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| World kidney day 2012 | | | Dr. Vijay Kher | 3/9/2012 10:52:11 PM |
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World Kidney Day (WKD) is a global health
awareness campaign focusing on the importance of
the kidneys and reducing the frequency and impact of kidney disease and its associated health problems worldwide.The campaign is celebrated every year on the second Thursday of March in more than 100 countries on 6 continents. This year we are celebrating 6th world kidney day and every year one aspect regarding kidney disease is the focus.
In previous years the themes have been Diabetes, Hypertension, this year the theme is regarding Organ donation and Kidney Transplantaion. Although Chronic Kidney disease can be managed with hemodialysis , Continuous Ambulatory peritoneal dialysis (CAPD) or Kidney Transplantation but, Kidney transplantation is the best treatment option for end stage kidney failure in terms of longevity (survival), cost effectiveness and quality of life compared to the dialytic modalities. There are at least 1.5 lakh new patients of end stage kidney failure every year in India. The most common causes for kidney failure are diabetes mellitus, glomerulonephritis, hypertension, stone disease , urinary tract infections and drug induced interstitial disease.
Kidney transplantation has the best outcome out of various organ transplants. 10-year survival of living related kidney transplantation is more than 85 %. It is important to have well matched donors, which usually come from brothers, sisters, parents and children. The outcome of 100 % matched kidneys (siblings only) measured by transplanted kidney half life (if 100 persons are transplanted 50 will be doing well for) is > 30 years, of 50 % matched kidneys (parents, children, siblings) - is about 16-18 years, and amongst 0 % matched kidneys the half life is 10-11 years. Surprisingly kidney transplant of spouse donors is as good as or better than 50 % matched kidneys.
India had attained a dubious distinction of a kidney bazaar where kidneys were bought in a market and rich foreigners would come for kidney transplants to India. It led to organ transplant act of 1994, which prohibits the sale of organs and allows kidney transplantation with donors selected from close relatives in the family and gives guidelines for accepting brain death criteria for organ donation. The donor, if selected well, has no short or long term risk of kidney donation and can get back to his/her pre donation health status in 2-4 weeks. In fact life span of donors is longer than average life span of
the common man in the community, as once accepted as donor, they are the healthiest group in the community. We have been involved in kidney transplantation over last 25 years. We have had very successful kidney transplant programmes at SGPGI Lucknow, Indraprastha Apollo Hospital New Delhi, Fortis Hospital NCR & now at Medanta the Medicity.
We do about 200 kidney transplants a year at Medanta - The Medicity. Our 1-year patient and graft survival is more than 97 %. These survival outcomes are comparable to the best in the world. The donor kidney is removed by laparoscopic surgery & /or robotic surgery, which means quicker recovery, less pain, early discharge from the hospital and early return to his or her work. We have one of the largest series of laparoscopic donor nephrectomy, pre-emptive kidney transplants (transplantation done without any dialysis) in the country and using innovative combinations of immunosuppressive drugs to improve long term outcome in kidney transplants. We also do steroid free transplantation and ABO incompatible transplantation.
There is a need for greater awareness amongst public about cadaver transplantation and brain death. World over, organ transplants are done from donors (whose brain is dead and the heart is beating), being kept alive on ventilators. This allows transplants of heart, lungs, liver, kidneys, intestine and pancreas etc. The organ transplant act of 1994 in India, recognizes brain death for organ donation purposes and provides guidelines for declaring patients as brain dead. However, despite having the law, people in general do not come forward to donate organs at the time of brain death of their relatives.
This is the main reason for lack of organs for transplantation, not being able to do other organ transplants. There is need for social awakening in this regard so that we also march along with other nations of the world, taking care of patients with end stage organ failure with organ transplants from the brain dead donors as well as living related donors.
Dr. Vijay Kher
Chairman
Div. of Nephrology & Tx Medicine
Medanta Kidney & Urology Institute
Medanta - The Medicity
Gurgaon |
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