Q: My wife has had kidney failure due to secondary amyloidosis. She is on maintenance hemodialysis (MHD) for last two years thrice a week. Her heart and liver condition is ok. She developed TB in the lungs for, which she is on treatment for the last three months. Can she go for a transplant now? What are the long-term success chances for her? My blood group is same as her's. My kidneys are ok; creatinine clearance rate is 150 and serum creatinine is 0.79. I have diabetes for the last 10 years for, which I am taking treatment regularly. My fasting level is 120 mg/dl and PP is 181 mg/dl. I also take stamlo beta once a day for high blood pressure, which is 130/80 mmHg. I am 50 and she is 48 years old. We have two daughters 24 and 21 years old and a son who is 12 years old. Can I give her my kidney? What will be the long-term effects of donation for me?

A:Patients with kidney failure resulting from secondary amyloidosis do fairly well with kidney transplant. Long term success of a transplanted kidney in such patients does depend upon the actual cause of secondary amyloidosis and the outcome of success is not significantly different from any other cause of kidney failure. In an ideal situation with a well matched kidney, one could expect normal life span of transplanted kidney to be anywhere from 5-8 years. It is also true that patients with secondary amyloidosis are relatively more prone to infections and cardiovascular complications resulting in slightly higher chances of morbidity and mortality over a period of time. In addition, in 20-30% cases, one could see recurrence of amyloid in the transplanted kidney if the underlying amyloidosis disease process flares up. The best chance of getting a well matched kidney, testing for which involves more than simple blood group matching is to seek potential donors from your wifes immediate relatives namely, siblings and cousins. Lastly, studies have shown that there are no harmful effects on the health of the donor even several years following the donation of the kidney organ. Also, if she is still being treated for active tuberculosis, it is definitely not advisable to go for kidney transplant surgery till she has completed the course of treatment with no active signs of any type of infection.