Kidney transplant or dialysis: Sad dilemma for financially weak

Farmer Sunil Shinde and his family sold their four-acre plot to undergo kidney transplant six months ago. He needs a repeat transplant for not being able to afford expensive post-care


When Anita Shinde sold their four-acre agricultural land for her husband’s kidney transplant, little did she know that this would come to nought. Sunil, a 41-year-old farmer from Varud village in Ahmednagar district, needs yet another kidney transplant as the previous procedure could not meet with success due to medical complications.

“He was undergoing dialysis for the past two years. We made the decision for kidney transplant as we were not able to afford long-term dialysis,” said Anita, adding, “Now that the transplant has failed, he is on dialysis again. We are left with nothing after selling our land for the transplant.” Sunil is undergoing treatment at Ruby Hall Clinic, Pune.

With some support coming from the CM fund and proceeds from the land they sold, the Shindes were able to raise around Rs10 lakh for the transplant. Just as they were losing hope before the upcoming procedure, the hospital stepped in and has assured to treat Sunil free of cost.

Sunil is among the lucky few to have help coming at the right time. The Ministry of Health estimates that the annual requirement for kidney transplant in India could range between 1-2 lakh. While only about 5,000 transplants occur, the numbers are alarmingly low when it comes to cadaver transplants. Another challenge is the staggering cost for transplants and post-operative care, something that most people cannot afford.

Doctors said that since a large section of people cannot afford post-operative management, they advise against kidney transplant. Dr Abhay Sadre, nephrologist from Ruby Hall Clinic, Pune, said, “There are many trusts that offer financial help for undergoing a transplant, but they are not offering any help for post-operative expenses. After undergoing transplant one must take immunosuppressants. As these drugs are costly, many cannot afford them and so doctors do not advice kidney transplant for patients who cannot afford post-operative management.”

While some charitable trusts offer dialysis facilities, these are rare in rural areas. “There are some patients who we suggest to remain on dialysis as it does not affect life expectancy. But if quality dialysis is not available, kidney transplant may be the only option. However, we do not suggest transplant for those who cannot ensure sanitised environment and post-operative care for the patient. The government and trusts need to step in and ensure help with post-operative costs,” added Dr Sadre.

Doctors added that there is an urgent need to make organ transplants more affordable. At present, non-cadaver organ transplants can cost anywhere between Rs5-6 lakh and cadaver organ transplant between Rs6-7 lakh.

Surekha Joshi, a medical social worker from Pune, said, “We often get frustrated when people come to us after transplant when their kidney has failed again, because they did not take medicines because of lack of money. There are patients who cannot seek the entire aid and then take some loan for the transplant.”