Аполлон ооруканаларында бөйрөктү трансплантациялоо, Лакхнау

Apollo Hospitals Lucknow (Apollomedics Super Speciality Hospital) offers kidney transplantation through an integrated programme that brings together nephrology, urology and transplant surgery, critical care, transfusion medicine, infectious diseases and dietetics under one roof. The following points explain why families across Uttar Pradesh consider the unit for renal replacement therapy.

• A single, coordinated transplant team: nephrologists, transplant and urological surgeons, anaesthetists, intensivists and transplant coordinators work as one unit, so donor work-up and recipient work-up move in parallel rather than one after the other.
• Decades of collective clinical experience: the consultants in the nephrology and urology departments bring several decades of combined practice in dialysis, vascular access, live-donor and deceased-donor transplantation, and post-transplant follow-up. Exact team size and individual profiles change over time and are best confirmed from the hospital's doctor listing or reception.
• The Apollo legacy: Apollo Hospitals began in 1983 and has since grown into one of the largest integrated healthcare groups in Asia. The group has one of the longest-running solid organ transplant experiences in India, and Lucknow patients benefit from group-wide protocols, second opinions and referral pathways.
• Full-spectrum dialysis support: haemodialysis, sustained low-efficiency dialysis (SLED) for unstable patients, continuous renal replacement therapy in the ICU, and peritoneal dialysis ? so a patient is never left without a bridge while awaiting transplant.
• Immunological and laboratory backbone: blood group and HLA typing, crossmatch testing, donor-specific antibody assessment and therapeutic plasma exchange capability, which are essential for ABO-incompatible and sensitised recipients.
• Modern operating and critical care infrastructure: HEPA-filtered modular operation theatres, laparoscopic donor nephrectomy expertise, dedicated transplant ICU beds and isolation facilities for immunosuppressed patients.
• Programmes tailored by age group: paediatric nephrology input for children with congenital or structural kidney disease, and geriatric-sensitive protocols for older recipients with heart disease, diabetes or frailty.
• Legal and ethical compliance: a hospital-based authorisation committee process in line with the Transplantation of Human Organs and Tissues Act and Rules, with transplant coordinators who guide families through documentation, State Authorisation Committee requirements and SOTTO/NOTTO registration for deceased-donor waitlisting.
• Камсыздандыруу жана TPA бөлүмүндө: support with pre-authorisation, cashless processing and CGHS/ECHS/Ayushman Bharat-type scheme documentation where applicable.
• Lifelong follow-up: structured post-transplant clinics, drug-level monitoring (tacrolimus trough levels), infection surveillance and dietary counselling, with teleconsultation options for patients returning to distant districts.

жалпы көрүнүш

Kidney transplant is a life-saving surgical procedure that involves replacing the function of diseased or non-functioning kidneys by placing a healthy kidney from a donor into the recipient. At Apollo Hospitals Lucknow, we aim to be among the most dependable centres for kidney transplant in the region, with a commitment to clinical excellence, advanced technology and personalised patient care. Our team of nephrologists and transplant surgeons uses established, evidence-based techniques and well-equipped facilities to work towards the best achievable outcome for each patient. With a strong focus on patient trust and honest counselling, we provide comprehensive support throughout the transplant journey.

In most transplants the patient's own kidneys are left in place, and the new kidney is placed in the lower abdomen (iliac fossa) and connected to the pelvic blood vessels and the bladder. This is why the procedure is sometimes described as adding a kidney rather than swapping one out.

Бөйрөктү трансплантациялоо эмне үчүн зарыл?

Kidney transplant becomes necessary when a person has end-stage renal disease (ESRD) or advanced chronic kidney disease (CKD), where the kidneys can no longer filter waste and excess fluid adequately. This can arise from diabetes, hypertension, glomerulonephritis, polycystic kidney disease, chronic interstitial disease, obstructive uropathy and, in a proportion of Indian patients, from disease of undetermined cause identified late.

The benefits of a kidney transplant are significant. Unlike dialysis, which requires ongoing treatment and can be time-consuming and exhausting, a successful kidney transplant can restore a large part of kidney function, improve quality of life and, for suitable candidates, improve long-term survival compared with remaining on dialysis. Patients often return to work and normal activities, face fewer dietary and fluid restrictions, and report better overall health. At Apollo Hospitals Lucknow we understand the urgency and are committed to timely, effective care.

Transplant is not suitable for everyone. Active untreated infection, active malignancy, severe uncorrectable heart or lung disease, and situations where a patient is unlikely to be able to take immunosuppressive medicines reliably are all reasons a transplant may be deferred or advised against. This is assessed honestly during work-up.

Кечигип калуу тобокелдиктери

Delaying a kidney transplant can lead to serious health complications. As kidney function declines, toxins accumulate, causing fatigue, nausea, poor appetite, breathlessness and swelling. Prolonged dialysis dependence is associated with vascular access infections, cardiovascular disease, anaemia, and mineral and bone disorder.

Timely treatment matters. Longer time spent on dialysis before transplant is generally associated with less favourable graft and patient outcomes, which is why pre-emptive transplantation ? transplanting before dialysis becomes necessary, usually when eGFR falls below about 15 to 20 mL/min/1.73 m? with progressive decline ? is recommended where a living donor is available. At Apollo Hospitals Lucknow we encourage early referral so that evaluation is not rushed.

Бөйрөктү трансплантациялоонун пайдасы

• Жашоонун сапатын жакшыртуу: most patients report better energy, appetite and the ability to resume work, study and family responsibilities.
• Better long-term survival for suitable candidates: registry data consistently show longer average survival after transplant than on maintenance dialysis, though individual results vary with age and other illnesses.
• Freedom from dialysis: a working graft removes the need for two to three dialysis sessions per week and the associated travel.
• Fewer disease-related complications: better control of anaemia, bone disease and, often, blood pressure.
• Greater dietary flexibility: potassium, phosphate and fluid restrictions usually ease considerably, though salt moderation and diabetes control remain important.
• Restored fertility potential: menstrual regularity and fertility often improve after transplant; pregnancy is possible but must be planned with the transplant team, usually at least a year after a stable graft and on pregnancy-safe medicines.

These benefits come with the lifelong responsibility of immunosuppressive medication, regular blood tests and infection precautions.

Даярдоо жана калыбына келтирүү

Даярдоо боюнча кеңештер

• Consultation: meet the transplant team to discuss medical history, current status and the transplant pathway.
• Pre-transplant evaluation: blood tests, tissue typing and crossmatch, imaging, cardiac assessment, infection screening and dental review to establish eligibility.
• Жашоо өзгөртүүлөр: balanced diet, appropriate physical activity, complete stoppage of smoking, tobacco chewing (gutkha, khaini) and alcohol.
• Колдоо системасы: identify a primary caregiver and a backup, since the first three months require frequent hospital visits.

Калыбына келтирүү боюнча кеңештер

• Кийинки кам көрүү: attend every scheduled review; early visits may be twice weekly.
• Дары сактоо: take immunosuppressants at fixed times, never skip or self-adjust doses, and avoid over-the-counter painkillers and unprescribed herbal or ayurvedic preparations without clearing them with the team.
• Сергек жашоо: continue a sensible diet, gradual physical activity and weight control.
• Бол билдирди: learn the warning signs of rejection and infection and know whom to call.

Our team guides you through each of these steps.

Current Clinical Guidance Followed

Care at the unit is aligned with widely accepted national and international guidance rather than local custom alone.

• Indian Society of Nephrology (ISN India) and Indian Society of Organ Transplantation (ISOT): the ISOT Indian consensus guidelines on the evaluation and management of the living kidney donor and on post-transplant care remain the principal Indian reference, and stress independent donor advocacy, long-term donor follow-up and vigilance for tuberculosis and other endemic infections.
• KDIGO 2020 Clinical Practice Guideline on the Evaluation and Management of Candidates for Kidney Transplantation: this shifted the field away from rigid age and BMI cut-offs towards individualised, risk-based candidate selection, and discouraged routine exclusion of older or obese patients purely on numbers.
• KDIGO 2009 guideline on the care of kidney transplant recipients, with subsequent updates: underpins induction and maintenance immunosuppression, infection prophylaxis and monitoring schedules.
• KDIGO 2024 CKD guideline: reinforces early referral, eGFR and albuminuria-based risk staging, and timely preparation for kidney replacement therapy ? including discussion of pre-emptive transplantation.
• Transplantation of Human Organs and Tissues Act, 1994, with the 2011 amendment and the 2014 Rules: the legal framework governing donor consent, near-relative documentation, authorisation committee approval for non-near-relatives, swap (paired exchange) transplants and deceased-donor allocation through NOTTO, ROTTO and the state SOTTO.
• National Organ Transplant Programme guidance: in recent years domicile-based restrictions on registering for deceased-donor waitlists in another state have been removed, and an upper age bar for registration for deceased-donor kidney transplant is no longer applied ? registration is now based on clinical suitability.

Where evidence is uncertain ? for example the ideal long-term immunosuppression regimen for an individual patient, or the exact benefit of transplant in a very frail elderly candidate ? the team will say so and discuss trade-offs rather than offer false certainty.

Timing of the Procedure and the Pre-Procedure Phase

Living-donor kidney transplant is a planned operation. Deceased-donor transplant is an emergency call that can come at any hour, and the recipient must reach hospital fasting and quickly.

Timelines are indicative. Committee schedules, donor fitness issues and the need for extra cardiac or infection work-up can extend them.

Technique and Donor Options Compared

Which options are available and appropriate for a given patient is decided after work-up and discussed openly.

Procedures Sometimes Performed Alongside

• Native nephrectomy: removal of one or both original kidneys in polycystic kidney disease with no space for the graft, in chronic infection, or in uncontrollable hypertension or troublesome haematuria. It may be done before or at the time of transplant.
• Ureteric stent placement: a temporary JJ stent is commonly placed at the time of the ureter-to-bladder join and removed a few weeks later by cystoscopy.
• Bladder or urinary tract reconstruction: occasionally needed in patients with a small, poorly compliant bladder or posterior urethral valve disease, more often in younger patients.
• Паратиреодэктомия: in long-standing severe hyperparathyroidism, usually staged separately rather than combined.
• Dialysis access ligation: a high-flow arteriovenous fistula may be closed later if it strains the heart; it is usually kept for several months as a safety net.
• Hernia repair or cholecystectomy: only if clinically necessary and safe to combine; usually deferred.

Phase-by-Phase Recovery

Returning to Normal Activity, Work and Exercise

Because the graft sits just under the abdominal wall in the lower abdomen, it is more exposed than a native kidney. Activity advice is built around protecting it.

• басуу: from the first day after surgery, increasing steadily.
• Тепкичтер: usually manageable within one to two weeks, slowly.
• Айдоочулар: generally after four to six weeks, once you can brake hard without pain and are off strong painkillers.
• Desk or office work: commonly six to eight weeks, sometimes earlier from home.
• Manual or farm work, lifting: usually not before three months, and only after surgical review, to reduce the risk of incisional hernia.
• Swimming and gym: typically after three months, once the wound is fully healed and cleared.
• Contact and collision sports: kabaddi, wrestling, boxing, martial arts, rugby and cricket as a wicketkeeper close in carry a real risk of direct trauma to the transplanted kidney and are generally discouraged; if a patient insists, a protective guard and an individual discussion are essential.
• Indian household positions: deep squatting, sitting cross-legged on the floor, and using an Indian-style squat toilet strain the lower abdominal wound. Use a Western-style toilet or a commode chair for at least six to eight weeks, and avoid floor sleeping in the early weeks ? getting up from the floor loads the incision. A firm bed at knee height is easier.
• Religious and social activity: prostration in prayer, large gatherings and temple or mosque visits should wait until at least three months, when immunosuppression doses are lower, because of infection risk.

Protecting the Graft and Preventing Recurrence

• Take tacrolimus or cyclosporine at the same times daily, and have trough levels checked on the schedule given, before the morning dose.
• Control blood pressure and diabetes tightly; post-transplant diabetes is common, especially in Indian patients with a family history.
• Maintain the fluid intake advised by the team, especially in the hot months from April to June, when dehydration can raise creatinine.
• Some original diseases can return in the new kidney, including focal segmental glomerulosclerosis, IgA nephropathy, membranous nephropathy and diabetic kidney disease. Regular urine protein checks help detect this early.
• Avoid NSAIDs such as diclofenac, ibuprofen and nimesulide, unprescribed antibiotics, contrast scans without informing the nephrologist, and unregulated herbal, ayurvedic or homeopathic products, some of which contain heavy metals or nephrotoxic ingredients.
• Be alert to tuberculosis, which is common in India and more likely under immunosuppression; report persistent fever, weight loss or cough.
• Boil or filter drinking water, avoid street food and cut fruit, and wear a mask in crowded places in the first few months.
• Use sunscreen and long sleeves; long-term immunosuppression increases skin cancer risk.
• Vaccinate as advised ? inactivated vaccines only; live vaccines are contraindicated after transplant, so complete them before surgery where possible.

Children and Older Patients

Балдар жана өспүрүмдөр

Transplant is the preferred treatment for children with end-stage kidney disease because it supports growth, schooling and development better than dialysis. Congenital anomalies of the kidney and urinary tract and posterior urethral valves are common causes in India, so bladder assessment is a key part of work-up. Growth, nutrition, immunisation status and school attendance are tracked alongside kidney function. Adolescence carries a well-documented risk of missed medicines, so families and the transplant coordinator plan reminders and supervised transition to adult care.

Улгайган адамдар

Age alone is no longer a barrier. Current guidance supports individualised assessment, and India has removed the earlier upper age limit for deceased-donor registration. Older candidates need careful cardiac evaluation, frailty and cognitive assessment, and a realistic discussion of whether transplant or well-supported dialysis will serve them better. Immunosuppression is often somewhat lighter, because infection risk rises with age. A reliable caregiver is essential.

If You Choose Not to Have a Transplant

Declining or deferring transplant is a legitimate choice, and it should be an informed one.

• Maintenance haemodialysis: usually two to three sessions a week, each three to four hours, with travel time on top. Requires a fistula or permanent catheter and carries risks of access failure and infection.
• Перитонеалдык диализ: done at home, gentler on the heart and better for those living far from a dialysis centre, but requires strict hygiene, storage space for fluid bags and carries a risk of peritonitis.
• Conservative kidney management: for very frail or elderly patients, symptom control, anaemia treatment, diet management and palliative support without dialysis, focused on comfort and quality of life.
• What to expect over time: without kidney replacement therapy, advanced kidney failure progresses to fluid overload, breathlessness, uraemic symptoms and eventually death. Timelines vary greatly between individuals and the team will discuss this honestly rather than give a fixed number.

You can change your mind. Many patients start on dialysis and come for transplant assessment months or years later.

Factors That Influence the Cost of Treatment

Kidney transplant cost is not a single figure. It depends on the clinical situation, and both donor and recipient expenses must be planned for. Apollo Hospitals Lucknow does not publish package prices on this page; for a written estimate specific to your case, please speak with the transplant coordinator or the billing and insurance desk.

Insurance and Cashless Treatment in India

• Most health insurance policies cover kidney transplant as a planned hospitalisation, but coverage depends on the sum insured, the policy wording and how long the policy has been active.
• Күтүү мезгилдери маанилүү. A pre-existing disease clause of two to four years commonly applies. If chronic kidney disease was diagnosed or declared before the policy started, the transplant may fall within that waiting period. Many policies also have a 30-day initial waiting period and specific waiting periods for named procedures.
• Пландалган жана кырсыктан камсыздандыруу: a transplant for chronic kidney disease is a planned medical hospitalisation and is not treated as an accident claim, so accident-only or personal accident policies typically will not respond. Some group corporate policies waive pre-existing disease waiting periods ? check your HR-provided policy document.
• Donor expenses: many policies cover the donor's hospitalisation and surgery under an organ donor benefit, but often only for the harvesting procedure and often up to a sub-limit. Donor pre-work-up, donor complications and donor follow-up are frequently excluded. Confirm this in writing before admission.
• Post-hospitalisation and medicines: immunosuppressants after discharge are usually reimbursed only for a limited post-hospitalisation window, commonly 60 to 180 days. Lifelong medication is generally out of pocket unless you hold an OPD or critical illness rider.
• Cashless process: the insurance desk sends a pre-authorisation request with clinical notes and an estimate to your insurer or TPA. Approval for planned transplant usually takes one to three working days, so submit at least a week before admission. Any enhancement during the stay needs a fresh request.
• Алуучу документтер: health card, policy schedule, government photo ID and address proof for patient and donor, relationship proof, previous dialysis and nephrology records, and employer letter for corporate policies.
• Мамлекеттик схемалар: Ayushman Bharat PM-JAY, state schemes, CGHS, ECHS and railway or PSU panels may apply. Whether the hospital is empanelled for your particular scheme, and what is covered, must be confirmed with the insurance desk before admission rather than assumed.
• Deductions to expect: consumables, non-medical items, room-rent proportionate deductions if you upgrade room category, and co-payment clauses common in senior-citizen policies.

Кирүүнү пландаштыруу жана эмне алып келүү керек

Кабыл алуу алдында

• Complete all legal documentation and authorisation committee approval; the surgery cannot be scheduled without it.
• Arrange accommodation near the hospital for at least four to six weeks after discharge if you live outside Lucknow.
• Identify a full-time caregiver. In joint families, name one primary decision-maker and one attendant so instructions are not lost between relatives; hospitals limit the number of attendants in transplant areas for infection control.
• Arrange blood donors from the family in advance.
• Get dental and any infection treatment finished beforehand.

алып Эмне

• All previous reports, dialysis records, discharge summaries, imaging and current prescriptions.
• Government photo ID and address proof for patient, donor and attendants; relationship documents; passport-size photographs.
• Insurance card, policy copy, pre-authorisation letter, and scheme cards where applicable.
• Loose, front-opening cotton clothing, non-slip slippers, a large water bottle and personal toiletries.
• A notebook or phone app for recording urine output, weight and medicine timings ? this habit continues at home.
• A separate bag for the donor, who will typically be admitted a day earlier and discharged before the recipient.

At home before discharge

• Set up a clean, well-ventilated room, ideally with a bed rather than floor bedding.
• Arrange access to a Western-style toilet or a commode chair.
• Buy a digital thermometer, a BP monitor, a weighing scale and a glucometer if diabetic.
• Fix a pill organiser and phone alarms for medicine times.

Warning Signs That Need Urgent Review

Contact the transplant team or attend the emergency department without waiting for the next appointment if you notice:

• Fever above 38?C, chills, or any unexplained fever lasting more than a day
• A sharp fall in urine output, or sudden weight gain of more than 1 to 2 kg in a day
• Pain, swelling or tenderness over the transplanted kidney in the lower abdomen
• Redness, discharge, gaping or increasing pain at the wound
• Burning urination, foul-smelling or blood-stained urine
• Persistent vomiting or diarrhoea, which can dangerously alter immunosuppressant levels
• Breathlessness, chest pain, or swelling of the legs and face
• Cough lasting more than two weeks, night sweats or unexplained weight loss
• Missed doses of immunosuppressant medicine, or vomiting soon after taking a dose
• New confusion, severe headache or seizure
• Any planned dental work, surgery, contrast scan or new prescription from another doctor ? inform the transplant team first

For Patients Travelling from Outside Lucknow<