On dialysis and considering transplant options? Pre-emptive transplant before dialysis gives the best outcomes — speak to our transplant team early, not after years on dialysis.
A successful kidney transplant gives better survival, better quality of life and better long-term outcomes than lifelong dialysis. Living donor transplantation — especially pre-emptive, before dialysis begins — gives 5-year graft survival of 85–90%. Our transplant programme at a kidney transplant hospital in Ahmedabad covers the complete journey: evaluation, surgery, immunosuppression and lifelong graft care.
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A successful kidney transplant at a specialised kidney transplant hospital is the closest thing to restoring normal kidney function. A transplanted kidney works continuously — 24 hours a day, 7 days a week — filtering the blood, regulating fluid balance and producing hormones that dialysis cannot replicate. Transplant recipients have a 50–70% lower mortality risk compared to matched patients remaining on dialysis, significantly better quality of life and freedom from the 3-times-weekly dialysis schedule.
Living donor kidney transplantation — using a kidney from a willing, healthy family member or spouse — offers better outcomes than deceased donor transplant: scheduled surgery at the optimal time, shorter cold ischaemia, better tissue matching and the option of pre-emptive transplant before dialysis is ever needed. The donor evaluation process is thorough and guided by an experienced kidney transplant surgeon to confirm that donation is safe, voluntary and in the donor’s long-term best interest. Our programme is fully compliant with the Transplantation of Human Organs and Tissues Act (THOTA).
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Kidney transplant evaluation should begin early — ideally when CKD reaches Stage 4 (GFR 15–30), not only when the patient is already established on dialysis. Early referral opens the pre-emptive transplant window.
GFR below 20 ml/min is the trigger to begin transplant workup — not below 10 when dialysis is urgent. Starting workup early allows time for a thorough recipient evaluation, donor identification and pre-emptive transplant before dialysis begins. Do not wait until you are on dialysis to ask about transplant.
Every patient on dialysis who is medically fit for transplant should be on the deceased donor waitlist — regardless of whether a living donor is available. Waitlist time accumulates from registration date. Register early, review regularly, keep the transplant team informed of any change in medical status.
If a family member or spouse is willing to be considered as a living donor — contact the transplant team immediately. Donor evaluation takes 6–12 weeks. The earlier the evaluation begins, the more likely pre-emptive transplant can be achieved before dialysis is needed.
Fatigue, fluid restriction, dietary limitations, 3-times-weekly dialysis sessions and the psychological burden of ESRD — if quality of life on dialysis is significantly impaired, transplant evaluation should be a priority. Transplant recipients report dramatically better quality of life compared to dialysis within months of a successful transplant.
Uncontrolled hypertension and diabetes on dialysis accelerate cardiovascular risk and reduce transplant candidacy over time. Optimising these before transplant workup gives better surgical outcomes and better graft longevity. Do not delay evaluation — but begin optimisation in parallel.
CKD Stage 4 (GFR 15–30) is the right time to have the transplant conversation — not Stage 5 or dialysis. A transplant workup completed at Stage 4 means all paperwork, crossmatch and donor evaluation are done in advance, enabling rapid progression to transplant when GFR reaches the threshold.
Patients who have lost a previous transplant can be evaluated for re-transplantation. Higher sensitisation (panel reactive antibody — PRA) from the previous graft makes crossmatch more challenging but not impossible. Re-transplant outcomes are slightly lower than first transplant but remain superior to remaining on dialysis.
Patients with polycystic kidney disease, Alport syndrome, primary hyperoxaluria or other hereditary nephropathies should discuss transplant planning early — including implications for family members as potential donors and genetic counselling for inheritance risk to offspring.
A kidney transplant guided by an experienced kidney transplant surgeon is not a single event — it is a journey from evaluation through surgery to lifelong graft care. Understanding each step reduces anxiety and helps families prepare fully.
A kidney transplant hospital in Ahmedabad is only as strong as its pre-transplant preparation, surgical expertise, immunosuppression management and long-term surveillance. All four must be strong.
Senior Consultant Transplant Urologist & Kidney Transplant Surgeon — Trayam Hospital
Dr. Renish Patel leads the kidney transplant programme at Trayam Hospital — overseeing recipient evaluation, donor workup, transplant surgery and post-transplant immunosuppression management. The programme philosophy is patient-centred: pre-emptive transplant wherever possible, thorough preparation before surgery, prompt biopsy protocol for any graft concern and structured lifelong surveillance to maximise graft longevity.
Too many patients with end-stage kidney disease spend years on dialysis without ever being formally evaluated for transplant. The conversation is not initiated, the workup is not started, and the window for pre-emptive transplant is missed entirely. Transplant is not an option of last resort — it is the best treatment available for eligible patients with ESRD, and the evaluation should begin at CKD Stage 4.
We initiate transplant workup when GFR falls below 20 ml/min. Pre-emptive transplant before dialysis is the best outcome for eligible patients with a living donor — and it requires early preparation.
Living donor evaluation begins as soon as a willing donor presents — regardless of recipient GFR at the time. The donor's evaluation timeline does not need to match the recipient's. Starting early maximises the chance of pre-emptive transplant.
Any unexplained creatinine rise above baseline by 20% is investigated with renal biopsy within 24–48 hours. Acute rejection treated early is reversible in 90% of cases. Delayed diagnosis risks irreversible graft loss.
On dialysis? CKD Stage 4? Have a willing donor?
The earlier you come to us, the more options are open. Bring your recent blood results, dialysis summary or nephrologist letter — our transplant team will give you a complete, honest assessment of your options.
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The transplant operation gives you a new kidney — how long it lasts depends almost entirely on what you do in the years that follow. These are the evidence-based steps that protect your graft.
Patients with ESRD (GFR below 15 ml/min) — on dialysis or approaching it. Requires absence of active malignancy, uncontrolled infection or significant cardiovascular disease making surgery unsafe. Age alone is not a contraindication. Formal transplant workup determines individual suitability.
Living donor — from a healthy family member or spouse; 85–90% 5-year graft survival; pre-emptive option; scheduled surgery. Deceased donor — from a brain-dead individual via NOTTO waitlist; slightly lower graft survival but superior to dialysis. Living donor is preferred when available.
Yes — thoroughly selected donors face no increased long-term kidney failure risk. Remaining kidney compensates to 70–75% of original function. Laparoscopic donor nephrectomy — minimal morbidity, return to work in 3–4 weeks. Donors monitored annually for life.
Lifelong tacrolimus + mycophenolate + prednisolone. Doses adjusted by drug levels and renal function. Anti-infective prophylaxis for first 3–6 months. Antihypertensives, aspirin, bone protection as indicated. Missing doses risks acute rejection.
Acute cellular rejection — rising creatinine, diagnosed by biopsy — treated with IV methylprednisolone, 90% reversal if caught early. Antibody-mediated rejection — plasmapheresis, IVIG, rituximab. Any creatinine rise above baseline requires biopsy without delay.
Living donor kidneys — median 15–20 years. Deceased donor — 10–10 years. Some function 25–30 years. Longevity maximised by blood pressure control, diabetes management, immunosuppression compliance and annual surveillance.
Transplant performed before dialysis begins (GFR 10–15 ml/min). Only possible with living donor. Better graft survival and rehabilitation than post-dialysis transplant. Requires early referral — start workup at GFR 20.
Governed by THOTA. Near relatives can donate with hospital Transplant Authorisation Committee approval. Unrelated donors require State Authorisation Committee approval. Trayam’s team manages the complete legal process — donor evaluation, ethics review and authorisation documentation.
Yes — transplant surgery and hospitalisation are covered by PMJAY and most major Indian health insurance policies. Post-transplant immunosuppression under standard drug coverage. Trayam is empanelled with all major insurers and government schemes.
Yes — most transplant recipients return to full-time work, travel, exercise and normal social life within 3–6 months. Restrictions: avoid NSAIDs, use SPF 50+ sunscreen daily, take immunosuppression at the same time every day, attend annual review. The vast majority of patients report dramatically better quality of life compared to dialysis.
Bring your recent blood results, dialysis summary or nephrologist letter. Our transplant team will give you an honest, complete assessment — including whether pre-emptive transplant is still possible.
