FAQ’s for Kidney Recipients

I am a kidney failure patient on dialysis; from whom can I get a kidney ?
For a renal failure patient needing kidney transplant, there are 2 options.
(1) Kidney from a healthy living donor
(2) Kidney a person who is Brain Dead (a Deceased Donor).

Who cannot get a kidney transplant?
Each patient is evaluated on a case-by-case basis; almost any person with renal failure upto the age of 65 can get a kidney transplant.

Is there a weight restriction?
No.

Can my child get a transplant?
Yes, children can also get transplants if matched with a suitable donor.

Which is better – dialysis or transplant ?
Transplant is a better option. On average transplant patients live twice as long as dialysis patients. Dialysis patients have to come to dialysis unit thrice a week or have thrice a day peritoneal dialysis at home. Transplanted patients enjoy a better quality of life, have more liberal salt and fluid intake, go to their work as usual, have normal family life. Also, in the long run, transplant is more economical. Transplant puts the patient back into society as he was before renal failure.

When is the best time to get a transplant?
In general, as early as possible, once dialysis is initiated. The transplant team and your nephrologists will determine the best time for you.

What medications will I have to take afterward?
Anti-rejection medications are taken as long as you have your transplanted kidney.
Following transplant, patients usually take:
• Medication to prevent kidney rejection
• Medications for other health issues (blood pressure, diabetes, etc.)

Who pays for the costs of transplant and other medications?
For patients undergoing transplant
1. In government hospitals (GH, Stanley) free transplant and free Tacro and MMF(immunosuppressive) medicines. This is for lifetime.
2. In private hospitals ( which are approved for Transplant under the CM Comprehensive Health scheme), for patients holding CM Comprehensive Health Scheme cards, free transplant and free free Tacrolimus and MMF(immunosuppressive) for 1 year.
3. In private hospitals, for any other patient, transplant cost could be of the order of Rs 5 Lakhs to 8 Lakhs and medication will be approximately Rs 1.2 Lakhs per annum initially; medicine and tests cost comes down from second year onwards.

How long will I be in the hospital?
Patients typically spend from 7 to 10 days in the hospital following kidney transplant surgery.

How successful are kidney transplant surgeries?
The success rate for kidney transplant is 90% in TN. Most transplanted kidneys start working immediately, but some start working slowly and you may need dialysis for one to three weeks after surgery. In India, only <5% of transplants fail immediately or soon after.

What would happen if kidney transplant didn’t work?
If transplanted kidney does not work, your Nephrologist may do blood test and perform kidney biopsy and treat accordingly.

What would happen if kidney transplant didn’t work despite all treatments? Would I die?
No. If the transplanted kidney doesn’t work, you can:
• Continue dialysis
• Pursue another transplant

What can patients do if they want a transplant but don’t have a suitable living donor?
Patients who do not have a living donor whose kidney will match, can register on a state waiting list to get a deceased donor transplant (cadaveric donor).

How do I get on the state waiting list?
You first decide on the hospital where you wish to get the transplant done and then ask your Nephrologist in that hospital to put you on the wait list after paying a onetime fee through a DD of Rs. 1000/- in favour of “TNMSC Organ Transplant”.
You will then be registered and be given your wait list number. Transplant Coordinator of the hospital will guide you on this. Registration through Government Hospitals is done free of cost.

How will I get the kidney once I get on the wait list?
Whenever there is a brain dead person in any of the participating hospitals, the organs are allocated to persons in the wait list. First few in the wait list will be alerted. Recipient tests will be performed by your doctor. Also, cross match test between first few recipients and brain dead donor will get carried out simultaneously. After these tests, the topmost listed fit recipient will be allocated the kidney.

How long is the average waiting time for a kidney?
Most patients wait for one to two years for a kidney from the deceased donor waiting list. If you want to get a kidney from a deceased donor, the important thing to do is to get on the list as soon as possible. Any patient who is on CAPD or hemodialysis for at least 2 months can get registered;

The first thing is, of course, to explore the possibility of living donor transplants from your relatives.

Is the waiting list fair?
Strict rules and Government orders have been set up to make sure that no one can jump the waiting list. Above all, there is full transparency to the waiting list. The waiting list is accessible to the hospitals where the patients can check their rankings. Matching is based on blood type and the wait time. Your income, caste or creed do not prevent you from receiving a kidney, nor do they move you up/down on the list.

For kidney recipients, there is no URGENT wait list either.

Is there a difference between having a living or deceased donor transplant?
Yes. Live related donor is superior. Living donor transplants last longer than deceased donor transplants. Because a living donor kidney is removed from a healthy donor in the operating room and transplanted right away, living donor transplants last on average for 15-20 years and deceased donor transplants last for 10-15 years. This is only an average and quite a good number of transplants last much longer.

Which kind of transplant happens faster?
If a living donor is available, a living donor transplant happens faster, often within 3 months. With a deceased donor transplant, most patients have to wait 1-2 years until a kidney is available from the list.

How does transplant compare to staying on dialysis?
Studies have shown that cadaveric kidney recipients live twice as long as dialysis patients. This is irrespective of diabetes, coexisting other illness, age or sex.

How does a person’s quality of life change if they get a transplant?
The quality of life the patients enjoy is like normal people except for taking medicines. They get back to work and will be productive to the family and society. Also, patients can take food and water liberally and increase the salt intake too. Their fertility and sexual functions also improve.

Is it possible for me to buy a kidney from a live donor?
Such transactions are illegal and punishable. None should attempt that.

I am willing to give my Kidney to any person with my blood group, can you arrange for someone else to give their kidney with my kin’s blood group to my kin?
This is called swapping; it is legally acceptable. You can contact your nephrologist / CTP for more details.

Can I be on more than one hospital wait list?.
No. You are allowed to be on only one hospital wait list at a given time. It will be the hospital where you have decided to get your transplant surgery done.

Which is the best hospital to get the transplant done?
You can view the list of hospitals registered under our program for cadaver transplant and call and visit them and decide where you are comfortable and make the decision.

Can you tell me the cost of a transplant in the various hospitals? Which is the cheapest?
Two costs are involved. One is the cost of surgery and the other is the cost of the medication you need to be on for lifetime after the surgery, in order to ensure that your body does not reject the kidney transplanted. This is called immunosuppression.

In Govt hospitals (GH and Stanley Hospitals at Chennai) you will get free transplant surgery and thereafter free immunosuppressive medicines for lifetime. Patients holding CM Comprehensive Health Scheme cards will get free transplant and free medication for one year in in select private hospitals approved by the Government for this purpose., As for private hospitals in general, you need to ask each of them their transplant cost.

Immunosuppressive medication will cost approximately Rs 1.2 Lakhs per annum.

Are there any blood products I should try to avoid?
Yes. Kidney patients should try to avoid receiving any blood products (whole blood, plasma, platelets, red blood cells) because this can increase antibody levels in your blood. High levels of antibodies make it difficult to find a tissue matched donor.

What happens if I change my Hospital?
Please note cadaver kidney is allocated to the registered patient and not to the hospital. Hence you are at liberty to shift to any hospital (approved by the Government for transplant) of your choice in Tamil Nadu.
You can change your hospital and request the new hospital to send in your details to us by mail and you will need to send a handwritten letter requesting us to change your registration from the old hospital to the new one with all details. This will not affect your priority in getting a kidney allocated from the common pool.

In case I would like to defer my transplant when my name comes up for the transplant, then will I be allowed to stay on the wait list?
During this time your status might change from being “active” on the kidney waiting list to being “inactive”. During the time when you’re listed as inactive, your wait list status remains same. However, you will not be called for deceased-donor transplant as your status is inactive. Once you are fit and willing, your nephrologists or transplant coordinator can make your status ”active”.

The reasons for being inactive vary, but might include health changes such as infection or hospitalizations. It may be a decision you make if you are going on vacation, or if you are not emotionally, monetarily or physically ready for transplant or if you’re waiting for a living donor. Once you are ready you will be put back as active and have the chance for a transplant.

Is there any way by which I can jump the wait list and be considered out of turn for a transplant?
This is not possible as we strictly follow the wait list.

What is a cross match?
Blood from both donor and recipient are taken to test the presence of preformed antibodies in the recipient’s blood against the donor’s organ. You will be taken up for transplant only if cross match test is negative

How long do I need to go for a checkup after the transplant?
You need to go for regular medical checkups throughout your life after the transplant. Initially it is twice a week; later it will be once a month or even once in 3 months. However lifelong medicines and periodic blood tests and regular consultations are necessary to get the full benefit of transplant. Also it is useful to remember that transplant replaces only the kidney and if you have other medical problems like diabetes, heart disease, high BP ans such other, you require extra care. You are also prone for infections and hence lifelong monitoring is needed.