Kidney Transplant Eligibility: Who Can Receive or Donate a Kidney?

One of the first questions families ask is, “Are we eligible for a kidney transplant?” The answer depends on much more than age or blood group.

In this blog, I will share all the required information about kidney transplant surgery to clear all common doubts from the audience.
The transplant team considers the complete health profile of both the recipient and donor before deciding whether transplantation can proceed safely.

A kidney transplant is an operation in which a healthy kidney from a living or deceased donor is placed into a person with kidney failure.

The transplanted kidney takes over essential functions such as filtering waste, removing excess fluid and maintaining the body’s chemical balance. A transplant is a treatment for kidney failure, not a cure.

A donated kidney may come from:

• A living relative
• A spouse or partner
• A friend or another approved living donor
• A deceased organ donor

A kidney transplant may be considered for people with advanced, permanent kidney disease or kidney failure.
The central question is not simply whether the kidneys have stopped working. Doctors must also determine whether the expected benefits of transplantation outweigh the risks for that particular patient.
KDIGO recommends assessing the individual’s total medical risk rather than judging suitability from one condition alone.

• Have advanced chronic kidney disease or kidney failure.
• Be medically fit enough for major surgery.
• Have a reasonable chance of benefiting from the transplant.
• Be able to take anti-rejection medicines consistently.
• Attend regular blood tests and follow-up appointments.
• Understand the risks and responsibilities of transplantation.

A person does not always need to start dialysis before being evaluated for a kidney transplant. Early referral may allow transplantation before long-term dialysis becomes necessary.

• Active or recently treated cancer
• Serious uncontrolled infection
• Severe heart, lung or blood vessel disease
• Ongoing substance misuse
• Uncontrolled psychiatric illness affecting treatment adherence
• Inability to take medicines or attend follow-ups consistently
• Other medical conditions that make major surgery excessively risky

These are not always permanent reasons for exclusion. For example, a person with an infection may become eligible after successful treatment.

Myth: Older adults cannot receive a kidney transplant.

Fact: Age alone does not automatically determine eligibility. Overall health, fitness for surgery and expected benefit are more important.

A potential living kidney donor should generally:

• Be at least 18 years old
• Make the decision freely and without pressure
• Have healthy kidney function
• Be medically and psychologically fit
• Have suitable kidney and blood vessel anatomy
• Have no serious transmissible infection
• Have no condition that creates an unacceptable future health risk

Conditions that may prevent donation or require further specialist evaluation include:

• Diabetes or abnormal glucose tolerance

• Significant or poorly controlled hypertension

• Reduced kidney function

• Excess protein in the urine

• Serious heart or blood vessel disease

• Significant chronic lung disease

• Severe obesity

• Active or recently treated cancer

• Certain kidney stones or kidney abnormalities

• HIV or other transmissible infections

• A history of blood clots

• Psychological concerns that affect voluntary consent or safety

Wanting to help is deeply valuable, but the transplant team must protect the donor from avoidable harm.

The donor and recipient don’t always have to share the same blood group, but they must be medically compatible or appropriate for a specialised transplant pathway.

Compatibility testing usually includes:

• ABO blood group testing
• Human leukocyte antigen, or HLA, typing
• Antibody testing
• Crossmatch testing

A crossmatch checks whether the recipient’s immune system is likely to react strongly against the donor kidney.

Yes. Indian law allows living kidney donation from near relatives, spouses and, in selected situations, people who are not near relatives.

Tests for the recipient

The evaluation may include:

• Blood group and tissue typing
• Antibody and crossmatch testing
• Complete blood tests
• Infection screening
• Heart and lung assessment
• Cancer screening, where appropriate
• Imaging of blood vessels
• Psychological and social evaluation

Tests for the donor

A potential donor may undergo:

• Kidney function tests
• Urine testing
• Blood pressure and diabetes screening
• Infection testing
• Heart and lung evaluation
• CT imaging of the kidneys and blood vessels
• Psychological assessment
• Independent consent evaluation

Kidney transplant eligibility cannot be decided by age, blood group or one laboratory result alone. Recipients must be fit enough to benefit from transplantation, while living donors must be carefully protected from unacceptable short-term and long-term risks.

Considering a kidney transplant or living donation? Consult an experienced nephrologist and transplant team for a complete eligibility assessment, compatibility testing and clear guidance on the next steps.

Learn about the transplant team, hospital facilities and available support on the Kidney Transplant Care in Thane service page.

Name: Horizon Prime Hospital in Thane

Address: Vibgyor, Ghodbunder Rd, near Hiranandani Estate, behind Ritu Nissan Showroom, B Wing, Patlipada, Thane West, Thane, Maharashtra 400607

Phone: 022 6855 6855

Website: prime.horizonhospital.com