Enriching kidney transplantation and beyond
The TransCare transplant programme is India’s new age flagship kidney transplant care programme with the passion of improving overall success in long-term transplant outcomes and ensuring a smooth transplant experience for patients suffering from kidney failure. Initiated and conceptualised by noted kidney transplant surgeon, from India, Priyadarshi Ranjan, the team consists of trained Transplant Surgeons, Physicians, Counsellors, Coordinators and other dedicated transplant professionals contributing to enrich the lives of thousands of transplant patients. The TransCare programme covers the three phases namely the pre-transplant phase, transplant surgery phase and the post-transplant management phase.
The pre-transplant counsellors assess you to finalise your kidney donor, get the medically relevant investigations, prepare your legal files for clearance from authorities, coordinate your medical specialist appointments so that you can be optimised for your transplant surgery. .
What needs to be monitored after a transplant and why is a TransCare follow up clinic important for you?
The current immediate surgical success rate of Kidney transplant is close to 98 percent, but the long term graft(kidney) outcome is what really matters for the patient. It has been seen that whereas several millions of successful kidney transplants are done each year, but a significant number do not sustain for long term due to inaccurate follow up and lack of screening protests for optimising immuonosupression of these grafts. Our teams are constantly working out to see and analyse these long term challenges to keep the kidney healthy and functioning for several years after transplant. Let’s have a closer look to see what problems can arise after the transplant.
- 1. Dangerous infections such as BK Virus, CMV etc are not only harmful for the graft kidney but could be fatal. They can be easily prevented by timely treatment and judicious tailoring of immunosupressive medicines.
- 2. The current medicines used to prevent rejection are also toxic for the graft kidney so their dose needs to be properly adjusted from time to time.
- 3. There is a slow process of chronic rejection which ultimately causes kidney graft loss over several years. It needs to be aggressively analysed and managed as per individual patients.
- 4. Several patients develop antibodies against their donor organ (kidney), which starts destroying the graft in due course. These antibodies need to be monitored and removed.
- 5. The transplant medicines alter the blood sugar and lipid profiles, so they need to be properly taken care of to prevent them from progressing to a threatening consequence such as stroke and heart attack. Diet and nutrition management here plays a key role.
- 6. The steroids(prednisone/ wysolone) can cause weakness of bones and muscles so a proper exercise schedule is a must to strengthen them along with calcium supplementation. That’s the entire concept of the transfit programme.
- 7. The nutritional requirements keep changing from time to time for the transplant patients to check their sugar levels, normalise the lipid abnormalities, combat obesity and adjust diet according to body weight. Intestinal infections can lead to diarrhoea, when an acute adjustment in diet is required or else your creatinine will start rising. The diet also needs to be adjusted according to your proteinuria levels from the transplant kidney so that we can regulate the protein load handled by the transplant kidney. The daily calcium and vitamin D requirement regulation is also important to keep your muscles and bones in good health. Additionally diet plays an important role in stabilising your blood pressure and proteinuria. Kindly stick to food guidelines whenever you are planning to travel and are not likely to have an access to home cooked food. Kindly take an advisory from us what to eat.
- 8. Several patients develop intestinal blunting as a response to the transplant medicine MMF so their gut mechanics changes and we need to adjust diet in accordance.
- 9. Regulation of salt intake is the cornerstone for management of blood pressure, resultant hypertensive proteinuria and to prevent blood pressure related chronic changes in the transplanted kidney, which decrease its survival.
- 10. The transcare wellness clinics also extend advice for planning pregnancy, gardening, sexual activity and other day to day activities.
- 11. An important area of research in today’s date is the role of molecular markers to detect early if there is anything going wrong with the graft. These markers have shown promising results in terms of detection of early graft changes and several other problems like chronic rejection or Drug toxicity.
- 12. The transplant medicines are very specific in terms of their adequate levels in the blood which needs to be strictly regulated. They interact with a lot of food items and other daily medicines such as pain killers or cough medicines etc so a proper pharmacy advice is a must.
- 13. Comprehensive eye check up is also important to detect complications like glaucoma and cataract which can occur due to long term steroid use, for transplant.