The Kidney Transplant, Indian Law and Medical Management

Kidney Transplant

India’s response to kidney failure has been largely through living donor transplants.

Living Donor Transplants:

Normally a family member or a friend offers to donate a kidney to save their loved one. The donors who get approved belong to these categories:

a. near relatives - spouse, parents, children, siblings, grandparents, grandchildren

b. other than near relatives - requires additional verification about their intent to donate.

Donor must be an adult with sound mind, willing to donate voluntarily, without expectation of any financial gain in cash or kind.

Refer to the THOTA Law to know your rights as a patient.

https://notto.mohfw.gov.in/act-end-rules-of-thoa.htm

If a person does not have a suitable donor, there’s an opportunity to get a Cadaver Transplant.

Cadaver Transplant:

With the help of the doctor, hospital, social worker a person can get listed for a kidney transplant after starting dialysis.

Tests Required to be Added to the Cadaveric Transplant Waiting List:

You will be asked to undergo a comprehensive medical evaluation at your transplant hospital to confirm your diagnosis, assess fitness for surgery, and ensure that a transplant is safe and beneficial for you.

Typical tests include:

• Blood tests: Blood group typing, complete blood count, liver and kidney function, electrolytes, coagulation profile.

• Infection screening: HIV, Hepatitis B & C, Tuberculosis, and other transmissible diseases.

• Tissue typing: HLA (Human Leukocyte Antigen) typing and cross-matching to improve compatibility.

• Imaging tests: Ultrasound, X-ray, CT or MRI scans to assess organ condition and overall health.

• Cardiac evaluation: ECG, echocardiography, or stress tests to check heart fitness for surgery.

• GFR, dialysis records.

In addition, a psychosocial assessment and financial counseling are usually done, since transplant requires long-term medicines and follow-up.

Once all reports are complete and reviewed, the hospital uploads your details into the state waiting list.

Determining the Compatibility of a Cadaveric Organ:

When a deceased donor organ is available, doctors check:

• Blood group match (ABO): Your blood type must be compatible with the donor’s.

• Tissue match (HLA typing): Shows how closely your immune system matches with the donor’s.

• Crossmatch test: Ensures you don’t have antibodies that would attack the donor organ.

If the organ is considered safe and suitable it will be offered to you.

When a cadaveric organ becomes available:

The transplant team will contact you as soon as a matching organ is available, usually by phone.

Always keep your phone nearby and inform your family so you can reach the hospital immediately when called.

Cadaveric organs must be transplanted quickly, so prompt communication and response are essential. Therefore, avoid long travels, stay reachable, carry your medical records, medications, and contact information for your transplant team.