• Living donor: The patient receives the kidney from a living donor. The living donor may be parents, relatives, neighbours or friends.
• Deceased donor: The patient receives the kidney from a deceased person who himself or his immediate relative chooses to donate kidneys after his death. 
• Swap exchange (paired exchange): In this type of kidney transplant, if the donor’s kidney is incompatible with the recipient, he may exchange the kidney with another pair of donors and the recipient. There is a simultaneous kidney transplant in two recipients
• ABO incompatibility:  Earlier, in the absence of advanced techniques, if the blood type of donor and recipient were incompatible, there was a rejection of the kidney by the immune system. However, with the availability of new techniques, a blood-type incompatible kidney transplant is possible. The patient has to undergo treatment before and after the kidney transplant surgery to reduce the risk of rejection. The doctor may inject immunoglobulins to reduce the risk of infection, perform plasmapheresis to eliminate antibodies and administer advanced medicines to reduce rejection risk.

The kidneys are one of the most important organs of the human body. They are bean-shaped, reddish-brown paired organs in the renal system that are normally located high in the abdominal cavity and against its back wall, lying on each side of the vertebral column and surrounded by adipose tissue. The right kidney is usually slightly inferior compared to the left kidney, probably because of its relationship to the liver.

The kidneys are highly complex organs with many parts. The main parts of the kidney are:

Kidney capsule (renal capsule): It is made of three layers of connective tissue or fat that protect the kidney from injury, increase its stability and connect the kidneys to surrounding tissues.

• • Renal Artery: it is a large blood vessel that controls blood flow into the kidney
  • Renal cortex: It is the kidney’s outer layer, where the nephrons (blood-filtering units) begin.
  • Renal medulla: The inner part of the kidney contains most of the nephrons.
  • Renal papillae: These are pyramid-shaped structures that transfer urine to the ureters.
  • Renal pelvis: These are funnel-shaped structures that collect urine and pass it down to the ureters.
  • Renal vein: It is the main blood vessel that carries filtered blood out of the kidneys.

The kidney performs some of the vital functions of the body, including:

• Maintaining the overall body fluid balance
• Regulating and filtering the minerals from the blood
• Filtering the waste products from food, medications and toxic substances
• Creating hormones that help produce red blood cells, promote bone health, and regulate blood pressure

The doctor also evaluates whether the patient is eligible for a kidney transplant. Several conditions are treated by kidney transplants. Some of them are:

• Kidney damage due to persistent high blood sugar levels (diabetes) or uncontrolled high blood pressure
• Glomerulonephritis is characterised by inflammation of the filtering unit of the kidneys
• Haemolytic uremic syndrome
• Urinary tract obstructions
• Interstitial nephritis causes inflammation in the kidney tubules
• Poisoning due to heavy metals, such as cadmium, mercury, cobalt, and arsenic
• Excessive consumption of medicines, such as aspirin, ibuprofen, and naproxen
• Lupus and other types of immune diseases
• Repeated urinary infection
• Polycystic kidney disease

A kidney transplant is not for everyone. Patients with advanced age, recently treated or active cancer, drug and alcohol abuse, and several cardiovascular diseases are generally not eligible for a kidney transplant. In general, a candidate should have the following to be a kidney transplant recipient.

• End-stage renal failure and on dialysis.
• Late-stage chronic kidney disease, approaching the need for dialysis.
• A life expectancy of at least five years.
• A full understanding of postoperative instructions and care.

Kidney transplantation involves placing a healthy kidney into the body where it can perform all the functions that a failed kidney cannot perform. The new kidney is placed on the lower right or left side of the abdomen where it’s surgically connected to the nearby blood vessels. The whole procedure takes about 3 to 5 hours to complete and is performed under general anaesthesia by a specialised team of anaesthetists, transplant surgeons (nephrologists), and other medical staff. The procedure of kidney transplant surgery is done in the following ways.

• The paramedical staff monitors heart rate, blood pressure, and blood oxygen level throughout the surgical procedure of both the donor and recipient.
• The procedure starts with the surgery of the donor.
• The donor’s kidney is removed, and then surgery for the recipient starts.
• After administering the anaesthesia to the recipient, a minute cut is made in the pelvis area. The cut is made just above the waistline on the side where the kidney is to be transplanted.
• The original kidney is not removed in most cases. It is removed only if the original kidney is causing pain or any issue in blood circulation. 
• The donor’s kidney is placed in the lower abdomen.
• Blood vessels are attached, and the ureter is also connected to the newly transplanted kidney.
• The newly transplanted kidney is sewn in its place. The transplanted kidney starts forming urine and blood filtering within minutes after being attached.
• The surgeon places a stent in the ureter to help in urinating. It is removed after 6-12 weeks.
• Then the cuts are closed using stitches, special glue or stapled.
• After this, it is dressed using a sterile surgical bandage.
• The patient will then be shifted to a recovery room to monitor vitals and post-operative recovery.