Nephrology and kidney transplantation in India: Past, present and future

Chronic kidney disease (CKD) has been recognized as a major global public health problem. The approximate prevalence of CKD in India is 800 per million populations (pmp). Kidney transplantation is considered as the best therapeutic modality for patients suffering from end stage renal disease (ESRD). Transplantation started in 1953 in Europe and USA and in India it started in 1965. The awareness of deceased donor organ transplants, cross-over transplants and other organs like liver and heart is also gradually increasing with Tamil nadu leading the country in deceased donor organ transplants. The alternative to post-transplant immunosuppression and associated problems is 'transplant tolerance' which means stable graft function with no immunosuppression while keeping immune system of the host intact. We at Ahmedabad have pioneered the technique of in vitro generation of human adipose tissue-derived mesenchymal stem cells (AD-MSC) and T-regulatory cells. Once again we have pioneered (in the world) the infusion of these cells along with hematopoietic stem cells in renal allograft recipients. Abrogation of antibodies using Bortezomib again established by our group in Ahmedabad which is now universally being adapted has improved renal transplant outcomes. This review briefly takes the reader to evolution of nephrology and kidney transplantation in India and shows that we have bright future!