Who can donate a kidney in India? Donor rules and tests

A kidney transplant gives a person with kidney failure a far better life than dialysis, and the most common source of a kidney in India is a living family member. If someone in your family has been told they need a kidney transplant, this guide explains who can donate, how the approval works and what the donor goes through. Dr. Aditya P.S. Sengar is Head of Renal Transplantation at Precision Urology Hospital, Lucknow, and has been part of more than 500 kidney transplants.

Who is allowed to donate a kidney in India

Living donation in India follows the Transplantation of Human Organs and Tissues Act (THOTA), 1994, as amended in 2011, and the 2014 Rules. The main points are:

• The donor must be an adult (18 years or older) and must agree freely, without pressure.
• Near relatives can donate. The law lists spouse, father, mother, son, daughter, brother, sister, grandfather, grandmother, grandson and granddaughter.
• Other relatives or friends can donate only out of affection, and only after an Authorisation Committee approves it. The committee checks that no money or reward is involved.
• Swap (paired) donation is allowed. If your relative's blood group does not match you, two families can exchange donors with approval.
• Buying or selling a kidney is a crime. Any offer of payment should be refused and reported.

If no living donor is available, the patient can be registered on the state waiting list for a deceased donor kidney, through the transplant hospital.

The approval process

Before surgery, the transplant team prepares a file for the Authorisation Committee. It usually includes:

1. Identity and address proof for the donor and the patient.
2. Proof of the relationship, such as a marriage certificate, birth certificates or family documents. A DNA test may be asked for when papers are not enough.
3. Photographs and a signed consent form from the donor.
4. A personal interview of the donor and the patient, often with family members, so the committee is sure the decision is voluntary.

The hospital team guides the family through each document, so there is no need to arrange this alone.

Tests a kidney donor needs

Donating is only allowed if it is safe for the donor. The donor work-up checks both kidneys and the donor's general health:

Most donor tests can be finished in a few weeks.

Who usually cannot donate

A person may not be accepted as a donor if they have:

• Diabetes, or high blood pressure that is hard to control
• Kidney disease, repeated kidney stones in both kidneys, or protein in the urine
• Cancer, or a serious heart, lung or liver illness
• An active infection such as HIV or hepatitis
• Severe obesity, or pregnancy at the time

A blood group mismatch does not always rule a donor out. ABO-incompatible transplants are possible with extra treatment before surgery, and swap donation is another route.

The operation and recovery for the donor

The donor's kidney is removed by keyhole (laparoscopic) surgery in most cases, through a few small cuts, so pain is less and recovery is quicker than open surgery. Read more about laparoscopic surgery.

• Most donors walk the same day or the next day and go home in about 3 to 5 days.
• Desk work can usually start again in 2 to 4 weeks. Heavy lifting waits for about 6 weeks.
• The remaining kidney grows slightly and takes over most of the work.

Life with one kidney

Most people with one healthy kidney live a normal, full life. Donors can work, travel, exercise, marry and have children. The donor should:

• Have a yearly check of blood pressure, urine and blood creatinine
• Keep a healthy weight, avoid tobacco and keep blood pressure and sugar in check
• Avoid regular use of painkillers such as diclofenac or ibuprofen unless a doctor advises them