people need their nutrition to be fed through a drip into a vein as their bowel is unable to absorb nutrients from any food. This patient population, if not treated appropriately treated will develop liver and or kidney failure. They will need a combination of liver, small intestine and kidney transplantation (multi-visceral transplantation). We have a successful on-going cadaver organ transplantation program which will make these types of complex operations possible. Moreover, we have the doctors and the technology available to optimize their care in all the aspects.Best liver Transplant SurgeonFacts about Liver Transplants Liver transplant involves surgical removal of your diseased liver and implanting a new liver. The liver can come from a cadaver (cadaveric liver transplant) or a living person can donate part of his liver (Living donor liver Transplant). Cadaver Liver Transplant Organs for liver transplant are obtained from deceased donors, after they or their families have given consent to be an organ donor. A liver transplant is a big step to take, but it can save your life. You will be able to take better care of your new transplant if you understand your illness and your treatment. You will need to reach certain goals in your recovery. It is very important that you understand what you must do to make your transplant work. You must take your medicines as told, keep your appointments, and stay in close touch with your doctors. Some facts about the liver The liver does several things: It helps digest your food. It clears wastes from your blood. It makes proteins that help your blood to clot. It stores the sugars (glycogen) that are used for energy. It makes proteins that the body must have. It helps use and store vitamins. It makes chemicals that protect the body. It breaks down many toxins. The liver also controls the way your body uses food and the way it works with your immune system. When the liver is badly damaged, it cannot grow enough new liver tissue to heal itself. Severe liver damage with scarring is called cirrhosis (sir o sis). Cirrhosis can lead to two problems: 1. Liver failure This happens when the liver cannot do what it is supposed to do. 2. Portal hypertension This happens when scarring in the liver stops blood from flowing through it. This causes pressure to build up in the vein that feeds the liver (portal vein). The liver can take a lot of damage, but when most of it is damaged, it will start to fail. Once a person has signs of liver failure, it means there is not much of the liver left for the body to use during sickness and times of need. Signs of liver failure may include: Yellow skin and eyes (jaundice) Forgetfulness, confusion, or coma (encephalopathy) Feeling very tired Muscle loss (muscle wasting) Itching Blood does not clot Other signs of liver disease are too much fluid in the stomach (ascites), infections, and bleeding in the stomach. There is no treatment that can help the liver do everything it needs to do. So when a person reaches a certain stage of liver disease, a liver transplant may be the only way to prolong their life. What will happen before my transplant? First, your doctor will refer you to a transplant specialist. Your General practitioner or a gastroenterologist will refer you for liver transplantation when and if your liver disease begins to get worse, and you show signs of liver failure or portal hypertension. This is a specialized operation, so you will need to go to a hospital where liver transplant is done. Your transplant surgeon will evaluate your health status. We call this evaluation the pretransplant evaluation. It is how we decide if a liver transplant is right for you. During this time, you and your family will learn what you need to know about having a liver transplant. You will have many tests done. This process can take a few days or a few weeks. It depends on how many tests you need to have. Some things that will happen during this evaluation: You will meet with the liver specialist, the transplant surgeon, and other doctors. The transplant coordinator will schedule you for lab tests (blood work) and x-rays. Most patients do not need a liver biopsy. You will receive the usual vaccines. Other tests to expect: X-rays and other imaging tests You will have regular x-rays taken, such as a chest x-ray. You will also have more specialized imaging tests, like a CT or MRI scan. These tests will give your doctors a detailed view of your liver, its blood supply, and other organs. The tests are also used to look for tumors in the liver. All these images will show the surgeon what he needs to know in order to do your operation. Endoscopy and colonoscopy You may have an endoscopy test done. During this test, the doctor will run a flexible tube with a tiny television camera on the end of it down your throat and into your stomach. With a colonoscopy, the doctor will run a tube through your rectum and into your large intestine. Both of these tests look for enlarged veins called varices. They are a sign of liver disease or problems with the lower intestine. If you have large varices, the doctor may tie them off with rubber bands. This prevents them from bleeding. You will be given medicine to make you sleepy during your colonoscopy and endoscopy. Heart and stress tests Since a liver transplant is major surgery, it is important to know that your heart and lungs are healthy. We will do a detailed evaluation of your heart. They may do an electrocardiogram (ECG), echocardiogram, and a stress test. If you have been a smoker, your may undergo lung function tests and a blood gas test. If you smoke, you need to quit before you have the transplant. Your emotional health will also be evaluated. Your emotional health is as important to your transplant team as your physical health. For this reason, you will also be seen by a team of health professionals like a social worker, psychologist, addiction specialist. We will schedule a family meeting so everyone can meet the transplant team. At this meeting, will explain what a liver transplant involves and answer any questions. This team can also help you with financial concerns, connect you to hospital services, and give you information on support groups. Finally, your nutritional needs will be evaluated. A dietician will talk to you about your nutritional needs and design an eating plan for you to follow. They will also support you in eating well to you help your body heal after your transplant. Cadaver Transplant If you are for cadaver transplant then you will be listed on a waiting list. You will be informed when your turn comes and there is a suitable liver for you. The Waiting List Be sure to notify your transplant center of any change in your medical condition. When a liver is found for you, the transplant team must be able to contact you quickly. Your coordinators will need a current list of names and phone numbers of people who will know where to reach you.Surgical GastroenterologySurgical Gastroenterology deals with wide variety of surgical procedures with diagnose and treatment of the digestive system.Kidney & Pancreas TransplantThe kidneys are organs whose function is essential to maintain life. Most people are born with two kidneys, located on either side of the spine, behind the abdominal organs and below the rib cage. The kidneys perform several major functions to keep the body healthy. Filtration of the blood to remove waste products from normal body functions, passing the waste from the body as urine, and returning water and chemicals back to the body as necessary. Regulation of the blood pressure by releasing several hormones. Stimulation of production of red blood cells by releasing the hormone erythropoietin. The normal anatomy of the kidneys involves two kidney bean shaped organs that produce urine. Urine is then carried to the bladder by way of the ureters. The bladder serves as a storehouse for the urine. When the body senses that the bladder is full, the urine is excreted from the bladder through the urethra. Kidney Disease When the kidneys stop working, renal failure occurs. If this renal failure continues (chronically), end-stage renal disease results, with the accumulation of toxic waste products in the body. In this case, either dialysis or transplantation is required. Common Causes of End-Stage Renal Disease Diabetes mellitus High blood pressure Glomerulonephritis Polycystic Kidney Disease Severe anatomical problems of the urinary tract Treatments for End-stage Renal Disease The treatments for end-stage renal disease are hemodialysis, a mechanical process of cleaning the blood of waste products; peritoneal dialysis, in which waste products are removed by passing chemical solutions through the abdominal cavity; and kidney transplantation. However, while none of these treatments cure end-stage renal disease, a transplant offers the closest thing to a normal life because the transplanted kidney can replace the failed kidneys. However, it also involves a life-long dependence on drugs to keep the new kidney healthy. Some of these drugs can have severe side effects. Some kidney patients consider a transplant after beginning dialysis; others consider it before starting dialysis. In some circumstances, dialysis patients who also have severe medical problems such as cancer or active infections may not be suitable candidates for a kidney transplant. Kidney Transplantation Kidneys for transplantation come from two different sources: a living donor or a deceased donor. Contact us for kidney & Pancreas transplant in India Transplant Evaluation Process Blood Type Testing Tissue Typing Crossmatch Serology. http://www.drgauravchaubal.in/