Kidney Transplant at BLK MAX Hospital, New Delhi, India.

Kidney transplant is a life-saving procedure for patients suffering from end-stage renal disease. At BLK MAX Hospital in New Delhi, patients receive comprehensive care from a team of experienced nephrologists and transplant surgeons. This hospital is renowned for its high success rates and state-of-the-art facilities.

A kidney transplant involves replacing a diseased kidney with a healthy one from a living or deceased donor. The surgery is performed under general anesthesia, and it typically takes 5 – 8 hours. Post-transplant, patients require close monitoring to prevent complications and ensure the new kidney functions properly.

When do you need a Kidney Transplant?

A kidney transplant is needed when a person suffers from end-stage renal disease (ESRD) or kidney failure, which occurs when the kidneys can no longer function adequately to meet the body’s needs. This condition can result from various causes, including chronic kidney disease (CKD), diabetes, hypertension, polycystic kidney disease, and glomerulonephritis. When the kidneys fail, waste products and excess fluids build up in the body, leading to severe health issues. At this stage, dialysis or a kidney transplant becomes necessary to sustain life. A transplant is often recommended over long-term dialysis because it can provide a better quality of life and increased survival rates.

Why Should You Choose BLK MAX Hospital?

Expertise: BLK Max Hospital has a team of highly experienced nephrologists, urologists, and transplant surgeons who specialize in kidney transplants.

Advanced Facilities: The hospital is equipped with state-of-the-art technology and modern facilities to ensure the highest standards of care.

Comprehensive Care: From pre-transplant evaluation to post-operative care, BLK Max provides a complete range of services to support patients throughout their transplant journey.

High Success Rates: The hospital boasts high success rates for kidney transplants, ensuring better patient outcomes.

Patient-Centric Approach: The hospital focuses on personalized care, ensuring that each patient receives tailored treatment plans and compassionate support.

International Patient Services: BLK Max offers dedicated services for international patients, including assistance with travel, accommodation, and language support.

Kidney Transplant at BLK Max Hospital

Cost of Kidney Transplant at BLK Max, India compared to other countries –

Day 1: Arrival and First Visit to BLK Max Hospital

Upon arriving at Indira Gandhi International Airport (IGI), the patient is transferred to their hotel for a brief rest. The hospital arranges for transportation to BLK Max Hospital, ensuring a smooth and comfortable journey. At the hospital, the patient visits the International Patients Lounge on the first floor, where Shikha and Milind, who serve as dedicated coordinators, assist with the process. After completing the registration and obtaining a unique Max ID, which is essential for accessing reports and managing financial transactions, the patient proceeds to the billing department. From there, they are taken to the first floor to meet with Dr. Shafiq, Urologist, Dr. Rana, Urologist, or Dr. Sunil Prakash, Nephrologist. The doctors perform a detailed examination, discuss the patient’s medical history, and recommend necessary tests to evaluate their condition. With the Max ID, patients can easily track their test results and manage their treatment-related expenses. The first day ends with the patient feeling confident and prepared for the next steps in their kidney transplant journey.

Kidney Transplant at BLK Max Hospital

Day 2 – 6 Pre-Transplant Work-Up for Donor and Recipient

Recipient

Blood Tests:

1. Blood Typing and Screening: Determines compatibility.
2. Subgroup for Blood Group A: Specifies blood group.
3. HbSAg: Screens for Hepatitis B.
4. HIV: Tests for Human Immunodeficiency Virus.
5. HCV: Tests for Hepatitis C Virus.
6. HLA Typing and Cross-Matching: Checks for human leukocyte antigen compatibility.
7. Flow CrossMatch: Assesses recipient’s antibodies against donor cells.
8. CBC with ESR: Complete Blood Count and Erythrocyte Sedimentation Rate.
9. KFT Extended: Kidney Function Test.
10. LFT: Liver Function Test.
11. Lipid Profile: Assesses cholesterol and triglyceride levels.
12. PSA (if male): Prostate-Specific Antigen.
13. PT/APTT: Prothrombin Time and Activated Partial Thromboplastin Time.
14. FBS/PP: Fasting Blood Sugar/Postprandial Blood Sugar.
15. HbA1c: Measures average blood glucose over 3 months.
16. HCV RNA (Qualitative/Quantitative): Measures Hepatitis C RNA levels.
17. TSH, T3, T4: Thyroid function tests.
18. CMV IgG and IgM: Cytomegalovirus antibodies.

Urine Tests:

1. Urine R/M: Routine and Microscopic examination.
2. Urine C/S: Culture and Sensitivity.

Radiology Tests:

1. ECG: Electrocardiogram.
2. 2D Echo/Dobutamine Stress Echo: Evaluates heart function (for >40 years).
3. Chest X-ray PA View: Assesses lungs and heart.
4. X-ray Pelvis AP: Examines pelvic region.
5. MCU/Uroflowmetry: Bladder and urinary flow assessment.
6. USG Whole Abdomen: Ultrasound of abdomen.
7. USG Colour Doppler Pelvic Arteries and Veins: Examines blood flow.
8. USG TVS: Transvaginal ultrasound.

Clearances:

1. Gynecology Clearance & Pap Smear (for females): Provided by Dr. Poonam Khera, Dr. Alka Sinha, or Dr. Nidhi Khera.
2. Psychiatry Clearance: Ensures mental health readiness.
3. Cardiology Clearance: By Dr. Manish Jain, Dr. Ashitab Tiwari, or other cardiologists.
4. PAC Clearance: Pre-Anesthesia Check-up.
5. Nephrology Clearance: By Dr. Sunil Prakash, Dr. Vishal Saxena, or Dr. Ashwini Goel.

Additional Tests:

1. DNA Fingerprinting: Ensures genetic compatibility.
2. Single Antigen Bead Class 1 & 2: Additional HLA compatibility tests.
3. Isohemagglutinin Anti A/B Titer: Measures antibody levels.
4. Sickle Cell Test
5. G6PD: Glucose-6-Phosphate Dehydrogenase test.
6. Blood Donation: 3 units required.

Donor

Blood Tests:

1. Blood Typing and Screening: Ensures compatibility.
2. HbSAg: Screens for Hepatitis B.
3. HIV: Tests for Human Immunodeficiency Virus.
4. HCV: Tests for Hepatitis C Virus.
5. CBC with ESR: Complete Blood Count and Erythrocyte Sedimentation Rate.
6. RFT Extended: Renal Function Test.
7. LFT: Liver Function Test.
8. Lipid Profile: Assesses cholesterol and triglycerides.
9. PSA (if male): Prostate-Specific Antigen.
10. PT/APTT: Prothrombin Time and Activated Partial Thromboplastin Time.
11. FBS/PP: Fasting Blood Sugar/Postprandial Blood Sugar.
12. HbA1c: Measures average blood glucose over 3 months.
13. CMV IgG and IgM: Cytomegalovirus antibodies.
14. TSH, T3, T4: Thyroid function tests.

Urine Tests:

1. Urine R/M: Routine and Microscopic examination.
2. Urine C/S: Culture and Sensitivity.
3. 24 hrs Urine for Creatinine/Protein: Collects urine over 24 hours to assess kidney function.
4. Sickle Cell Test: Essential for African donors.
5. G6PD: Glucose-6-Phosphate Dehydrogenase test.

Radiology Tests:

1. ECG: Electrocardiogram.
2. 2D Echo/Stress Echo (>40 years): Evaluates heart function.
3. Chest X-ray PA View: Assesses lungs and heart.
4. USG Whole Abdomen/Pelvis: Ultrasound.
5. USG TVS: Transvaginal ultrasound (if applicable).
6. DTPA Renal Scan: Nuclear Medicine test for kidney function.
7. CT-Renal Angiogram: Visualizes kidney blood vessels.

Clearances:

1. Gynecology Clearance & Pap Smear (for females): Provided by Dr. Poonam Khera, Dr. Alka Sinha, or Dr. Nidhi Khera.
2. Psychiatry Clearance: Ensures mental health readiness.
3. Cardiology Clearance: By Dr. Manish Jain, Dr. Ashitab Tiwari, or other cardiologists.
4. PAC Clearance: Pre-Anesthesia Check-up.
5. Nephrology Clearance: By Dr. Sunil Prakash, Dr. Vishal Saxena, or Dr. Ashwini Goel.
6. Psychologist Clearance: By Dr. Dinika or Dr. Priyanka.

Additional Tests:

1. Medical Meeting: Reviews all test results and ensures readiness for transplant.
2. DNA Fingerprinting: Ensures genetic compatibility.
3. High-Resolution HLA Typing: Detailed HLA compatibility test (if required).
4. Blood Donation: 1 unit required.

Day 7: Document Verification for Kidney Transplant

On Day 7, the focus is on verifying the essential documents for the kidney transplant procedure. This step ensures that all medical, legal, and financial requirements are met for a smooth and compliant transplant process. The hospital’s team meticulously reviews each document to validate the eligibility and preparedness of the patient and donor.

Required Documents for International Patients:

1. Detailed Medical Records: Comprehensive medical history and diagnosis reports.
2. Doctor’s Referral Letter: Indicating the necessity for a transplant.
3. Blood Group Report: Blood typing results for both donor and recipient.
4. HLA Matching Report: Human leukocyte antigen (HLA) compatibility report.
5. Passports: Copies of passports for donor and recipient.
6. Photographs: Recent passport-sized photos of both donor and recipient.
7. Proof of Relationship: Documents proving the relationship between donor and recipient.
8. Medical Visa: Valid medical visas for both parties.
9. Consent Forms: Notarized consent forms from both donor and recipient.
10. Ethics Committee Approval: Clearance from the hospital’s ethics committee.
    

    Kidney Transplant at BLK Max Hospital

Day 8: Report Review and Medical Meeting

On Day 8, the focus shifts to a thorough review of the pre-transplant medical reports. The patient and donor meet with the transplant team, including their respective doctors, to discuss the results of the tests conducted over the previous days. If all reports indicate that both the donor and recipient are fit for the procedure, a formal medical meeting is convened to finalize the details of the transplant. This meeting includes discussions on the surgical plan, post-operative care, and any remaining queries.

However, if the reports reveal any issues, the doctors will prescribe necessary medications or treatments to address these concerns. The goal is to optimize the health of both donor and recipient before proceeding with the transplant. This step is crucial to ensure the highest chances of a successful surgery and recovery. The patient and donor are closely monitored, and follow-up tests are scheduled to re-evaluate their readiness for the transplant.

Day 11: Legal Meeting

On Day 11, the patient and donor attend a crucial legal meeting to finalize the legalities of the kidney transplant. This meeting is essential to ensure all legal requirements and regulations are thoroughly met and documented. Representatives from the hospital’s legal team, along with the transplant coordinator, oversee the session. They review all necessary documentation, including the consent forms, identification proofs, and the comprehensive medical reports for both the donor and recipient.

The primary objective of this meeting is to confirm the voluntary nature of the donation, ensuring there is no coercion or financial inducement involved. Both the donor and recipient are briefed on their rights and responsibilities, and any queries or concerns they might have are addressed. Once all parties are satisfied, the final legal consent is obtained, allowing the transplant to proceed as planned. This step is pivotal in upholding the ethical standards and legal framework governing organ transplantation in India.

Day 12-15: Kidney Transplant Procedure

On Day 12, the transplant date is confirmed, and both the recipient and donor are provided with detailed instructions regarding the procedure. These include dietary restrictions, medications to avoid, and other pre-operative preparations. The recipient is admitted a day before the transplant for final assessments and preparation.

On the morning of the transplant, the patient is transferred to the operating theater. The procedure, which typically lasts around 8 hours, involves the surgical removal of the donor’s kidney and its transplantation into the recipient. The transplant team, including surgeons, anesthetists, and nurses, work together to ensure a smooth procedure. The recipient is closely monitored during and after the surgery to ensure proper kidney function and address any potential complications.

Day 15-22: Post-Transplant Recovery and Monitoring

Following the transplant, both the recipient and the donor are closely monitored for complications and recovery progress. The recipient is observed for 7 days to ensure the transplanted kidney is functioning properly, and the donor is monitored for 5 days for any signs of recovery. During this period, medical staff regularly check vital signs and kidney function. After 10 days, the recipient undergoes stitch removal, and after 3 weeks, a follow-up procedure is scheduled to remove any stents. Both individuals are given instructions for post-operative care, including medications and lifestyle adjustments for optimal recovery.

What is the HLA Matching test?

HLA (Human Leukocyte Antigen) matching in kidney transplant is a critical test that compares the donor’s and recipient’s tissue types. It ensures that both share similar genetic markers, which reduces the risk of organ rejection after the transplant. The better the match, the more successful the transplant will likely be. The HLA matching process involves analyzing specific proteins on the surface of cells to determine compatibility between the donor and recipient. Ideally, a close match between 6 HLA markers (out of 12) is preferred for optimal success.

What is the Cross Matching test?

Crossmatching is a crucial test in kidney transplantation to assess the compatibility between the donor’s and recipient’s immune systems. It involves mixing the recipient’s blood with the donor’s blood to see if there is a reaction. If there is no reaction, it indicates compatibility and the transplant can proceed. However, if there is a reaction, it suggests that the recipient’s body may reject the kidney, and the transplant cannot be performed. This test ensures the safety and success of the transplant procedure.

What is a Medical Meeting?

A medical meeting in kidney transplant refers to a collaborative session where the transplant team, including nephrologists, urologists, surgeons, and other specialists, discuss the patient’s condition and treatment plan. The goal is to assess the patient’s eligibility for a transplant, review diagnostic test results (like HLA matching and crossmatching), and determine the appropriate approach for the surgery. It is a critical step in ensuring that the transplant process goes smoothly and that the patient receives personalized care.

What is a Legal Committee?

A legal committee in kidney transplant refers to a group of legal professionals who review and ensure that the transplant process adheres to all legal and ethical standards. This committee evaluates consent forms, organ donation procedures, and the legality of living donor arrangements. They ensure that all legalities, including donor-recipient agreements and ethical considerations, are properly addressed before proceeding with the transplant. The committee also helps prevent any legal complications that may arise during the transplantation process.

Possible Side Effects of Kidney Transplant –

1. Infection: Immunosuppressant drugs, necessary to prevent organ rejection, can increase the risk of infections.
2. Rejection: Despite the use of immunosuppressants, there is still a risk that the body will reject the new kidney.
3. Cancer: Long-term use of immunosuppressants can increase the risk of developing certain types of cancer.
4. Diabetes: Post-transplant diabetes mellitus (PTDM) can occur as a side effect of some immunosuppressive medications.
5. High Blood Pressure: Hypertension can develop or worsen after a transplant.
6. Bone Thinning: Medications can lead to osteoporosis or weakened bones.
7. Weight Gain: Lifestyle changes and medications can contribute to weight gain.
8. Cardiovascular Disease: Increased risk due to long-term immunosuppressant use and pre-existing conditions.

Do’s and Don’ts After a Kidney Transplant

For the Recipient:

Do’s:

1. Follow Medication Schedule: Take immunosuppressants and other medications exactly as prescribed to prevent rejection.
2. Maintain Hygiene: Practice good hygiene to reduce infection risk.
3. Regular Check-ups: Attend all follow-up appointments and regular health screenings.
4. Balanced Diet: Eat a balanced diet rich in fruits, vegetables, and lean proteins.
5. Stay Hydrated: Drink plenty of water to keep the new kidney functioning well.
6. Exercise: Engage in moderate physical activity as recommended by your doctor.

Don’ts:

1. Avoid Infections: Stay away from crowds and people with infections.
2. No Smoking: Avoid smoking as it can increase the risk of complications.
3. Limit Alcohol: Keep alcohol consumption to a minimum.
4. No Heavy Lifting: Avoid heavy lifting and strenuous activities until cleared by your doctor.
5. Avoid High-Risk Foods: Stay away from raw or undercooked foods that might cause foodborne illnesses.

For the Donor:

Do’s:

1. Follow Recovery Plan: Adhere to the post-surgery recovery plan provided by your healthcare team.
2. Stay Hydrated: Drink plenty of fluids.
3. Healthy Diet: Maintain a nutritious diet to support healing.
4. Monitor Health: Keep an eye on any signs of infection or complications.
5. Light Activity: Gradually increase activity levels as recommended.

Don’ts:

1. Avoid Strenuous Activity: Steer clear of heavy lifting and intense exercise until fully healed.
2. No Smoking: Avoid smoking to promote better recovery.
3. Limit Alcohol: Refrain from alcohol consumption during the recovery period.
4. Avoid Infections: Stay away from environments with high infection risks.
5. No Driving: Do not drive until you have clearance from your doctor.

Success Rate of Kidney Transplant in India

India boasts a high success rate for kidney transplants, generally ranging from 85% to 95% in the first year post-surgery. This impressive success rate is attributed to advanced medical facilities, skilled surgeons, and comprehensive post-operative care. The survival rate of patients and the longevity of the transplanted kidney significantly depend on various factors, including the recipient’s overall health, adherence to medication, and regular follow-ups. BLK Max Hospital in New Delhi is among the top institutions known for its high success rates in kidney transplantation, ensuring patients receive world-class care and support.

Will Insurance Cover Your Kidney Transplant?

In India, most health insurance companies cover kidney transplant procedures. However, coverage details and extent may vary depending on the insurance provider and the specific policy. It is crucial to review your policy documents or consult with your insurance provider to understand the coverage, including pre- and post-transplant expenses, medication costs, and follow-up visits.

Top 5 Insurance Companies in India Covering Kidney Transplant:

1. Star Health and Allied Insurance
2. Religare Health Insurance (Care Health Insurance)
3. ICICI Lombard Health Insurance
4. HDFC ERGO Health Insurance
5. Max Bupa Health Insurance