What are the possible post-transplant risks?
The post-surgical risks, like every other transplant surgery, include rejection, infection, bleeding or reaction to anaesthesia.
Rejection happens when the body fails to recognise the new kidney and fights to destroy it. During the first few weeks or months post-surgery, your body may try to reject your new kidney. This is called acute rejection and occurs in 25 - 55% of the recipients. You’ll be given immuno-suppressants to counter this problem. Remember, it is mandatory to continue these medicines for the rest of your life.
There is also a chance of chronic rejection - a gradual, progressive loss of kidney function that may occur over many years. Unfortunately, there’s no known treatment for chronic rejection and the patient may have depend on dialysis again or opt for another transplant.
Aster Centre of Excellence in Multi-Organ Transplant has a very strong infection control system that’s managed by a highly-trained team of infectious diseases & infection control Physicians. Besides, we also have advanced technology like the HEPA Filter that purifies air to 0.3 microns, creating a safe and sterile environment for the patient.
What are the pre-transplant formalities?
You will have to go through a series of investigations before the surgery to ensure that the donor kidney matches your tissue and blood type. You will also be screened for other health problems including heart or lung diseases.
After these tests, you will be enlisted on the transplant list and also on the organ sharing network list. As soon as a matching recipient is available, we will let you know; and if all factors are favourable, our entire team will work as one to ensure you undergo the surgery without any issues.
What are the types of kidney transplant?
There are two types of kidney transplants: Live donor Transplant and Cadaver Transplant
When a person is transplanted with a kidney from a live donor, it is called Live Donor Transplant. The donor could be anyone - a family member, friend, colleague or even a random person who is generous enough to gift life by donating one of his/ her kidney.
Usually, the success rates of kidney transplants in which the donor and recipient belong to one family (parent/ sibling) are higher. This is because of high donor-recipient compatibility, which means the chances of rejection are very low. A live donor makes things easy as the waiting period is lesser and the patient gets well faster.
Cadaver transplant is when the kidney is got from a donor who is certified brain-dead. He or she would have would have signed up for donation before death. The kidney is surgically removed after obtaining consent from the deceased’s family and transplanted in the recipient.
What is Kidney Transplant?
Kidney transplant is the process of replacing the diseased kidney with a healthy, donated kidney. It is recommended only if the kidneys are so damaged that they cannot be managed medically (Chronic Kidney Disease or End Stage Renal Disease).
In some cases, transplant might not be a practical solution if the patient has an active infection or another life-threatening disease such as cancer, severe heart or lung diseases.
Fortunately, according to worldwide figures, the success rate of kidney transplant is above 95%. This not only comes as a reassurance for those opting for transplant, but also reaffirms the fact that kidney transplant is indeed an effective mode of treatment.
What Are The Conditions That Warrant Bone Marrow Transplant?
The broad group of conditions where Pediatric Bone Marrow Transplant (BMT) is useful are as follow - If the bone marrow starts failing to produce blood elements – Aplastic anemia. These individuals have low hemoglobin, white cell counts, and platelet counts and require monthly blood transfusions. Providing new bone marrow from a healthy donor can cure these patients. If the hemoglobin is abnormal – Thalassemia, sickle cell anemia, and other hemoglobinopathies. These children require periodic blood transfusions and Pediatric Bone Marrow Transplant (BMT) can be curative for these diseases. Cancers–Blood cancers (acute leukemia), solid tumors (neuroblastoma), and many other cancers can be treated with Pediatric Bone Marrow Transplant (BMT). Primary Immune Deficiency diseases – Some children are born with a problem in their immune system and fall ill repeatedly. They may be hospitalized for infections on several occasions. Repeated ear discharge, pneumonia, or diarrhea are often noted. Such children require immunological testing. In many of these immune deficiencies, Pediatric Bone Marrow Transplant (BMT) is curative. Severe Combined Immune Deficiency is often present in young children who fail to gain normal weight and fall ill repeatedly. This condition is universally fatal without a Pediatric Bone Marrow Transplant (BMT). Metabolic diseases – Some children are born with defects in the enzymes required for a normal metabolism - Inherited disorders of metabolism, congenital storage diseases.
Do I still need to worry about my surgery?
Thyroid Surgeries are Safe surgeries with minimal risks. Speak to your surgeon before Surgery and clarify all your doubts and concerns. Your surgeon will allay all your fears regarding the surgery.
Are there any complications during or after thyroid surgery?
Thyroid surgery is generally a safe procedure. The vast majority of patients undergoing an operation on the thyroid gland have no complications.
However, as with any surgical procedure, there are some risks associated with the operation and these will be fully explained to you by your surgical team.
Will I need Thyroid replacement tablets after my operation?
Patients who have had a total thyroidectomy or near-total thyroidectomy will need thyroid tablets postoperatively and this will be life long.
What are the potential complications that I should know?
The thyroid gland is close to many nerves and blood vessels and hence the surgery carries a minor risk involving injury to these structures. These are more likely to occur in patients undergoing Surgery for cancer Lymph node surgery Surgery for a large thyroid (goiter) Revision thyroid or lymph node surgery
Nerve Injury: There are nerves running in close proximity to the thyroid gland which is responsible for the quality and the pitch of your voice – Recurrent laryngeal nerves and the superior laryngeal nerves one each on each side. Injury to these nerves may result in a change in voice These voice changes are usually transient lasting for few days to few weeks. However, in very rare scenarios especially in thyroid cancer surgeries, there is a minimal risk of permanent voice damage. Hence professionals whose career involves their voice – like singers and teachers need to discuss with your surgeon prior to surgery. Uncommonly injury to laryngeal nerves on both sides may warrant placing a breathing tube through the windpipe (tracheostomy). In most instances, it is short-term.
Low Calcium levels: We have four parathyroid glands, two on each side, each about the size of a grain of a lemon seed attached behind the thyroid gland. They are involved in regulating calcium levels in the blood. Normally the surgeon identifies and saves some or all of these glands.
However, during thyroid surgery the parathyroid glands can be bruised, damaged, or excised, causing low calcium levels in blood manifested by a sensation of tingling in the fingers and lips (pins and needles sensation) and/or cramps in the fingers. Even if the parathyroid glands are saved, there may be stunning of the glands causing low calcium levels for several days to weeks. These may be managed by replacing calcium usually orally by tablets.
Other Potential Complications
Neck Numbness: Some patients may experience numbness around the thyroid surgery scar after their operation. This usually subsides with time.
Swallowing Difficulties: Mild swallowing difficulties may occur usually pain-related improves with analgesics
Wound related issues: Swelling around the wound may be seen for a few days – these are usually normal after surgery. Wound Infections are rarely seen Occasionally fluid may accumulate behind the wound called a seroma. Normally subsides with time.
Thyroid Storm: An Extremely rare complication in patients with the overactive thyroid gland (thyrotoxic patients) undergoing surgery Caused by a sudden excessive amount of thyroid hormone released into the bloodstream during surgery. Hence all thyrotoxic patients must be put on medications to achieve normal thyroxine levels prior to surgery.
Do I need to come for suture removal?
Normally an absorbable suture would be placed at the operative site and may not require removal of sutures. In case of any nonabsorbable suture usage, your surgeon will let you know when can they be removed. Thyroidectomy is not a particularly painful operation and pain relief is rarely necessary after 72 hours. It is normal to feel tired following thyroid surgery and it may take up to a month before you feel you have your energy levels back.