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Pre Transplant in Pune

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Before undergoing a transplant, a thorough evaluation is essential, encompassing:

Imaging-tests
Imaging
  • CT scans of the head, chest, and abdomen.
  • X-rays of the upper GI tract.
  • X-ray of the small bowel.
  • Ultrasound for detailed visualization of internal organs.
  • Endoscopy for a comprehensive examination.
Blood-tests
Blood and Genetic Testing
  • Blood tests, including gene compatibility assessments.
  • Cancer screening tests to evaluate overall health.
General-health-exam
Medical and Psychological Assessment
  • General health exam, including physical examination.
  • Social and psychological evaluation to gauge stress, financial factors, and support systems.
Social-and-psychological-evaluation
Additional Tests
  • Stress tests, pulmonary function testing, heart catheterization, and motility studies.
colonoscopy
Colonoscopy and Ultrasound
  • Colonoscopy to inspect the entire colon.
  • Ultrasound to create internal organ images using sound waves.

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Pre-Transplant in Pune

Before you get an intestinal transplant treatment in Pune, talk to a doctor and know how long you might have to wait. There are more people needing transplants than there are organs available, so the waiting period in India can be quite long. While waitlisted, your doctor will start necessary treatments to keep you well and ready for the transplant. Make sure to tell your doctor if anything changes with your health.

Intestinal Transplant Process

Upon organ availability, the hospital will urgently admit you and provide information. Tests and evaluations are conducted to assess your health for surgery. Anesthesia is administered in the operating theater before the procedure. Some patients may require ventilator support based on their health conditions.

The surgery involves making an incision, evaluating the abdomen for abnormalities, and removing the intestine. The donated organ(s) are then placed in the abdomen. A stoma is created for monitoring, and a Gastrojejunostomy tube may be inserted.

After the procedure, the incision is closed.

Complications of Intestinal transplant

Complications are possible with intestine transplant surgery, as with any surgical procedure. While not every patient will experience these, it's wise to understand them. Here are some common complications:

Surgical Complications:

During or shortly after intestinal transplant surgery, certain complications may arise, including:

  • Wound Infection
  • Blood Clot Formation:
      • Artery or vein clotting in the lungs, heart, spleen, pancreas, or liver.
  • Diabetes Development
  • Bile Leakage from Bile Ducts
  • Uncontrollable Bleeding

Immunosuppressant-Related Complications:

To facilitate the adjustment of the new organ in the body, immunosuppressants are prescribed. However, this comes with potential complications, exposing the recipient to various infectious diseases.

  • Rejection:
    • In some cases, the body may not accept the new organ, leading to potential dysfunction. The immune system may recognize the transplanted organ as foreign, increasing the risk of rejection.

  • Side Effects of Anti-Rejection Medications:
    • Medications prescribed for liver function and overall health can result in significant side effects, including:
      • Weight Gain
      • High Blood Pressure
      • Kidney Damage
      • Cholesterol Imbalance

Vascular Complications:

  • Thrombosis:
    • Formation of clots in the artery or vein of the newly transplanted intestine, causing a halt in blood supply.
  • Bleeding:
    • High risk of internal bleeding associated with major surgeries, potentially requiring blood transfusion and additional surgical intervention.
  • Leak:
    • Occasional leaks may occur where the new intestine is connected to the recipient's organ, necessitating surgical intervention to rectify the issue.

Laboratory evaluation

Prior to the transplant, a comprehensive laboratory evaluation is conducted, including:

  • Blood Group (ABO): To determine compatibility with a potential donor.
  • Complete Blood Count (CBC): To assess the degree of anemia and planning pre-transplant treatment.
  • Urine Routine and Culture: To rule out urinary tract infection and assess proteinuria levels.
  • Liver Function Tests: To detect any impairment in liver function.
  • Blood Glucose: To evaluate diabetes status and control.
  • Lipid Profile: To identify abnormalities and plan appropriate treatment.
  • Renal Function Tests: To assess preoperative electrolytes for fitness.
  • Coagulation Tests (PT/PTT/BT): To rule out bleeding and coagulation abnormalities.
  • Viral Disease Screening (HbsAg/HCV/HIV/EBV/CMV IgG): To detect and treat viral diseases, activating prophylaxis as needed after transplant.
  • Tissue Typing/HLA: To determine compatibility between the donor and recipient.
  • Lymphocyte Cross-Match: To identify antibodies against donor T and B cells, assessing compatibility and the risk of organ rejection.
  • Uroflowmetry Post-Void Residue: To assess obstruction and bladder status before transplant.
  • CT scan/Iliofemoral Vessel Doppler: To detect kidney stones or calcifications in iliac blood vessels where donor kidney vessels will be joined.
  • Gastrointestinal Endoscopy: To be required for selected patients showing positive stool occult blood or a history of peptic ulcers.

Donor Assessment

People who want to donate undergo detailed health checks to make sure they are healthy and compatible. These tests include looking at the heart and lungs, checking blood group compatibility, and doing crossmatch tests to understand immune system risks, as required by the Human Organ and Tissue Transplant Act.

Health Check for Donors

Before donating a kidney, individuals are carefully checked to confirm they are healthy, don't have any illnesses that can be passed to the recipient, and can safely donate a kidney. The assessment includes checking the heart and lungs, and a battery of relevant medical tests, to get a complete picture of their health.

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