Q: I am a 25 years old man who has been diagnosed with kidney failure - fifth stage. I am planning for a kidney transplant. What other options do I have? What is the life expectancy after a transplant? What changes do I need to make in my lifestyle after a transplant?

A:At your age your choice should only be transplant. There are other choices as well like permanent haemodialysis or permanent peritoneal dialysis, but these are not a patch on the quality of life you will have on a transplant. The closer the relationship of the donor to you, the better the transplant with the best donors being identical twins. The next best is between brothers and sisters whose tissue typing shows identical match while others will be below this - rest of the brothers and sisters, then parents, then grandparents, and then first cousins, aunts and uncles and so on. The closer the relationship the better and longer the transplant will last, but remember when a kidney is rejected you can have another transplant. I have done three transplants in a patient who is still living after 20 years. The longest surviving patient I have had is 25 years on one transplant. The drugs for transplant are wonderful now, with people venturing into unrelated transplants because of that. Quality of life will be no different from a normal person after the first five years. You must always be careful about food and water and environment. Cleanliness is the key.