Any patient with chronic renal disease wherein the nephrologist opines that the kidney function can never return to normal is qualified to transplant. Provided the basic reason for renal impairment is manageable and therefore the new kidney will not be damaged after transplantation. For example if diabetes is the reason for renal damage then the patient should be adequately controlled so that the new transplanted kidney is also not affected by the diabetes.

Whenever the kidney impairment is deemed permanent and the patient has otherwise a very long expected survival, these patients should be screened for transplantation since these patients will benefit the maximum from transplantation.

The best donor are those who are directly related to the patient and are therefore emotionally deeply attached to the patient. However sometimes such individual is unavailable then unrelated person can also donate provided there is on coercion or financial transaction involved.

All these patients are then screened by the transplant coordinator and then the file is submitted to the department of health. Once the clearance is reached from swasthya bhaban only then we can proceed to the transplantation.

Once a donor has been selected the suitability for the transplantation is assessed by blood group cross matching, and HLA matching. Also the potential donor should have normal renal function to begin with. The left kidney is preferred as the donor kidney in which case the blood supply of the kidney is also assessed since single renal artery and vein are preferred for the donor kidney so that it is technically easier to perform the transplantation.

Once the patient has been selected for the donor. The patient is prepared for surgery. The best approach to remove the donor kidney is by laparoscopy, since the kidney is least handled and trauma is less therefore the organ is delivered to the recipient team in the most pristine fashion.

Generally we use a five port approach to access the kidney and the organ is finally delivered by a small incision

Once the renal vessels have been disconnected the kidney has to be rapidly delivered and then cooled so that there is no nephron damage.

Generally we have been able to maintain a warm ischemia time of less than 10mins
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While the donor team is preparing the kidney for harvest. The transplant recipient team prepared the bed for the donor kidney.
The kidney is best placed in the right lower part of the abdomen, where the blood supply is attached to the vessels going towards the legs of the patient.
The ureter is then attached to the bladder over a stent and therefore the procedure is completed.