Kidney Transplantation

Kidney transplantation is the best long-term treatment for advanced kidney failure — far better than long-term dialysis in terms of survival, wellbeing, and cost over time. India has a well-established transplant programme with many public and private centres. The main limits are donor availability and cost.

Two sources of donors

• Living donor — usually a close relative (parent, sibling, spouse, child). Regulated strictly under the Transplantation of Human Organs and Tissues Act (THOTA) to prevent commercial trade; near and dear altruistic donation is permitted.
• Deceased (brain-dead) donor — via the national organ-sharing network. Waiting times can be years; donor registration and public awareness are growing but still well short of need.

Who is eligible

• Most people with stage 5 CKD (dialysis or near) and without severe heart disease, active cancer, or uncontrolled infection.
• Pre-emptive transplant (before starting dialysis) gives the best outcome — ask about it early.
• Age is no absolute barrier; careful evaluation of the individual.

The process in brief

• Recipient workup — fitness for surgery, heart, infections, cancer screen, tissue typing and crossmatch.
• Donor workup (living donor) — two kidneys functioning well, otherwise healthy, tissue match, psychological assessment, legal approval under THOTA.
• Transplant surgery — new kidney placed in the lower abdomen; donor kidney usually recovered laparoscopically for living donors.
• Immunosuppression for life to prevent rejection — typically a three-drug regimen.
• Close follow-up — frequent first 3 months; life-long annual checks including cancer screening (skin, cervix, colon) because of long-term immunosuppression.

Living on a transplant

• Take immunosuppression exactly as prescribed — missed doses cause rejection.
• Watch for infections — flu + pneumococcal + Hep B vaccines before transplant; avoid live vaccines after. Treat fevers early.
• Skin sun protection; regular dermatology check (risk of skin cancer rises with immunosuppression).
• BP, sugar, cholesterol control — cardiovascular disease is the leading cause of death after transplant.
• Dietary advice — low salt, moderate protein, individualised potassium and phosphate if kidney function isn't perfect.
• Pregnancy is possible 1–2 years post-transplant with stable function — joint nephro + obstetric care.

India-specific points

• Ayushman Bharat / PM-JAY and state schemes cover transplant costs at many empanelled centres — ask the hospital's transplant coordinator.
• Don't buy organs. Commercial transplantation is illegal, unsafe, and medically poorly done. Sign the deceased-donor registry to help bridge the gap.