Kidney transplant in India

First, the donor question

For an international patient this comes before everything else, because it decides whether the rest of the page is relevant to you.

• You must bring a living donor. There is no waiting list in India for a foreign national to join, and deceased-donor kidneys are allocated to Indian citizens.
• The donor must normally be a near relative: spouse, parent, child, sibling, grandparent or grandchild. Anyone outside that group requires state authorisation committee approval, which is a much harder route.
• Paying a donor is a criminal offence in India. An authorisation committee interviews both of you specifically to check that no money is involved. Anyone offering to find you a kidney is offering to commit a crime.
• The donor needs their own visa, own workup and own recovery time in India. Budget and plan for two people.

The full legal picture, including the embassy documentation you will need to prove the relationship, is set out on organ transplant in India. Read it before you plan anything else.

Matching: what actually has to line up

Two things are checked before a donor is accepted, and a third is checked if the first two do not fit.

• Blood group compatibility. The traditional first hurdle, and it works much like a blood transfusion. A group O donor can give to most recipients; an AB recipient can receive from most donors.
• Tissue typing and crossmatch. A laboratory test that checks whether your immune system already carries antibodies against the donor's tissue. A positive crossmatch normally rules that donor out.
• ABO-incompatible transplant. Where blood groups do not match, some centres can still proceed by removing the relevant antibodies from your blood beforehand. It is more involved and costs more than a standard transplant, so ask for it to be priced specifically rather than assuming the figure above applies.

A common and reasonable question is whether a relative "matching" means being the same blood group. Not exactly. Compatibility, not identity, is what is required, and the laboratory decides. Send the blood groups of every willing relative at the consultation stage, because it often turns out that the person the family assumed was the donor is not the best one.

What it costs in India

What happens, step by step

1. Review before you travel. A nephrologist and transplant surgeon look at your kidney function, dialysis history, cardiac fitness and your potential donor's basic details on video.
2. Documentation. The relationship evidence and embassy paperwork are assembled. This runs in parallel with everything else and is usually the slowest part, so start it first.
3. Workup in India. Both of you are assessed in full: bloods, tissue typing and crossmatch, imaging of the donor's kidneys, cardiac and infection screening for you. Dialysis continues during this period.
4. Authorisation committee. Donor and recipient are interviewed, documents examined, and approval given before any surgery can be scheduled.
5. The two operations. The donor's kidney is removed, usually laparoscopically, and placed into your lower abdomen. Your own kidneys are normally left in place. The new kidney often starts making urine on the table.
6. Recovery and stabilising. Six to ten days in hospital for you, less for the donor, then weeks of close outpatient monitoring while immunosuppressant levels are tuned and any early rejection is caught.
7. Clearance to fly. Only once your medication levels and kidney function are stable, and you have a written plan for continuing care at home.

What the donor goes through

Donating a kidney is real surgery on a healthy person, and the donor's interests deserve to be stated separately rather than folded into the recipient's story.

The kidney is usually removed laparoscopically through small incisions, the hospital stay is shorter than the recipient's, and most donors are back to normal activity within four to six weeks. Living with one kidney is compatible with a full and normal life, with the sensible caveat that donors should have their blood pressure and kidney function checked periodically for the rest of their lives, and should avoid regular use of anti-inflammatory painkillers.

The donor is assessed independently of you, and part of that assessment is confirming that they are donating freely. A donor can change their mind at any point, right up to the day, and the hospital will support that without explaining it to the family. That protection exists for good reason, and it is worth the recipient knowing about it too.

If you are on dialysis

Most people arrive already on dialysis, and it continues throughout the assessment and approval period. Two practical points. Arrange your dialysis sessions in India as part of the plan rather than as an afterthought, and ask for them to be priced, since they sit outside the transplant package and the approval process takes weeks. And bring your dialysis records with you, including how long you have been dialysing, your access history and any transfusion history, because previous transfusions can affect your antibody levels and therefore your crossmatch.

Life after the transplant

A transplanted kidney works for as long as it is protected, and protecting it is a daily job rather than a one-off event. You take immunosuppressant medication every day without gaps, have regular blood tests to check both the drug levels and the kidney's function, and watch for infection more carefully than before, because the same medicines that stop rejection also dampen your defences.

Before you leave India, settle three things in writing: the exact medicines and doses, where and how often you will be tested at home, and who your local nephrologist is. Then confirm the medicines are actually obtainable and affordable in your country. Transplants are more often lost to interrupted medication after the patient goes home than to anything that happens in theatre.

Where it is done

Kidney transplant needs a dedicated unit: transplant surgeons, nephrologists, a tissue-typing laboratory, dialysis facilities, intensive care, and a transplant coordinator experienced with the legal process for foreign nationals. Our partner network includes accredited multi-speciality hospitals with established programmes. See our partner hospitals.

Related

• Organ transplant in India: the rules
• Liver transplant in India
• Urology treatment in India
• Medical visa for India
• Our partner hospitals