Do you know that more than 2,00,000 patients receive kidney transplants in India annually? India stands at the second position after the United States for performing kidney transplants. Experienced medical personnel, well-equipped hospitals, qualified nursing staff, easy availability of medical visas are some factors that make India shine in the list of medical tourism destinations.
The first-ever successful human kidney transplant was performed at the King Edward Memorial Hospital in Bombay, India in 1965. It was performed on a hypernephroma patient using a cadaver donor.
Kidney Transplantation - An Overview!
Kidney transplant is the organ transplant into a patient suffering from end-stage renal disease. It is a surgical process that demands the replacement of a healthy kidney from a living or deceased donor into a person whose kidneys don’t function properly.
Health Disorders That May Require Kidney Transplantation
End-stage renal disease is the most common cause of kidney transplantation when the kidneys lose about 90 percent of their ability to function normally. The health issues responsible for end-stage kidney disease are:
High blood pressure - chronic, uncontrolled
Polycystic kidney disease
Chronic Glomerulonephritis - inflamed tiny filters in the kidneys (glomeruli)
Other Urological diseases
When a person suffers from end-stage kidney disease, he/she needs to have waste filtered out of their bloodstream via dialysis or a kidney transplant to live a long, healthy life.
Kidney Transplant Options: Types Of Kidney Transplant Available
Depending on the source of availability of kidney, there are two types of renal transplants:
- It is the removal of a kidney from a living donor and the replacement of a diseased kidney of the recipient.
- The donor can be an immediate relative of the recipient such as father, mother, sibling, spouse, children, grandparents, first cousins.
- In the case of deceased donors, the process begins with matching the blood group and offered to the first patient on the waiting list.
- Unfortunately, the demand for deceased donor organs far outnumbers the supply. Therefore, not all patients undergo a deceased donor kidney transplant.
In India, more than 80 percent of transplants are from living donors.
Legal And Ethical Aspects Of Kidney Donation
When it is about organ donation and transplantation, the Indian government follows strict rules and if anyone, found guilty, has to face a heavy penalty. Once the patient case is evaluated by the transplantation team along with all the legal documents, they proceed with the treatment. Also, living donors are classified as:
A close relative or related by blood such as parents, siblings, children, grandparents, grandchildren.
The donor is not related by blood such as a spouse, siblings of the spouse, parents of the spouse, then it requires permission from the government describing that no commercial angle is involved while organ donation.
In case, when a foreigner is coming to India for kidney transplantation, then he/she should bring the donor along only after a senior embassy of their country of origin or the Government of the concerned country approves of the relation between the donor and recipient.
Meanwhile, the Indian legislation also ensures that the kidney transplantation should be ethically performed in India.
Kidney Transplantation: Organ Donation Acceptance Procedure
As a foreigner, you have to bring your donor along. However, you have to undergo a legit process to get approval from the Embassy and Government of your country for the donor. While in India, living donor transplant is acceptable in two forms - related and non-related donor, there is a list of documents the donor and the recipient should bring along.
For Related Donor: The required list of documents are:
Medical visas by the donor and recipient.
Passport photocopy and passport size photographs of the donor and the recipient.
NOC from the embassy with all the documents attested.
A family photo depicting the relationship between the donor and the recipient.
Birth certificate/school certificate/any government approved ID proof displaying the parent’s name showing the relationship between the donor and recipient.
The donor should also bring the marriage certificate if married.
Bank account statement and ITR for three financial years by the donor and recipient.
Patients need to bring all the medical papers from their native countries.
In the case of an unrelated donor, the documents are the same. However, there are some additional documents to be attached along:
NOC from the donor’s relative implying no objection regarding organ donation.
Proof of unfit related donors should be carried along with their blood group reports and treatment papers.
Attested recipient’s family tree by the area head.
The presence of the donor’s relative before the Authorization Committee meeting is mandatory.
All the affidavits containing photographs and attested by the magistrate.
Also, along with the above-mentioned documents, the following forms must be duly filled:
Psychiatrist evaluation of the donor
HLA DNA profiling report
Self consent for deceased donation
Consent for organ donation from family (in case of non-related donors)
Consent for organ donation from unclaimed bodies
Brain death declaration form
Joint transplant application by donor/recipient
Registration of hospital for organ transplantation
Registration of hospital for organ retrieval
Grant of registration
Renewal of registration
The decision by hospital authorization committee
The decision by district authorization committee
Verification of Domicile for non-near-relative
Letter from Embassy
Also, the donor’s minimum age should be 18 years old and should have a similar blood group as of the recipient’s.
Talking about deceased donor renal transplantation, it still occurs at a lesser rate. Out of 3,500 kidney transplants every year, only 5 percent of deceased renal transplants take place annually.
Getting Ready For Transplant: Preparations To Be Done Before Transplant
With many steps involved in a kidney transplant, the process begins with an evaluation process whether you’re ready for the transplant followed by finding a donor. Even before the evaluation process, the important step involves choosing a transplant center.
Step 1: Finalizing A Transplant Center: While selecting a transplant center, you need to get answers to the following questions and they are:
- Does your insurance policy cover your medical expenses at the transplant center you choose?
- Is the transplant center accredited by NABH (National Accreditation Board for Hospitals & Healthcare Providers) and JCI (Joint Commission International)?
- What is the experience of a transplant center in treating patients suffering from the same disease as you have? Some centers specialize in treating particular diseases.
- Is the center far from your hotel, accommodation, or home? How will you coordinate your follow-up care with local physicians?
- Will the staff provide emotional care services to you, your family, and the caregiver?
Step 2: Evaluation Process: To check whether you qualify for a kidney transplant, you need to undergo an evaluation process by your transplant team. This may include the following tests:
- Blood and tissue type tests
- HIV and Hepatitis tests
- Prostate test (for men)
- Mammogram and Pap smear (for women)
- Heart and lungs functioning test
- Kidney and liver tests
- Colon exam (colonoscopy)
Although there are some health issues that can refrain you from undergoing a kidney transplant and they are:
- Serious health problem
- Drug or alcohol issue
- Severe, untreated mental health issue
- Recently treated cancer
- Advanced age
- Severe heart disease
Step 3: Finding A Donor: Before the transplant, you will need to undergo several tests to find a good match for you so that the new kidney is accepted by your immune system. The match is done based on the type of blood group to avoid rejection by the recipient’s body.
If your blood group is:
- O, you can get a kidney from a donor having an O blood group.
- A, then the perfect match for you is either the A or O blood group.
- B, then the perfect match for you is either the B or O blood group.
- AB, then you have all four choices: A, B, AB, or O blood group.
Above all, it is important to be selective about your transplant team. It is a team of medical professionals who work closely to bring best-desired results. The team comprises physicians, surgeons, nurses, dietitians, and social workers. The team pledge to support the patient physically, emotionally, and financially.
Kidney Transplantation Vs Dialysis: Which Is Better?
It brings only a 10-15 percent improvement in the functionality of kidneys.
A transplanted kidney has the ability to function far better. It functions 75-80 percent better than the diseased one.
Involves regular sessions of dialysis.
Once done, the patient can lead a new, healthy life.
Follow a strict diet plan.
Can drink and eat freely after a certain period of time.
Low energy levels because of regular sessions.
Feel more energetic.
Lesser survival rates.
Better survival rates.
From the above table, it is concluded that kidney transplant surgery has better outcomes as compared to dialysis and hence, should be preferred to avoid regular visits to the hospital for dialysis.
Outcomes And Surgical Complications Associated With Kidney Transplantation
Kidney transplantation cures advanced kidney disease and kidney failure. Nonetheless, it comes with risks and complications like any other surgery.
Sometimes, some diseases may return even after a transplant.
As kidney transplant involves the replacement of a new kidney with a diseased one, it may come with several risks such as rejection of the donor organ or side-effects of immunosuppressants that are prescribed to prevent the rejection of a donated kidney.
Therefore, it is advisable to consult with your family, friends, and most importantly, with your healthcare advisor. Although, undergoing kidney transplantation is your personal decision.
Kidney transplant may come with a series of complications, such as:
Bleeding around the incision site
Leakage from or blockage of the ureter tube that connects the kidney to the bladder
Chances of infection or tumor that can be transmitted from the donated kidney
Or even, death
Care After Kidney Transplant: Anti-Rejection Medicine Side-Effects
As a kidney transplant involves a transplanted kidney into the recipient’s body. If you’re fortunate enough, your body will accept it. However, there are some incidents when these prescribed immunosuppressants may cause side-effects and they are:
Bone thinning (Osteoporosis)
Bone damage (Osteonecrosis)
High blood pressure
Excessive hair growth or hair loss
Weight gain or weight loss
Prone to develop cancer, particularly skin cancer
Evolution Of Kidney Transplantation: Success Rates In India
The success rate of kidney transplantation in India is highly competitive in the world. Overall, success rates are great.
Live donor transplants have a better success rate as compared to the deceased ones.
Living donor transplants have a 90-95 percent success rate, while deceased donor transplant has an 85-90 percent success rate for the first year.
Also, a blood-related donor brings better results as compared to the non-blood related donor.
Cross-matching and HLA typing reports play a significant role in making kidney transplantation successful.
How Donor and Recipient Factors Influence Kidney Transplant Costs?
As kidney transplant requires a lot of efforts, therefore, there are several factors involves that control the cost of the procedure. The cost is likely to vary from patient to patient depending on the individual parameters, medical history, and needs. Similarly, it also involves the characteristics of a donor that varies from one individual to the other.
Also, the cost of transplant procedures is higher as compared to other surgical procedures as it involves two parties - the donor and the recipient. The parameters of the donor and the recipient may vary which results in affecting the total cost of transplantation.
Some important factors that affect the cost of kidney transplantation are:
The Choice Of Country:
- India offers affordable medical treatment as compared to other medical tourism destinations.
- The cost of kidney transplantation in India is quite less as compared to Singapore which costs five to ten times high.
Recipient And Donor Parameters:
- Before undergoing a transplant, the team conducts an evaluation process which includes a series of blood and biochemistry tests of both recipient and donor.
- If by any means, the outcomes are unfavorable, then it may lead to medical treatment which, in turn, affects the total cost of treatment.
First Transplant Vs Second Transplant:
- Sometimes, the person has to undergo the second transplant due to certain medical issues. This means there are higher chances of rejection after the second transplant.
- Therefore, the second transplantation requires a little extra effort, care, medications, etc.
- Also, in the second transplantation, the patient may require intravenous immunoglobin (IVIG) treatment, which adds up to the total cost of the procedure.
Type Of Donor:
- When the donor is unrelated by blood, then it needs additional medical management and thorough monitoring.
- In such cases, the cost may go higher due to the extra dose of anti-rejection medicines.
- The cost of treatment is directly proportional to the total stay of the donor and the recipient in the hospital.
- However, in no complication arises, then the donor is discharged after five days and the recipient has to stay for 10 to 12 days after the surgery.
- But, if a complication arises, then either or both of them have to stay in the hospital for the extra number of days which may affect the hospital bill.
Ethics Committee Approval:
- Prior approval from the Ethics Committee is mandatory in case of an unrelated donor.
- An Ethics Committee is a team of doctors, physicians, psychiatrists, police officers, and other concerned professionals.
- The Ethics Committee ensures that there is no commercial angle behind this transplantation.
- The interview also involves the presentation of a certain set of documentation in a local language before the Ethics Committee. This documentation and translation also require extra cost.
Other factors that add up to the total cost of the transplantation process are:
The overall health of the patient
Accommodation, food, transportation, and other basic amenities
Pre-surgery costs including thorough physical examination, donor’s consultation, blood tests, dialysis (if required), medications, documentation, psychiatrist evaluation.
Surgical costs include OT charges, anesthesia charges, laboratory charges, surgical team fees.
Post-surgery costs including medications, dialysis (if needed), follow-up sessions, stent removal.
Kidney Transplantation Cost
Top Hospitals For Kidney Transplant In India
BLK Super Specialty Hospital, New Delhi:
The hospital holds expertise in kidney transplant, renal biopsies, hemodialysis, renal angiography & angioplasty, and other laparoscopic renal surgeries.
Medanta, The Medicity, Gurgaon: This hospital has a well-equipped Kidney and Urology institute that performs a number of kidney transplants every year.
Fortis Memorial Research Institute, Gurgaon: This hospital keeps abreast of the latest advancements in the medical field. It has experienced nephrologists that make this hospital the best kidney transplant hospital in India.
Fortis Hospital, Mulund, Mumbai:
You can trust Fortis Healthcare Group when it is about medical treatment. Kidney transplant surgery is one such specialty for what this hospital is known.
Apollo Hospital, Bangalore: It is a 250-bedded multi-specialty hospital that has the best team of nephrologists and urologists and conducts a number of kidney transplants annually.
Top Kidney Transplant Specialists In India
Dr. Vijay Kher: He is a well-known Nephrologist with 37 years of experience. He holds expertise in Kidney Transplant, advanced renal disease, and acute kidney injury.
Dr. V. Chandrasekhar: He is currently associated with the Department of Kidney Transplant at Global Hospitals, Chennai. His medical interests are General Nephrology, Hypertension, Kidney Transplantation, Interventional Nephrology.
Dr. Abdul Munnon Durrani: He is a renowned Urologist with 17 years of experience. He has performed more than 3,000 endourological procedures.
Dr. Zaheer Amin Virani: He is a well-experienced Nephrologist with 14 years of experience. He holds expertise in all forms of dialysis including acute and chronic peritoneal dialysis, hemodialysis, continuous therapies like continuous venovenous hemofiltration/hemodialysis (CVVH/CVVHD) and arterio-venous hemofiltration, /hemodialysis (CAVH/CAVHD).
Dr. Y. Sandeep Reddy: He is a renowned Nephrologist with 12 years of experience. He holds expertise in treating complex kidney diseases and all types of Glomerular diseases.
How Vaidam Health Understand You Better In Making Your Medical Journey Worthy
As kidney transplant involves the donor and the recipient along with proper legal formalities and documentation. Vaidam Health provides the right consultation while giving details about related/unrelated donors, what documents are required, what forms need to be duly filled, best surgeon, hospital, medical visa required, and more. The patient-relation team provides 24/7 assistance throughout your medical journey and even after you return to your home country post-treatment.