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Organ Transplant

 

Heart Transplant in India:

A heart transplant is the surgical replacement of a person’s diseased heart with a healthy donor’s heart. The donor is a person who has died and whose family has agreed to donate their loved one’s organs.

Since the performance of the first human heart transplant in 1967, heart transplantation has changed from an experimental operation to an established treatment for advanced heart disease.

350 Heart Transplants in India in the last 24 years

Heart transplant remains the gold standard for the treatment of end-stage heartfailure. The first successful heart transplant in India was done at the All India Institute of Medical Sciences (AIIMS), New Delhi on August 3, 1994. The patient survived for 14 years.

It gives a patient with congenital heart disease the opportunity to have a normal heart with normal blood circulation. If the transplant goes well, heart function and blood flow will be better than ever.

Why is a Heart Transplant needed?

People who have advanced (end stage) heart failure, but are otherwise healthy, may be considered for a heart transplant.

Best Heart Transplant in India

 

The following basic questions should be considered by you, your doctor, and your family to determine if heart transplantation is right for you:
  • Have all other therapies been tried or excluded?
  • Are you in generally good health other than the heart or heart and lung disease?
  • Are you likely to die in the near future without the transplant?
  • Can you adhere to the lifestyle changes, including complex drug treatments and frequent exams, required after a transplant?

If you answered “no” to any of the above questions, heart transplantation may not be for you. Also, if you have additional medical problems, such as other severe diseases, active infections, or severe obesity, you most likely will not be considered a candidate for transplant.

Eligibility for Heart Transplant

A patient becomes eligible for a heart transplant if there has been zero or little response to all others forms of treatment. It begins with a comprehensive assessment of the patient, the underlying causes necessitating a transplant and pre-existing conditions.

The condition that necessitates a heart transplant is congestive heart failure, also known as weakening of the heart muscles.

How does it affect the heart?

The donor heart is matched to the recipient by blood type and body size. As the heart transplant recipient, you must take medications to prevent his or her immune system from rejecting the new heart. These drugs are called immunosuppressive medication. Your medical team will balance the amount of immunosuppressive medication you need to prevent rejection of your new heart with the risk of side effects, which include infection or cancer.

What Is the Process for Getting a Heart Transplant?

In order to get a heart transplant, you must first be placed on a transplant list.But, before you can be placed on the transplant list, you must go through a careful screening process. A team of heart doctors, nurses, social workers, and bioethicists review your medical history, diagnostic test results, social history, and psychological test results to see if you are able to survive the procedure and then comply with the continuous care needed to live a healthy life.

Once you are approved, you must wait for a donor to become available. This process can be long and stressful. A supportive network of family and friends is needed to help you through this time. The health care team will monitor you closely to keep your heart failure in control until a donor heart is found. The hospital must know where to contact you at all times should a heart become available.

How Are Organ Donors Found?

Donors for heart transplants are individuals who may have recently died or become braindead, which means that although their body is being kept alive by machines, the brain has no sign of life. Many times, these donors died as a result of a car accident, severe head injury, or a gunshot wound.

Heart Transplant in India

Donors generally give their permission for organ donationbefore their death. The donor’s family must also give consent for organ donation at the time of the donor’s death.

What Happens During a Heart Transplant?

Once a donor heart becomes available, a surgeon from the transplant center goes to harvest the donor heart. The heart is cooled and stored in a special solution while being taken to the recipient.



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Activity Restrictions

Heart transplant recipients have no specific activity restrictions. Discuss activity ideas with your transplant cardiologist.



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Liver Transplant and Biliary Sciences

liver transplant program

 

We welcome you to MSOI’s liver transplant program. We have on our panel, extremely talented, professional & most experienced teams for liver transplant in various cities in India. Teams of 200 members, more than 20 years of experience, 2000+ transplants; making us your no 1 choice for Living Related Liver Transplants.

We will ensure round the clock care and best in class post surgery follow up. Our patients receive the highest standard of patient safety during & post-surgery.

When is transplant necessary?

 

  • When cancer has developed in the liver.
  • When kidneys have started failing as a result of liver disease.
  • When fluid accumulation cannot be cleared by water tablets.
  • When you start losing consciousness.
  • When you start getting recurrent bouts of abdominal infection, either peritonitis or
    cholangitis.

What is the success rate of liver transplant?

Liver transplantation has been accepted as a therapeutic option for patients with end-
stage liver disease since 1983, with continual improvements in patient survival as a
result of advances in immunosuppression and medical management, technical
achievements, and improvements in procurement and preservation.

According to a study , people who have a liver transplant have an 89% percent chance of living after one year. The five-year survival rate is  75 percent . Sometimes the transplanted liver can fail, or the original disease
may return.

It’s important that your doctor monitors your recovery long after the transplant to detect any problems. You’ll likely need regular blood tests. According to  John Hopkins , you’ll also need to take antirejection medications for the rest of your life.

Four thousand consecutive patients who underwent liver transplantation between February 1981 and April 1998 were included in an analysis and were followed up to March 2000. The effect of donor and recipient age at the time of transplantation, recipient gender, diagnosis, and year of transplantation were compared. Rates of retransplantation, causes of retransplantation, and cause of death were also examined.

The overall patient survival for the entire cohort was 59%; the actuarial 18-year survival was 48%. Patient survival was significantly better in children, in female recipients, and in patients who received transplants after 1990. The rates of retransplantation for acute or chronic rejection were significantly lower with tacrolimus-based immunosuppression. The risk of graft failure and death was relatively stable after the first year, with recurrence of disease, malignancies, and age- related complications being the major factors for loss.Significantly improved patient and graft survival has been observed over time, and graft loss from acute or chronic rejection has emerged as a rarity.

Survival rates for female patients were significantly better than for males, with 1-, 5-, 10-, 15-, and 18-year survival rates of 77%, 64%, 53%, 44%, and 44% for male patients and 80%, 71%, 62%, 56%, and 55% for females

Is living related liver donation safe?

 

It is a major operation for the donor as well. The risk of death is 1 in 500.

With the advancements in modern day liver transplant techniques, Live Liver Donations Confirmed As Safe. According to Johns Hopkins researchers, individuals who donate a portion of their liver for live transplantation usually recover safely from the procedure and can expect to live long, healthy lives.

How is life after liver transplant?

 

The patient must eat hygienic food, go for regular blood tests and comply with immunosuppressive medications.

There are many new things a person experiences after liver transplantation. Before you leave the hospital, your team will provide all the instructions you and your family will need in caring for the “new” you.

Three months after the operation, most patients have recovered fully, returned to work, and are enjoying active lives. Our goal is to provide expert care and excellent follow-up, working with your primary care
physician, to make the extent and quality of your life appreciably better than before. We urge you and your local doctor to keep in touch with the CLDT to let us partner in your ongoing care.

Liver Transplant Surgery in India

 

Liver Transplant

A liver transplant is required if you are suffering from end-stage liver disease. One of the most common conditions is liver cirrhosis in which the healthy tissues are replaced with damaged ones that can stop the liver to function properly. It can be a life-threatening disease and the liver may require transplantation. The donor can be a patient who is brain dead or has recently died.

Why it’s done?

Liver transplant is a treatment option for people who have end-stage liver failure that can’t be controlled using other treatments and for some people with liver cancer. Liver failure can occur rapidly, in a matter of weeks (acute liver failure), or it can occur slowly over months and years (chronic liver failure).

Liver failure has many causes, including:

  • Liver cirrhosis
  • Alcoholic liver disease
  • Nonalcoholic fatty liver disease
  • Early-stage liver cancer
  • Hemochromatosis
  • Primary biliary cirrhosis
  • Primary sclerosing cholangitis
  • Wilson’s disease
  • Biliary duct atresia
  • Cystic fibrosis
Risks & Side Effects of Anti Rejection

 

Liver transplant surgery carries a risk of significant complications, including:

  • Bile duct complications, including bile duct leaks or shrinking of the bile ducts
  • Bleeding
  • Blood clots
  • Failure of donated liver
  • Infection
  • Memory and thinking problems
  • Rejection of donated liver

After a liver transplant, you’ll take medications for the rest of your life to help prevent your
body from rejecting the donated liver. These medications can cause a variety of side
effects, including:

  • Bone thinning
  • Diabetes
  • Diarrhea
  • Headaches
  • High blood pressure
  • High cholesterol
  • Rejection of donated liver
How to prepare?

 

Being placed on the waiting list

If you have chronic liver failure, your doctor may refer you to a transplant center to undergo evaluation for liver transplant. The transplant center team conducts a wide variety of tests and procedures to determine whether to place your name on the waiting list for a new liver.

Tests, procedures and consultations you may undergo include:

  • Laboratory tests,including blood and urine tests to assess the health of your organs, including your liver
  • Imaging tests, such as an ultrasound of your liver
  • Heart tests, to determine the health of your cardiovascular system
  • A general health exam,including routine cancer screening tests, to evaluate
    your overall health
  • Nutrition counseling with dietitians, who assess your nutritional status and
    make recommendations regarding nutritional intake before and after transplant
  • Psychological evaluation,to determine whether you fully understand the risks of a liver transplant
  • Meetings with social workers,who assess your support network to determine whether you have friends or family to help care for you after transplant
  • Addiction counseling,to help people with alcohol, drug or tobacco addictions to quit
  • Financial counseling,to help you understand the cost of a transplant and post-transplant care and to determine what costs are covered by insurance

Once these tests and consultations are completed, the transplant center’s selection committee meets to discuss your case. It determines whether a liver transplant is the best treatment for you and whether you’re healthy enough to undergo a transplant. If the answer to both questions is yes, then you’re placed on the transplant waiting list.

Determining your position on the waiting list

Doctors use results of liver function tests and other factors to determine your prognosis and your place on the transplant waiting list. Your prognosis is sometimes called your Model for End-Stage Liver Disease (MELD) score. The higher your MELD score, the more dire your situation. Organs are allocated based on MELD scores. People with higher MELD scores generally are offered donated livers first. MELD scores range from 6
to 40.

Some liver conditions, such as liver cancer, may not result in a person getting a high MELD score. The transplant center can request additional MELD points for people with specific diseases if they meet defined criteria.

Waiting for a new liver

Your wait for a donor liver could be days, or it could be months. Or a donor liver that’s a good match for you might not become available.

As you wait for a new liver, your doctor will treat the complications of your liver failure to make you as comfortable as possible. Complications of end-stage liver failure are serious, and you may be frequently hospitalized. If your liver deteriorates, your MELD score is updated.

Living liver donors

A small percentage of liver transplants are completed each year using a portion of a liver from a living donor. If you have a family member or friend who is willing to donate part of his or her liver to you, talk to your transplant team about this option.

Living-donor transplants have good results, just like transplants using livers from deceased donors. But fewer living transplants are performed because of restrictions on the donor’s age, size and health that make finding a good match difficult. The surgery carries significant risks for the donor. Your transplant team can discuss the risks with you and the potential donor.

What to expect?

During a liver transplant

If you’re notified that a liver from a deceased donor is available, you’ll be asked to cometo the hospital immediately. Your health care team will admit you to the hospital, and you’ll undergo an exam to make sure you’re healthy enough for the surgery.Liver transplant surgery is done using general anesthesia, so you’ll be unaware during the procedure.

The transplant surgeon makes a long incision across your abdomen to access your liver. The location and size of your incision varies according to your surgeon’s approach and your own anatomy.

The surgeon disconnects your liver’s blood supply and the bile ducts and then removes the diseased liver. The donor liver is then placed in your body, and blood vessels and bile ducts are reattached. Surgery can take up to 12 hours, depending on your situation.

Once your new liver is in place, the surgeon uses stitches and staples to close the surgical incision. You’re then taken to the intensive care unit to begin recovery.

Liver transplant using a living donor

If you’re receiving a liver transplant from a living donor, such as a friend or family member, surgeons will transplant a portion of the donor’s liver in your body. Surgeons first operate on the donor, removing the portion of the liver for transplant. Then surgeons remove your diseased liver and place the donated liver portion in your body. They then connect your blood vessels and bile ducts to the new liver.

The transplanted liver portion in your body and the portion left behind in the donor’s body regenerate rapidly.

After a liver transplant

After your liver transplant, you can expect to:

  • Possibly stay in the intensive care unit for a few days. Doctors and nurses will monitor your condition to watch for signs of complications. They’ll also test your liver function frequently for signs that your new liver is working.
  • Spend 5-10 days in the hospital. Once you’re stable, you’re taken to a transplant recovery area to continue recuperating.
  • Have frequent checkups as you continue recovering at home. Your transplant team designs a checkup schedule for you. You may undergo blood tests a few times each week at first and then less often over time.
  • Take medications for the rest of your life. You’ll take a number of medications after your liver transplant, many for the rest of your life. Drugs called immunosuppressants help keep your immune system from attacking your new liver. Other drugs help reduce the risk of other complications after your
    transplant.
Results

 

Expect six months to a year of recovery before you’ll feel fully healed after your liver transplant surgery. You may be able to resume normal activities or go back to work a few months after surgery. How long it takes you to recover may depend on how ill you were before your liver transplant.

Once these tests and consultations are completed, the transplant center’s selection committee meets to discuss your case. It determines whether a liver transplant is the best treatment for you and whether you’re healthy enough to undergo a transplant. If the answer to both questions is yes, then you’re placed on the transplant waiting list.

Survival rates after liver transplant

Your chances of a successful liver transplant and long-term survival depend on your particular situation. In general, about 72 percent of people who undergo liver transplant live for at least five years. That means that for every 100 people who receive a liver transplant for any reason, about 72 will live for five years and 28 will die within five years.

People who receive a liver from a living donor have higher survival rates because having a living donor usually means a shorter wait for a liver. For liver transplants using living donors, the five-year survival rate is about 78 percent. That means that for every 100 people who receive a liver transplant using a living donor, 78 will live for five years and 22 will die within five years.

Kidney Transplant

MSOI offers all kinds of transplants, including ABO incompatible KTP (Kidney Transplant Procedure) (transplant without a blood type match)

A kidney transplant is a surgical procedure to place a kidney from a live or deceased donor into a person whose kidneys no longer function properly.

Your kidneys remove excess fluid and waste from your blood. When your kidneys lose their filtering ability, dangerous levels of fluid and waste accumulate in your body — a condition known as kidney failure or end-stage kidney disease. A kidney transplant is often the best treatment for kidney failure.

Only one donated kidney is needed to replace two failed kidneys, making living-donor kidney transplantation an option.

How Are Organ Donors Found?

Donors for heart transplants are individuals who may have recently died or become braindead, which means that although their body is being kept alive by machines, the brain has no sign of life. Many times, these donors died as a result of a car accident, severe head injury, or a gunshot wound.

Kidney Transplant Surgery in India
Why it’s done?

 

A kidney transplant is used to treat kidney failure (end-stage kidney disease), a condition in which your kidneys can function at only a fraction of normal capacity. People with end-stage kidney disease need either to have waste removed from their bloodstream (dialysis) or a kidney transplant to stay alive.

Common causes of end-stage kidney disease include:

  • Diabetes
  • Chronic, uncontrolled high blood pressure
  • Chronic glomerulonephritis — an inflammation and eventual scarring
    of the tiny filters within your kidneys (glomeruli)
  • Polycystic kidney disease

Sometimes kidney disease can be managed with diet, medication and treatment for the underlying cause. If despite these steps your kidneys still can’t filter your blood adequately, you might be a candidate for a kidney
transplant.

Risks

 

Kidney transplantation can treat advanced kidney disease and kidney failure, but it is not a cure. Some forms of kidney disease may return after transplant.

The health risks associated with kidney transplant include those associated directly with the surgery itself, rejection of the donor organ and side effects of taking medications (anti-rejection or immunosuppressants) needed to prevent your body from rejecting the donated kidney.

Complications of the procedure

Kidney transplant surgery carries a risk of significant complications, including:

  • Blood clots
  • Bleeding
  • Leaking from or blockage of the tube (ureter) that links the
    kidney to the bladder
  • Infection
  • Failure of the donated kidney
  • Rejection of the donated kidney
  • An infection or cancer that can be transmitted with the donated
    kidney
  • Death, heart attack and stroke
Anti-rejection medication side effects

After a kidney transplant, you’ll take medications to help prevent your body from rejecting the donor kidney. These medications can cause a variety of side effects, including:

  • Acne
  • Bone thinning (osteoporosis) and bone damage (osteonecrosis)
  • Diabetes
  • Excessive hair growth or hair loss
  • High blood pressure
  • High cholesterol
  • Increased risk of cancer, particularly skin cancer and lymphoma
  • Infection
  • Puffiness (edema)
  • Weight gain
How you prepare?
Choosing a transplant center

If your doctor recommends a kidney transplant, you may be referred to a transplant center. You’re also free to select a transplant center on your own or choose a center from your insurance company’s list of preferred providers.

When you’re considering transplant centers, you may want to:

  • Learn about the number and type of transplants the center performs each year
  • Ask about the transplant center’s patient and kidney survival rates
  • Consider additional services provided by the transplant center, such as coordinating support groups, assisting with travel arrangements, helping with local housing for your recovery period and offering referrals to other resources

After you’ve selected a transplant center, you’ll need an evaluation to determine whether you meet the center’s eligibility requirements for a kidney transplant.

The team at the transplant center will assess whether you:
Best Heart Hospitals in India
  • Are healthy enough to have surgery and tolerate lifelong post- transplant medications
  • Have any medical conditions that would decrease transplant success
  • Are willing and able to take medications as directed and follow the suggestions of the transplant team
Finding a donor & Staying Healthy

 

A kidney donor can be living or deceased, related or unrelated to you. Your health care team will consider several factors, such as blood and tissue types, when evaluating whether a living donor will be a good match for you. Family members are often the most likely to be compatible kidney donors. But many people undergo successful transplants with kidneys donated from people who are not related to them.

If a compatible living donor isn’t available, your name will be placed on a waiting list for a deceased-donor kidney. Because there are fewer available kidneys than there are people waiting for a transplant, the waiting list continues to grow. The waiting time for a deceased-donor kidney is usually a few years.

Paired kidney donation may be an option if you’ve found someone willing to donate a kidney, but the donor’s blood and tissue aren’t compatible with yours. Rather than donating a kidney directly to you, your donor may give a kidney to a person whose blood and tissue is compatible with the donor’s kidney, and you receive a kidney from another transplantee’s donor.

Whether you’re waiting for a donated kidney or your transplant surgery is already scheduled, work to stay healthy. Being healthy and as active as you’re able can make it more likely you’ll be ready for the transplant surgery when the time comes. It may also help speed your recovery from surgery. Work to:

  • Take your medications as prescribed
  • Follow your diet and exercise guidelines
  • Keep all appointments with your health care team
  • Stay involved in healthy activities, including relaxing and
    spending time with family and friends

Stay in touch with your transplant team and let them know of any significant changes in your health. If you’re waiting for a donated kidney, make sure the transplant team knows how to reach you at all times. Keep your packed hospital bag handy, and make arrangements for transportation to the transplant center in advance.

What can you expect?

 

Before the procedure
Finding a match

A kidney donor can be living or deceased, related or unrelated to you.

Tests to determine whether a donated kidney may be suitable for you
include:

  • Blood typing.typing. It’s preferable to get a kidney from a donor whose blood type matches or is compatible to your own. Blood-type incompatible transplants are also possible but require additional medical treatment before and after transplant to reduce the risk of organ rejection. These are known as ABO incompatible kidney transplants.
  • Tissue typing.If your blood type is compatible, the next step is a tissue typing test called human leukocyte antigen (HLA) typing. This test compares genetic markers that increase the likelihood the transplanted kidney will last a long time. A good match means it’s less likely that your body will reject the organ.
  • Crossmatch. The third and final matching test involves mixing a small sample of your blood with the donor’s blood in the lab. The test determines whether antibodies in your blood will react against specific antigens in the donor’s blood. A negative crossmatch means they are compatible and your body isn’t as likely to reject the donor kidney. Positive crossmatch kidney transplants are also possible but require additional medical treatment before and after the transplant to reduce the risk oyour antibodies reacting to the donor organ.Additional factors your transplant team may consider in finding the most appropriate donor kidney for you include matching age, kidney size and infection exposure.

During a kidney transplant

Kidney transplants are performed with general anesthesia, so you’re not aware during the procedure. The surgical team monitors your heart rate, blood pressure and blood oxygen level throughout the
procedure.

During the surgery:
  • The surgeon makes an incision and places the new kidney in your lower abdomen. Unless your own kidneys are causing complications such as high blood pressure, kidney stones, pain or infection, they are left in place.
  • The blood vessels of the new kidney are attached to blood vessels in the lower part of your abdomen, just above one of your legs.
  • The new kidney’s ureter — the tube that links the kidney to the bladder — is connected to your bladder.

Kidney transplant surgery usually lasts about three to four hours.

After a kidney transplant

After your kidney transplant, you can expect to:

  • Spend several days to a week in the hospital. Doctors and nurses monitor your condition in the hospital’s transplant recovery area to watch for signs of complications. Your new kidney will make urine like your own kidneys did when they were healthy. Often this starts immediately. In other cases it takes several days. Expect soreness or pain around the incision site while you’re healing.
  • Have frequent checkups as you continue recovering. After you leave the hospital, close monitoring is necessary for a few weeks. Your transplant team will develop a checkup schedule for you. During this time, if you live in another town, you may need to make arrangements to stay near the transplant center.
  • Take medications the rest of your life. You’ll take a number of medications after your kidney transplant. Drugs called immunosuppressants help keep your immune system from attacking your new kidney. Additional drugs help reduce the risk of other complications, such as infection, after your transplant.
Results

 

After a successful kidney transplant, your new kidney will filter your blood, and you will no longer need dialysis.

To prevent your body from rejecting your donor kidney, you’ll need medications to suppress your immune system. Because these anti-rejection medications make your body more vulnerable to infection, your doctor may also prescribe antibacterial, antiviral and antifungal medications.

After transplant, skin checkups with a dermatologist to screen for skin cancer and keeping your other cancer screening up to date is strongly advised.