Kidney transplant in India for international patients: a guide

A kidney transplant in India is possible for international patients, and for most families it means a living donor transplant: a healthy close relative gives one kidney, and usually travels to India with the patient. Before surgery, the hospital’s transplant team must accept the case and a government-approved Authorisation Committee must approve the donor. If the patient is on dialysis, the journey itself also needs careful planning.

This guide walks through each step in plain language, for the patient and for the son, daughter, brother or spouse who is organising everything. It is general information, not medical advice. Only the nephrologists and transplant surgeons who read your reports can say whether a transplant is right for you.

What a kidney transplant is, and who it is for

NHS Blood and Transplant describes a kidney transplant as a treatment for people with long-term kidney failure, also called chronic or end-stage kidney failure. A kidney is taken from one person, the donor, and given to another, the recipient. Kidneys can come from living donors or from people who have died.

Whether a transplant is the right next step is a medical decision. Nephrologists (kidney physicians) look at the cause of the kidney failure, the heart and blood vessels, infections, past surgery and the patient’s general strength. Some patients are advised to stay on dialysis for a while or to treat another problem first. That is why the first step is always to send reports, not to buy a ticket.

Why most international patients plan around a living donor

NHS Blood and Transplant gives several reasons a living donor kidney is often preferred:

• It is more likely to work straight away. Kidneys from living donors are more likely to work immediately and to keep working for longer.
• It lasts longer on average. NHSBT gives an average of 20 to 25 years for a living donor kidney, compared with 15 to 20 years for a kidney from a deceased donor. Every patient is different.
• It can be planned. The operation can be booked in advance and usually happens during the day.
• It can sometimes happen before dialysis. Living donation makes it more likely that a transplant can be done before the patient needs dialysis (a “pre-emptive” transplant).

For a foreign patient there is a second, practical reason: India’s transplant rules, explained next, mean the donor is normally a relative who comes with you.

India’s transplant law: what international families must know

Organ transplants in India are governed by the Transplantation of Human Organs and Tissues Act and the Transplantation of Human Organs and Tissues Rules, 2014. NOTTO, the national organ transplant body under the Ministry of Health and Family Welfare, publishes the Act and Rules on its website. This is what they mean for you, in simple words.

Who can donate

The Rules define “near relatives” as grandmother, grandfather, mother, father, brother, sister, son, daughter, grandson and granddaughter, above eighteen years of age. A spouse can also donate; the Rules deal with spousal donors through their own forms.

Rule 7 says a transplant is not allowed when the recipient is a foreign national and the donor is an Indian national, unless they are near relatives. Rule 20 adds that an Indian living donor who wishes to give to a foreigner who is not a near relative “shall not be considered”. In practice, the donor travels with the patient from home.

NHS Blood and Transplant notes that a donor does not need to be the same age, blood group or tissue type as the recipient. Some Indian hospitals offer transplants across blood groups: Medanta and BLK-Max both list ABO-incompatible kidney transplants on their websites. Whether that is suitable for you is for the transplant team to decide.

The Authorisation Committee

Every transplant where the donor or the recipient is a foreign national needs the approval of an Authorisation Committee, usually the one at the hospital. The main points for families:

• The embassy certificate (Form 21). A senior official of your country’s embassy in India must certify the relationship between donor and recipient. If your country has no embassy in India, your government issues the certificate in the same format.
• A joint application (Form 11) signed by the donor and the recipient.
• A personal interview. The committee meets the donor and the recipient, and the Rules say these interviews are video recorded.
• Extra care for Indian donors. If the donor is an Indian near relative of a foreign patient, the Rules say the case is examined “with greater caution”.
• A quick written decision. The committee must give its final decision within 24 hours of the meeting.

The transplant coordinator at the hospital tells you which papers your family needs. Start with your embassy early, because this is often the step that takes longest.

Step 1: Send the patient’s reports

The hospital cannot give an opinion without recent medical information. Ask your kidney doctor at home for copies of:

• A summary letter from the treating nephrologist, with the cause of kidney failure if it is known
• Recent blood tests, including kidney function (creatinine, urea), blood count, electrolytes and blood group
• Your dialysis details, if you are on dialysis: type, how often, and since when
• Kidney ultrasound and any CT or MRI scans, with the written reports
• Heart tests if you have them, such as an ECG or echocardiogram
• Tests for infections such as hepatitis B, hepatitis C and HIV, if they have been done
• A list of all current medicines
• Basic details of the possible donor (age, relationship, blood group if known)

Photos taken on a phone are fine to start, as long as every page is clear. Send them on WhatsApp to Healway Global and we share them with the transplant teams you choose.

Step 2: The opinion, the donor plan and the written estimate

The nephrology and transplant team reviews the reports and replies with an opinion: whether a transplant seems suitable, which tests are still needed, and whether the proposed donor can be considered. Where the hospital offers it, you can also have a video consultation with the team before deciding.

Then ask for a written estimate. A kidney transplant estimate should cover the recipient and the donor: tests, surgery, hospital stay, early medicines and follow-up visits. Ask what is included and what is not, and what could change the figure. Healway Global never publishes prices on its behalf. We ask the hospital for its own estimate in writing, and you pay the hospital directly. Our own role is explained on the fees page.

Donor evaluation

The donor goes through a full medical check: blood and urine tests, matching tests, imaging of the kidneys, heart tests and a mental fitness assessment (the 2014 Rules include a form for this). NHSBT says a kidney is only removed when doctors judge the short- and long-term risks to the donor to be acceptably low. Some of these tests can be done at home first, if the hospital agrees, to save time in India.

Step 3: Dialysis, the medical visa and travel

If the patient is on dialysis

Travelling on dialysis is possible but it must be organised before you book flights. Kidney Care UK advises giving your kidney team at least three months’ notice before travelling abroad on dialysis, and not booking the trip until a dialysis place is confirmed. The Royal Free Hospital in London says the receiving unit will ask for your dialysis prescription, medication list and blood results, and advises checking your hepatitis B vaccination before you go.

For a transplant trip, ask the transplant hospital whether it will provide your dialysis during the evaluation period and to confirm it in writing, and plan the flight around your dialysis day. Carry enough medicines for the whole stay, plus extra in case of delays, and a letter from your doctor listing them.

The e-Medical visa

India’s official e-Visa portal offers an e-Medical visa for the patient and an e-Medical Attendant visa for family members. The portal says:

• Only two e-Medical Attendant visas are granted per e-Medical visa.
• The visas allow multiple entries.
• You can apply online at least 4 days before arrival, and up to 120 days ahead.
• The patient needs a letter from the Indian hospital on its letterhead, with the date or tentative date of admission.

The donor usually travels as one of the two attendants, so think carefully about who the second person will be. Check the visa validity shown on the official portal when you apply. Healway Global helps you get the hospital letter and plans your arrival; read about our airport-to-airport support.

Step 4: The transplant and the hospital stay

After arrival there are final tests for the patient and the donor, the Authorisation Committee meeting, and then the operation. Your transplant team plans the timing for both of you.

	The recipient	The donor
The operation	The donated kidney is transplanted; your surgeons explain how	One kidney is removed; the St George’s leaflet describes hand-assisted keyhole surgery, and BLK-Max says it uses laparoscopic donor nephrectomy
Typical hospital stay	From 3–4 days to over a week, according to NHSBT; living donor recipients often stay less time	An NHS leaflet from St George’s Hospital gives an average of four days
Early weeks	Clinic visits at least weekly at first, with frequent blood tests	No heavy lifting for 4–6 weeks; usually 3–6 weeks off work, depending on the job

Your own transplant team will give you your plan. NHSBT explains that drips and tubes are removed as soon as possible, usually within one to three days, and that a small stent between the new kidney and the bladder is removed when it is safe, sometimes after leaving hospital.

About the donor’s risks

Donating a kidney is major surgery. The St George’s leaflet states that the risk to the donor’s life is one in 3,000, and lists a very small risk of the donor later developing kidney failure. It also says donors should have their kidney function and blood pressure checked every year for life. The donor should discuss these risks with the transplant team in private, and no one should ever feel pressured to donate.

Step 5: Going home and lifelong follow-up

A transplant is the start of lifelong care, not the end of treatment.

• Medicines every day. NHSBT explains that some anti-rejection (immunosuppressant) medicines are needed for the lifetime of the transplant, such as tacrolimus, mycophenolate and steroids. It is very important to take them exactly as prescribed.
• Regular blood tests. NHSBT says blood tests are needed to make sure the tacrolimus dose is right, and your team will also check how the new kidney is working.
• Clinic visits. NHSBT says most patients attend at least weekly at first and, after a year without serious problems, about every 3 to 4 months.
• A doctor at home. Before you fly back, make sure a nephrologist at home has the hospital’s discharge summary and agrees to share your care.

Ask the Indian team how long they want you to stay nearby after discharge, and how follow-up will work once you are home. Healway Global keeps the line open with the team after you return.

Questions to ask the transplant team

Write these down and take them to your first consultation:

1. Is a transplant the right option for me now, or should I stay on dialysis for a while?
2. Can my chosen relative be considered as a donor? What if our blood groups are different?
3. Which documents do we need from our embassy, and how long does the committee usually take?
4. How long should we plan to stay in India, for the patient and for the donor?
5. Will dialysis be provided during the evaluation, and is it in the written estimate?
6. Which medicines will I take after the transplant, and can I get them at home?
7. How will follow-up work after we fly back?

Hospitals and doctors for kidney transplant

Several JCI and NABH accredited hospitals in and around Gurugram and Delhi run kidney transplant programmes:

• Medanta – The Medicity, Gurugram. Medanta says its kidney transplant programme was established in 2009 and lists blood-group-matched, ABO-incompatible, paired exchange (swap), robotic, paediatric and repeat transplants. Its renal care team includes Dr. Shyam Bihari Bansal.
• BLK-Max Super Speciality Hospital, New Delhi. BLK-Max lists living and deceased donor transplants, ABO-incompatible and pre-emptive transplants, and laparoscopic donor nephrectomy. Its nephrology and renal transplantation department is headed by Dr. Sunil Prakash.
• Fortis Memorial Research Institute, Gurugram. Fortis lists kidney transplants among its services; its nephrology department is headed by Dr. Salil Jain.
• Max Super Speciality Hospital, Saket. The Max team includes Dr. Dinesh Khullar in nephrology and Dr. Anant Kumar in urology and renal transplant.

See all of them on our kidney and transplant page. Choosing between hospitals is your decision; we share opinions and estimates side by side so you can compare.

How Healway Global can help

Healway Global is a medical travel company based in Gurugram, close to the hospitals where our patients are treated. We help families from Nigeria, DR Congo, Chad, Rwanda and many other countries plan treatment in India, step by step.

• WhatsApp first, no forms. Send one message and a real person replies, in English, French or Arabic.
• Only JCI and NABH accredited hospitals. We work with Medanta, Max Healthcare and Artemis, and with others such as Fortis on request. See them on our hospitals page.
• A written estimate before you travel, for the patient and the donor, and you pay the hospital directly.
• Video consultation first, where the hospital offers it, so you can speak to the transplant team before deciding.
• Help with the paperwork. We explain the documents the Authorisation Committee asks for, so you can start with your embassy early, and we help plan dialysis around your travel.
• Airport to airport. We help with the visa letter, your stay, and every day in the hospital, until you fly home.

We never promise outcomes, and we will tell you honestly if we think India is not the best option for you. To start, read how it works, see our guide to liver transplant in India, or simply send us a message on WhatsApp with the reports you have.