Nephrology department is the oldest department of the institute.The Nephrology Department had been assigned a 50 bed clinical unit in 1973.
Primarily it started as dialysis facility for patients with acute renal failure. Peritoneal and hemodialysis facilities which were in their very primitive form in Ahmedabad in those days were gradually upgraded in 1977. With time, the patient load kept on increasing and the facilities were improved upon.
This facility turned out to be the nucleus of the future Institute of Kidney Diseases and Research Center and metamorphosed in to the Department of Nephrology and Transplantation Medicine by 1981.
The department started achieving excellence in areas of clinical nephrology, native renal biopsy program and services with addition of teaching program. Research has evolved well and successfully translated from bench to bedside.
Teaching programs under the banner of National Board of Examinations, New Delhi and Gujarat University were established in 1981. Every year 2 students have been enrolled in D.M. program under Gujarat University and 1 student under the D.N.B. program of National Board.
Thus the institute has gifted at least 64 Nephrologists to the country, 37 qualified as D.M. Nephrology and 27 with D.N.B. Nephrology. Some of them have been acclaimed as good Nephrologists overseas also. The old students of the institute are scattered across all the continents. We have a separate Paediatric Nephrology section in this department established in 1991.
At present the department has 2 clinical units with 60 beds in each unit and 12 residents totally. There is an active teaching program in the institute and we have students coming from all over the country to take advantage of this program. Approximately 7000 new patients and 10100 old patients are treated annually; 5300 new patients are admitted every year.
The institute has busiest dialysis centers in the country with 53 separate centers of dialysis.
These are divided as follows: Central Hemodialysis with 10 units where 9100 procedures are performed annually, infectious diseases hemodialysis has 9 units with about 8300 procedures performed annually and pre-transplant hemodialysis with 7 units handling about 2100 procedures yearly. Patients on deceased donor waiting list are treated in a dedicated area having 4 units handling about 2760 procedures annually; and peritoneal dialysis with 9 units are handling about 1000 procedures yearly. This institute has 2 SLED and 2 CRRT machines in ICU as of the beginning of year 2011. This number may increase in future looking to the needs of liver transplant program.
As time went by, we improvised upon our biopsy program and today we have one of the biggest and best programs in the country with about 1000 native biopsies and 600 renal allograft biopsies performed every year.
Renal transplantation program began in 1979. However initially we were heavily dependent upon surgical skills of friends from McMaster University, Canada and a few other Indian friends. Our first team was trained in 1979. Initial program was erratic and we did not have good results measured in terms of graft and patient survival.
As we moved in to the new premises in 1992, we consolidated our efforts towards improving upon our skills and quality care. Our initial transplantation program had about 40 transplants a year. We had a major breakthrough in 1998 with our research translated in to clinic. It was actually encouraging tips from Prof.
Thomas Starzl and Prof. John Dossetor in 1996 which geared us towards better performance. Today, we can boast to have one of the best transplantation programs of the world and we are pioneers in achieving prope tolerance (achievement of early stable graft function with minimum / no acute rejection episodes using very low dose and minimum number of immunosuppressants) and robust tolerance in renal transplantation.
Cadaver transplantation has always been the express need of Indian patients for a very long time. Patients with end stage renal disease now being identified at an alarming rate of 150 new patients per million every year; are ever increasing in the long waiting lists of patients in need of organs for transplantation.
The reasons are numerous, ranging from genuine non-availability of donors from the families to inherited diseases to non-willing members of the family to donate kidney. The Human Organs Transplantation Act was passed by the Indian parliament in 1994. This act provided the new legal definition of brain death.
Health is state matter therefore the legislative assembly of Gujarat state adopted this legislation 1997. This allowed us to establish renal cadaver transplantation program. So far we have performed 326 cadaver renal transplants.
Stella Mimano, a young African woman aged 32 years contacted the institute after reading about Dr. H.L.Trivedi and his work through the internet. She was impressed with his research on “tolerance”.
She underwent renal transplantation at the institute on 12th November 2000 and went back soon to Nairobi, Kenya after achieving stable graft function on low dose immunosuppression. Word spread in whole of Kenya that there is a center in Ahmedabad, India which gives very good services and excellent results with transplantation.
The cost of Rs. 3,50,000/- (in Indian currency) was amazingly low for them as compared to a transplant worth around US $ 10,000/- at other centers in the world where they had to stay on high dose immunosuppression all their life!
Thus we embarked upon an active transplantation program initiated by an African lady. So far we have transplanted approximately 45 patients from outside India since 2000, most of them belonging to Kenya. We also have treated patients from Uganda, Nigeria and non-resident Indians from U.S., Italy, Dubai and African countries.
We are happy to state that we have been very successful by and large not only in transplanting them but with our tolerance induction protocol, most of them are living a very good quality of life with minimum/no immunosuppression! The prerequisite for foreign patients is that they should bring a donor from their own country and bring the permission of their government authority for transplantation at our center.
We are also having transplantation programme with standard triple immunosuppression. We have a programme of Paired Kidney Transplantation and ABO Incompatible Renal Transplantation.