Comprehensive Urocare Clinic , Sector 53 , Gurgaon -

Hello,

Mein Doctor Amit Goel Consultant Urology, Aaj aapko kidney transplant se related kuch jankari dunga. Sabse pahle to hamare sharir mein kidney ka kya kaam hai? hamare sharir mein do kidneys hoti hai. Ek right side aur ek left side aur Inka kam hota hai blood ko filter karna aur usmein se waste material ko nikalna aur usko urine mein takdeel karna. Ab end-stage kidney disease dono kidney ko affect karti hai jismein ki dono kidneys kam karna band kar deti hai aur jo kidney ka kam hai yani ki waste material ko urine mein takdeel karna wo kaam karna kam ho jata hai ya band ho jata hai jiski vajah se waste material sharir ke andar ikattha hona shuru ho jata hai aur uski toxicity ke symptoms humein aane shuru ho jaate hain. End-stage renal disease ke causes mein sabse common cause hai hypertension aur diabetes aur iske alawa heavy metals ki toxicity ya poisoning joki ayurvedic medicines khane ki vajah se ho sakti hai ya fir pain killers ka jo log bohot jyada istemal karte hain unh logon ko aisi problem ho sakti hai. Iske alawa kuch ek antibiotics bhi kidney ko nuksan pahuncha sakti hai.

Jabh bhi kabhi ek single kidney ka damage hota hai patient ko usually koi pareshani nahi hoti kyunki dusri wali kidney takeover kar leti hai aur kam marriz ka chalta rahata hai lekin kabhi bhi jab donon kidney saath-saath affect ho jaati hai yani ki kam karna band kar deti hai us condition mein humko us waste material ko nikaalne ke liye kuch kritrim pranali ka istemal karna padta hai joki ya to dialysis ki form mein hum patient ko de sakte hain ya fir kidney transplant ki form mein ham patient ko de sakte hain. Kidney transplant mein mai aapko batana chahunga ki kidney transplant sabse prakrutik aur best tarika hai is waste material ko sharir se bahar nikalne ke liye aur jahan tak possible ho agar aapke pass donor hai to kidney transplant karana chahiye. Kidney transplant kya hai? kidney transplant mein ek acchi kam karti hui kidney donor ke sharir se ham nikaalte hain usko recipient yani rogi ko pratyaropit kar dete hain. Donor do tarike ke ho sakte hain ya to living donor ya fir cadaver donor.

Living donor yani ki koi bhi jita-jagta aadami jo apni kidney ko daan karta hai usko ham living donor kehte hain aur ye aapka koi rishtedar ho sakta hai jo ki aap se blood se related hai ya fir aapka spouse ho sakta hai. Aaj ki latest technology mein ham aajkal laproscopic technique se yani keyhole technique se surgery ko karte hain jismein ki bohot chote-chote scar se operation ho jata hai aur patient ko bohot kam pain hota hai, bohit hi jaldi uski return of normal activity bohot fast hoti hai. Cadaver donor yani ki jab patient koi death hoti hai ya brain death ho jati hai to wo aapne organ donate karta hai usmehi kidney ka bhi retrieval kiya jata hai, kidney ko nikala jata hai aur us kidney ko fir recipient ke andar pratyaropit kiya jata hai. Kidney donation karne ke liye sabse jyada jaruri cheez hai ki aapka recipient yani ki rogi hai uska or donor ka achha blood group matching hona chahiye aur tissue matching hona chahiye. Iske alava hamen donor ko koi aisi bimari yani ki cancer ya heart ki koi badi bimari ya lung ki koi badi bimari nahin hai ye hame pehle dekh lena hota hai aur recipient ka bhi pura workup karne ke bad hi ye transplant ki parkariya ki jaati hai. Abh hame kya expect karna chahiye surgery se ye main aapko batata hoon.

Jab surgery ke liye recipient aur donor dono ko sath-sath hi do operation theatre main ek hi time mein liya jata hai aur kareeb-kareeb 3:30 se 4:30 ghante ke lagbhag mein ye operation pura kiya jata hai. Is transplant ka procedure actually hai kya? to jo donated kidney hai usme jo artery hai aur jo vein hai aur jo ureter hai usko ham recipient yani ki jo rogi hai uske sharir ke andar jodte hain aur joki normally neeche ki taraf neeche ki right side mein normally is bhag mein lagaya jata hai. Main aapko batana chahunga artery us nas ko kehte hain jis se blood kisi organ ke andar jata hai yani kidney ke andar jo nas blood lekar ke jaati hai usko artery kahate hain aur jo nas blood wapas lekar ke aati hai usko ham vein kehte hain.

To ye operation hai iske alawa jab ham ek bar patient admit hota hai uske baad donor ko kareeb 3 se 4 din Hospital mein rakha jata hai aur recipient ka stay kareeb-kareeb ek hafte se lekar ke do hafte tak rehta hai aur ek baar jab recipient ko ham operation ke baad mein usko hamen post-operative time mein immunosuppressant medicine yani ki defence system ko daba ke rakhne wali medicines per rakhna padta hai kyunki jo donor ki kidney hai us kidney ko recipient ka sharir as a foreign body treat karta hai aur usko reject karne ki koshish karta hai to rejection ko prevent karne ke liye hame recipient ko kabhi-kabhi lifelong bhi immunotherapy yani ki medicine jo immunity yani defence system ko suppress karti hai hamen aise unko de ke rakhna padta hai. Main aapko batana chahunga ki kidney transplant ke aaj ke scenario mein bohot hi acche results hai joki 90 percent se jyada achha success rate or long-term survival hai or kidney transplant ke mariz definitely aur jo dialysis ke marriz hai unse bohot hi acchi unki life future mein rahti hai.

Thank you.

Hello,

Mein Doctor Amit Goel Consultant Urology, Uro-Oncology and Kidney Transplant Surgeon. Aaj aapko kidney cancer yani gurde ke cancer ya renal cell carcinoma ke bare mein kuch jankari dunga. Sabse pahle to kidney hamare sharir mein kya kaam karti hai, hamare sharir mein do kidneys hoti hai joki is area mein pai jaati hai aur Inka kam hota hai blood ko filter karna aur usmein se waste material ko nikalkar ke usko urine mein takdiil kar dena jab kidney ka cancer ho jata hai to uska treatment hame karna jaruri hota hai ab sabse pahle hamen ye janna jaruri hai ye ki iske risk factors kya hai? Risk factors iska koi exact karan aaj tak ham nahi dhundh paye hain lekin iska kafi strong association cigarette smokers ya jo log tambaku ka istemal karte hain un logon mein paya jata hai ya fir jin logon ke andar mein hereditary kidney ke cancer hai yani ki familial kidney cancers iska ek reason hai.

Iske alawa jin logo ke andar motapa hai ya ya fir jo log lambe samay se dialysis per hai uske sath kuch association paya gaya hai yani in logon ke andar incidents thoda sa jyada paya jata hai. Kidney ka cancer males mein females ki apeksha mein males mein jyada paya jata hai aur iska maximum incidence 50 se 70 ki umar mein dekha jata hain. Abh ham aate hain lakshan ki taraf ki kidney ke cancer ke kya lakshan hote hain? jab kidney ka cancer chhota hota hai yani tumor chhota hota hai tab use case mein usually incidentally detected tumor hote hain jabh ham kisi aur karan se pet ka ultrasound ya koi CT Scan ya koi janch karte hain tab usmein yah tumor kidney ke andar paye jaate hain usko ham incidentally detected renal cancer ya renal tumor cancer kahte hain. Aapki jankari ke liye main batana chahunga ki kidney ke andar jitne bhi tumor paye jaate hain usmein se more than 95% tumors cancers hote hain aur sirf 5% ke lagbhag tumor benign hote hain isliye agar koi bhi tumor kidney ke andar paya jata hai to usko najarandaaz nahi karna chahie aur uska treatment lena chahie.

Anya lakshan jo kidney ke tumor mein paye jaate hain wo kidney ke tumor ya cancer mein paye jaate hain wo hote hain peshab ke andar khoon jana ya fir koi lump jaisi feeling hona ya swelling hona is hisse ke andar ya fir koi pain ka ehsas hona, weakness yani ki kamjori hona, weight loss, fever hona ya fir bhookh na lagna. Inmein se koi bhi symptom agar aap dekhte hain to turant aapko apne doctor ya urologist ko consult karna chahiye Ab kidney cancer ke detection ke liye ultrasonography aur CT scan primary imaging ke test hai. Iske alawa ham kuch blood test aur urine test karte hain aur koi bhi tumor ya cancer ke treatment karne se pehle hame staging karni hoti hai jiske liye ham PET CT scan karate Hain aur PET CT Scan hame batata hai ki hamare sharir mein kahin aur to koi tumor nahi hai aur ye hame help karta hai agge ka treatment decide karne mein.

Abh aate hain iske treatment ki taraf, treatment mein surgical treatment best form of treatment hai. Surgical treatment do tarah ke ho sakte hain ya to hum radical nephrectomy karte hain yani ki pura ka pura kidney ham sharir se bahar nikal dete hain aur aaju-baju mein agar koi cheez involved hai, koi structure involved hai hi to hum usko bhi saath-saath bahar nikal dete hain ya fir partial nephrectomy jismein ki ham sirf kidney ka wo part jismein tumor hai usko nikaalte hain uske sath-sath ek normal part of kidney nikal dete hain aur jo bhi non-involved kidney ka part hai usko ham chhod dete hain. Aaj ke time mein ye kidney laparoscopic technique ya robotics se sambhav hai jisko ki hum keyhole surgery bhi kahate hain, jismein ham bohot chote-chote se scars yani incision se is operation ko karte hain aur patient ko kafi kam pain hota hai, cosmetically kaafi accha hota hai aur iske alawa return to normal activity yani aap normal karya per jaldi se ja sakte hai. Iske alawa aur treatment bhi uplabdh hai joki ham metastatic setting mein jab tumor kidney se bahar ja chuka hai kahin fail chuka hai use condition mein ham patient ko dete hain jismein ki immunotherapy aur targeted therapy aati hai. Targeted therapy mein sunitinib and axitinib hamare pass available hai aur anya kahin dawaiyan available hai aur iske alawa immunotherapy therapy mein hamare pass Nivolumab available hai. Kidney ke tumors mein main aapko batana chahunga ki radiotherapy aur chemotherapy ka bohot achcha role nahin hai.

Thank you