Factors that affect the success rate of kidney transplant in India
The source of a kidney can be a living or a deceased donor. A living donor kidney transplantation has a higher long-term survival rate than a cadaveric kidney transplant.
The most important factor that decides the fate of a transplanted kidney is the age and health of the patient. If the patient is physically fit and otherwise healthy, the chances of success post-surgery increase. Age, too, plays a vital role here.
Older patients have higher survival rates than patients who are below the age of 65. If the patient is below 65 years of age, the chances of graft loss and rejection are high. Before the patient undergoes a kidney transplant, their eligibility for the surgery will be evaluated through a series of tests.
The age and health of the donor is also an indicator of kidney transplantation outcome. Receiving a kidney from a young donor provides better survival rates after a kidney transplant. Similarly, a kidney from a healthy individual promises less chance of immune rejection and graft loss.
Therefore, the doctor will conduct a comprehensive pre-transplant evaluation to examine the health status of the donor. These often include a list of diagnostic tests that determine the donor’s eligibility for the test.
To become a candidate for kidney donation, an individual must not suffer from uncontrolled high blood pressure, diabetes, cancer, HIV, hepatitis, or acute infections.
HLA, often abbreviated for human-leukocyte antigen test, is a diagnostic test that calculates the genetic compatibility between a donor and a patient. The better is the match between the patient and the donor, the lower is the chance of graft loss or rejection.
A full match is an ideal way towards having successful transplant surgery. However, a patient can also survive with a half-match kidney transplant with the life-long support of immunosuppressive medications.
The downside of being on immunosuppressive medication is increased susceptibility to a variety of infections and other diseases.
Except for advanced donor age and HLA-mismatch, many factors can cause graft loss and rejection post-transplant surgery. Immune rejection can be of two types – acute or chronic. Acute rejection occurs within a few days to weeks after the surgery.
Whereas chronic rejection can lead to a rejected kidney even after as much as a decade. Other factors that may increase the chance of rejection, and eventually, lower survival rates are prior sensitization, prolonged cold ischemia time, delayed graft function, previous instances of rejections, and inadequate immunosuppression.
