Kidney Transplant Cost in India: Unveiling Realities and Choices

Kidney transplantation stands as a significant milestone in modern medicine, offering a substantial improvement in the quality of life for individuals worldwide facing irreversible kidney failure, also known as end-stage renal disease (ESRD). What was once considered an experimental, risky, and limited treatment option 50 years ago has now evolved into a standard clinical practice in over 80 countries. This transformation has shifted from being confined to a selected few in prestigious medical centers within high-income economies to becoming a routine procedure in many high- and middle-income countries. 

Renal transplantation has seen notable progress in various nephrology fields, with improvements in long-term survival compared to maintenance dialysis. Recognizing the ongoing challenges, the International Society of Nephrology (ISN) and the Transplantation Society are committed to collaborative efforts. They aim to implement joint global outreach programs, leveraging their combined expertise to establish and enhance kidney transplant programs in low- and middle-income countries.

Countries such as the USA, China, Brazil, and India lead in the number of kidney transplants performed, while Austria, USA, Croatia, Norway, Portugal, and Spain exhibit the greatest population access to transplantation. India's considerable cost advantage, coupled with a well-trained medical workforce, contributes to the success of kidney transplant surgeries in comparison to developed countries. Moreover, India is among the leading countries in performing maximum kidney transplants every year.

A kidney transplant involves surgical interventions to replace a person's failing kidneys with a healthy one which is taken from a deceased or living donor. End-stage renal disease patients require dialysis or a kidney transplant for waste product elimination from the bloodstream. This process is essential for survival. 

Types of Kidney Transplant

Following are the different approaches by which kidney transplantation is done:

ABO-Compatible Transplant: ABO-compatible transplants show best results because the donor and receiver have the same blood groups. Since the recipient's immune system is less likely to perceive the transplanted kidney as foreign body. Moreover, ABO compatibility lowers the possibility of rapid rejection.

ABO-IncompatibleTransplant: Here, the recipient's and donor's blood groups do not match. Although less common, this type of transplant can be done with extra medical interventions to lower the recipient's antibody levels and minimize rejection chances. Stronger immunosuppressive drugs are given for longer periods of time.

Current Scenario of Kidney Transplants in India

End-stage renal disease is characterized by irreversible renal damage, where survival becomes impossible without dialysis or renal transplantation. It is a prevalent global issue, with approximately 70,000 new cases reported in India each year. Around 7500 kidney transplants are done every year at 250 kidney transplant centers in India. Around 27 kidney transplants have been performed on children under the age of 12 in India over the past 7.5 years. 

Most transplant centers report impressive patient survival rates exceeding 90% at one year, with mean graft survival rates ranging from 80% to 90% over the same period. Greater compatibility in family-related grafts, considering cross-matching, HLA-B, and DR matching, contributes to longer survival. Notably, the establishment of criteria for brain death and cadaveric renal transplant by the parliament in 1993 has been a significant stride, facilitating more donors and curbing the illicit trade of organs from unrelated sources.

According to government data, the kidney was the most transplanted organ in India over the past five years, followed by the liver and the heart. The data, presented to the Lok Sabha on December 8 by the National Organ and Tissue Transplant Organisation and the Union Health Ministry, showed that the kidney accounted for 75 percent of all organ transplants performed in India over the previous five years with 43,983 transplants, followed by the liver with 13,084 transplants (22%), and the heart with 911 transplants.

In India, kidney transplants typically cost around Rs. 8,75,000. However, the cost of a kidney transplant in India varies depending on a number of factors and varies from case to case, ranging from Rs. 6,20,000 to Rs. 12,75,000. Costs, however, might differ based on the various hospitals in various cities.

Cost of Kidney Transplant in Different Cities of India

Following are the factors affecting the cost of kidney transplant in India:

Doctor’s expertise: The number of successful cases accomplished by a doctor may affect the cost of treatment. Generally, higher the expertise, higher will be the cost.

Doctor’s experience: The doctors with more years of work experience in kidney transplant surgeries will charge more.

Overall health status of patients: People having prevailing illnesses and old-age people will be at risk of getting more complications. So, there will be more post-operative care for them which will increase the cost.

Out of pocket expense: If your treatment is not being covered under your health insurance policy, then you may have to pay a higher out of pocket amount for the treatment. 

Pre-Surgical expenses: Various diagnostic tests will add to the total cost of the treatment.

Hospital fees: If you are choosing a government hospital for your treatment, then the cost of the treatment will definitely be highly affordable. On the contrary, if you choose any private or corporate hospital for your treatment then you will have to pay a higher amount.

Type of surgery: Depending upon your condition, your doctor will plan the treatment approach for you. This will also impact the cost of treatment depending upon the approach chosen.

City where hospital is located: Hospitals located in bigger cities like Delhi, Mumbai, Chennai, Noida, Gurugram, etc. may charge comparatively more than the hospitals located in the smaller cities. This is because hospitals in the metropolises can facilitate you better in every aspect.

Top 5 Hospital for Kidney Transplant in India

1. Fortis Hospital, Bangalore (Bannerghatta Road)
2. Kokilaben Dhirubhai Ambani Hospital Mumbai.
3. Medanta - The Medicity Hospital, Gurgaon
4. Fortis Hospital Gurgaon
5. Indraprastha Apollo Hospital New Delhi

Summary

For some, the only option left is probably a kidney transplant if their kidneys have completely failed.  If you have end-stage renal disease (ESRD), you will require dialysis in order to survive. However, a kidney transplant can eliminate your need for a dialysis machine permanently. To replace two failing kidneys, just one healthy kidney is needed. This allows a living individual to give a kidney to a patient suffering from end-stage renal disease. India's significant cost advantage over developed nations, along with a highly skilled medical workforce, makes kidney transplant surgeries there more successful. Furthermore, India is one of the top nations in the world for the number of kidney transplants performed annually.

What is the duration of the Kidney Transplant Procedure? 

As the procedure is done under general anesthesia, kidney transplant surgery typically takes two to three hours. 

What are the prerequisites for kidney transplant with regard to eating and drinking?

The day before the renal transplant procedure, you should refrain from eating or drinking anything, even water, before 8 hours to surgery. It is strictly advised to not take large meals the night before surgery. You will receive comprehensive instructions from your doctor regarding what to eat and drink a day before the procedure.

How is kidney Transplant Done?

Individuals diagnosed with end-stage renal illness who have few options, such as dialysis, and are in otherwise good health, are recommended candidates for kidney transplants. Living donors undertake comprehensive medical and psychological evaluations to verify their fitness for donation. The donor's kidney is implanted in the recipient's lower abdomen, and the blood vessels and ureter are connected.

Why do patients need a Transplant?

Stage 5 of kidney disease is referred to as Kidney failure, which occurs when the glomerular filtration rate (GFR) drops below 15. If someone is suffering from end stage renal disease (ESRD) or kidney failure, he/she might require kidney transplantation. A severe (90 to 95%) fall in kidney function is indicated when high blood creatinine levels (8 mg/dL) are found. Kidney transplant becomes an important option to minimize the restrictions and inconvenience of long-term dialysis treatment, best kidney specialist.