Kidney transplantation in India: Challenges and future recommendation

Singh, N. P.; Kumar, Anish

doi:10.4103/2394-7438.174839

Cited by 13 publications

(14 citation statements)

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“…Deceased organ transplantation in India is still in infancy phase due to lack of awareness, level of affordability, inadequacy of funds and unclear, poor national policies. [ 2 ] Live-related and live-unrelated donors form the alternative. India has approximately 180–200 kidney transplant centres.…”

Section: Discussionmentioning

confidence: 99%

“…The centres with greater load of patients in a particular area should identify such needs and should do the needful for better outcome. [ 2 11 ]…”

Section: Discussionmentioning

confidence: 99%

“…Awareness about swap kidney transplant is still less in India. [ 2 3 ] As per the State Directorate of Health Services, participation by public hospitals in this type of transplant is negligible due to huge cost, lack of adequate operation theatres (OTs), etc. [ 4 ]…”

Section: Introductionmentioning

confidence: 99%

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Successful first swap renal transplant in a public hospital

et al. 2016

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Section: Discussionmentioning

confidence: 99%

“…The centres with greater load of patients in a particular area should identify such needs and should do the needful for better outcome. [ 2 11 ]…”

Section: Discussionmentioning

confidence: 99%

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Successful first swap renal transplant in a public hospital

et al. 2016

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“…Deceased donor program is still in budding stages and limited to very few institutions. [ 6 ] All prospective transplants have to be pre-approved by a local Organ Transplant Authorization Committee.…”

Section: Methodsmentioning

confidence: 99%

Immunoadsorption in ABO-incompatible kidney transplantation in adult and pediatric patients with follow-up on graft and patient survival: First series from India

Tiwari

Aggarwal

Arora

et al. 2020

Asian J Transfus Sci

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BACKGROUND: There are no published reports on desensitization protocol for ABO-incompatible kidney transplants using Immuno-Adsorption (IA) plasmapheresis from India. IA offers certain advantages including processing of larger plasma volumes, quicker reduction of isoagglutinin titers and no requirement of replacement fluids. AIMS AND OBJECTIVES: Authors' center evaluated success of desensitization protocol, and graft/patient outcomes when IA procedures were performed for desensitization in adult and pediatric ABO-incompatible kidney transplant patients. METHODS: Patients undergoing ABO-incompatible kidney transplant with use of IA were evaluated at tertiary care center in north India. Patient records for 2-years were collated from hospital information system (HIS) and procedure forms. RESULTS: Sixteen IA procedures were performed in five patients who underwent successful ABO-incompatible kidney transplant. Initial isoagglutinin IgG titer ranged from 32-512. Mean number of IA procedures performed to achieve the desired pre-transplant IgG titer ≤8 was 3.2. New IA column was used for each patient (and re-used for the same patient, if needed, after sterilization with Low temperature steam of formaldehyde). Mean plasma volume processed during each IA procedure was 4.5 times. No adverse events were observed during any IA procedure. All patients achieved successful desensitization. All patients continue to do well clinically with mean follow-up period of 8.8 months. Although IA was expensive, it offered advantages like specificity, larger plasma volume processing with desired reduction in titer, no 'replacement fluid' requirements and no adverse events in present case series. CONCLUSION: IA plasmapheresis was universally successful in decreasing the ABO-isoagglutinin titers to desired level in all prospective ABO incompatible kidney transplant patients.

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“…Chronic kidney disease affects more than 10% of the world population and millions are dying as there is no affordable treatment. 1 Risk of kidney damage may affect a person for several reasons such as diet, habits, lifestyle, and heredity. Hypertension, diabetes, immune-mediated kidney injury, glomerulonephritis, pharmaceutical drugs, and environmental toxins are some of the well-established factors which generally risk kidney health.…”

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confidence: 99%