Contraindications of Kidney Transplant
Kidney transplantation may not be recommended in patients who have:
- Serious active infection (such as tuberculosis, osteomyelitis, peritonitis). In such cases transplantation can be considered after complete recovery.
- Any condition with a life expectancy of less than 2 years
- HIV infection: The immunity (power or ability to fight off infection) of HIV positive patients is already lowered hence they have an increased tendency to reject the transplanted kidney. Giving them standard immunosuppressive therapy (drugs used to suppress the body’s immune system), can further aggravate the disease itself.
- Active cancer. These patients may have an increased risk of metastasis (spread of cancer to other parts) with immunosuppressive therapy.Such patients have to wait for transplant for a minimal time of 2 cancer free years from the time of last cancer treatment.
- Persistent drug/alcohol abuse problem. Kidney transplant may be considered only after a period of 6-month abstinence and psychiatric evaluation in such cases.
- Serious and incapacitating mental illness where the patient cannot comply with the treatment schedule.
Uncontrolled cancer, HIV positivity, active systemic infections and/or any condition with a life expectancy < 2 years are absolute contraindications to kidney transplant.
A previous chronic or recurrent (repeated) infection, cancer, viral hepatitis, gastro-intestinal complications, myocardial infarction (heart attack) and/or peripheral vascular disease (blood vessel disease in lower limbs) are not always considered absolute contraindications, but they do indicate the need for a careful check-up before considering kidney transplantation. Hence, it is imperative to get an assessment of the overall health status of a person before kidney transplantation.