What Is a Kidney Transplant — How It Works and What Patients Need to Know
A kidney transplant places a healthy kidney from a donor into a patient whose own kidneys have stopped working adequately. The new kidney takes over the filtering job — removing waste from the blood, regulating fluid balance, controlling blood pressure — that the original kidneys can no longer do.
It sounds simple, and in experienced hands the surgery itself is relatively straightforward compared to transplanting other organs. The complexity is in the immunology — getting the recipient's immune system to accept the new organ rather than destroy it.
When Is a Kidney Transplant Necessary?
End-stage renal disease (ESRD) is the clinical term for kidneys that have lost most of their function — typically less than 15 percent of normal. At this point, the kidneys cannot sustain life without replacement therapy.
The two options are dialysis and transplant
Dialysis filters the blood artificially, either through a machine (haemodialysis) several times a week, or through fluid instilled into the abdomen (peritoneal dialysis) daily. It keeps patients alive but it is demanding, time-consuming, and carries cardiovascular risk over the long term. It is not a cure.
Kidney transplant replaces kidney function with a working organ. A successful transplant allows most patients to return to near-normal life — dietary restrictions are significantly eased, fluid intake normalises, and the physical burden of dialysis disappears.
Common causes of ESRD that lead to transplant include:
- Diabetic nephropathy (kidney damage from long-standing diabetes)
- Hypertensive nephropathy (from poorly controlled blood pressure)
- Chronic glomerulonephritis (immune-mediated kidney inflammation)
- Polycystic kidney disease
- Repeated kidney infections causing scarring
Living Donor Transplant — The Standard for International Patients
In India, international patients follow the living donor route. A close family member — parent, sibling, adult child, or spouse — donates one kidney. The donor lives normally with one kidney; the remaining kidney compensates by increasing its function over time.
The donor undergoes a thorough pre-operative evaluation: blood tests, kidney function assessment, CT scan of the kidneys to assess anatomy and the blood supply, cardiac evaluation, and psychological assessment. If the donor passes all of this, they proceed to surgery.
A Transplant Authorisation Committee reviews every international living donor case. The committee verifies the donor-recipient relationship and confirms the donation is voluntary. This process exists to protect donors and cannot be bypassed. Prime Medical helps prepare all documentation the committee requires.
How the Surgery Works
Both surgeries happen simultaneously — the donor operation in one theatre, the recipient operation in another.
Donor surgery: The kidney is removed through either an open incision in the side or more commonly through laparoscopic (keyhole) technique — three small cuts, a camera and instruments. Laparoscopic donor nephrectomy means less pain, faster recovery, and a shorter hospital stay (three to five days versus five to seven for open surgery). The donor's remaining kidney gradually increases its function.
Recipient surgery: The diseased kidneys are left in place (removing them is unnecessary and adds surgical risk unless they are causing specific problems like recurrent infection or high blood pressure). The new kidney is placed in the lower abdomen — the pelvis — where it is connected to the blood vessels and the ureter (the tube carrying urine to the bladder). This location is chosen because the blood vessels and bladder are close and accessible.
Once the connections are made and blood flow is restored, the kidney often begins producing urine within minutes on the operating table. That first urine production is a good sign — it means the organ is working.
Recipient surgery takes three to five hours. Hospital stay is seven to ten days.
After the Transplant — What Patients Need to Understand
1. Immunosuppression: The immune system must be suppressed to prevent it from recognising and attacking the transplanted kidney. This is lifelong. The main drugs are tacrolimus (a calcineurin inhibitor), mycophenolate mofetil, and low-dose steroids. The doses are higher in the first year and gradually tapered as the risk of rejection decreases.
2. Monitoring: Blood tests — kidney function, tacrolimus levels, full blood count — are done frequently in the first year. Typically weekly for the first month, then fortnightly, then monthly as stability is confirmed.
3. Infection risk: Immunosuppression reduces the body's ability to fight infection. Preventive antibiotics and antifungal drugs are prescribed for the first months. Patients are educated on warning signs.
4. Rejection: Can be acute (sudden drop in kidney function, usually treatable with high-dose steroids) or chronic (gradual decline over years, more difficult to reverse). Most acute rejection episodes are caught and treated before significant damage occurs through the monitoring regimen.
A successfully transplanted kidney can last fifteen to twenty-five years or more. Some patients receive a second transplant if the first eventually fails.
Robotic Kidney Transplant — Available at India's Top Centres
Robotic-assisted kidney transplant uses the da Vinci surgical system to place the kidney through smaller incisions with greater surgical precision. Compared to conventional open transplant:
- Reduced blood loss
- Lower wound infection rate
- Shorter hospital stay
- Faster return to activity
Medanta – The Medicity in Gurugram is one of the first hospitals globally to perform robotic kidney transplant under regional hypothermia. Apollo Hospital Delhi and Max Hospital Saket also offer robotic kidney transplant.
Kidney Transplant Hospitals in Prime Medical's Network
MGM Healthcare, Chennai (JCI, NABH, NABL) — Dr. V Chandrasekaran leads transplant services. Experienced with international patients from East and West Africa.
Indraprastha Apollo Hospital, New Delhi (JCI, NABH) — One of South Asia's largest transplant programmes. Robotic transplant available. Africa desk.
Max Super Speciality Hospital, Saket, Delhi (JCI, NABH, NABL) — Strong transplant team. Robotic kidney transplant. Regular experience with African patients.
Fortis Memorial Research Institute, Gurugram (JCI, NABH, NABL) — Kidney transplant alongside broader surgical programme.
Artemis Hospital, Gurugram (JCI, NABH) — Prime Medical partner. Kidney transplant capability.
For patients from Addis Ababa, Kampala, Dar es Salaam, Mwanza, Banjul, or elsewhere in Africa who need a kidney transplant: share kidney function reports, dialysis history, and the potential donor's details with Prime Medical Solutions. Dr. V Chandrasekaran and the transplant teams review within 48 hours.
To book a consultation, call the number on our website.
