A kidney transplant is a surgical procedure that places a healthy kidney from a living or deceased donor into a person whose kidneys have failed. It is the preferred treatment for end-stage kidney disease (ESKD), offering better survival and quality of life compared to long-term dialysis. India performs over 10,000 kidney transplants annually, with success rates comparable to the best centres worldwide.
Who Needs a Kidney Transplant?
Patients with end-stage kidney disease (GFR less than 15 ml/min) or those on dialysis are candidates for transplant. Common causes include diabetic kidney disease, chronic glomerulonephritis, polycystic kidney disease, and hypertensive nephrosclerosis. Age, overall health, and absence of active infection or malignancy determine eligibility.
Types of Kidney Transplant
Living Donor Transplant
A healthy person donates one kidney. Living donor kidneys last longer (15-20 years) because they are healthier and the surgery is planned. The donor can live a normal life with one kidney.
Deceased Donor Transplant
The kidney comes from a person who has been declared brain dead. The waiting time in India can be 1-5 years depending on blood group and compatibility.
ABO-Incompatible Transplant
Transplant between donor and recipient with different blood groups, made possible through desensitization protocols including plasmapheresis and rituximab.
Swap / Paired Exchange Transplant
When a willing donor is incompatible with their recipient, two or more incompatible pairs swap donors so each recipient gets a compatible kidney.
Pre-Transplant Evaluation
Before transplant, both donor and recipient undergo a thorough evaluation:
- Blood group and HLA typing (tissue matching)
- Crossmatch test to check antibody compatibility
- Complete blood work — kidney function, liver function, CBC, electrolytes
- ECG, echocardiography, chest X-ray for cardiac clearance
- Doppler ultrasound of donor kidney to assess blood vessels
- Infection screening — hepatitis B/C, HIV, TB, CMV
- Cancer screening as per age group
- Psychological evaluation for both donor and recipient
The Surgery
Kidney transplant surgery typically lasts 3-4 hours. The new kidney is placed in the lower abdomen (not in the original position). The surgeon connects the kidney's blood vessels to the recipient's iliac vessels and attaches the ureter to the bladder. The failed kidneys are usually left in place unless they are causing problems like recurrent infections or very large size.
Post-Transplant Care & Medications
Lifelong immunosuppressive medications prevent rejection. Common regimen includes:
- •Tacrolimus (Prograf) — primary anti-rejection drug
- •Mycophenolate mofetil (CellCept) — prevents immune response
- •Prednisolone — anti-inflammatory steroid
- •Trimethoprim-sulfamethoxazole — infection prophylaxis
- •Pantoprazole — stomach protection
Regular monitoring of drug levels, kidney function, blood sugar, and blood pressure is essential. Never miss or adjust doses without consulting your nephrologist.
Success Rates
95%+
One-year graft survival
85%
Five-year graft survival
15-20 yrs
Living donor kidney lifespan
Risks & Complications
- Acute or chronic rejection — the immune system attacks the new kidney
- Infection — due to immunosuppression (urinary, chest, CMV)
- Post-transplant diabetes — side effect of steroids and tacrolimus
- Hypertension — common, requires medication
- Increased cancer risk — especially skin cancer with long-term immunosuppression
- Recurrence of original kidney disease in the transplant
Frequently Asked Questions
How long does a transplanted kidney last?
A living donor kidney lasts 15-20 years on average, while a deceased donor kidney lasts 10-15 years. Proper medication adherence and lifestyle changes can extend graft survival significantly.
Can I live a normal life after kidney transplant?
Yes. Most transplant recipients return to work, travel, and enjoy normal activities within 3-6 months. Regular follow-up with your nephrologist and lifelong immunosuppression are essential.
Is kidney transplant better than dialysis?
For suitable candidates, transplant offers better survival, quality of life, and fewer dietary restrictions compared to long-term dialysis. It is considered the gold standard treatment for end-stage kidney disease.
What are the risks of kidney transplant?
Risks include infection, rejection, side effects of immunosuppressants (diabetes, hypertension, infections), and surgical complications. Regular monitoring minimizes these risks.
Consult Dr. Rajesh Goel for Transplant Evaluation
Dr. Rajesh Goel is an experienced nephrologist in Delhi who guides patients through every step of the transplant journey — from evaluation to post-transplant care.