Non-Blood Group Matched Kidney Transplants Now Possible

Chandigarh, April 25, 2014: Kidney failure requiring dialysis affects 2 to 3 lakh people in our country every year. The long term healthier and cheaper option for these patients is kidney transplant. The source of a kidney is either a related donor or cadaver donor, means accidental brain dead donor. Blood groups need to match when human organs are transplanted from the donor’s body to that of the recipient and almost 40% of Kidney failure patients do not have relatives with matching blood group. But, doctors at Ivy Hospital Mohali have proved that it's possible to save a patient in the city even if a donor with a matching blood group cannot be traced.

 ABO incompatible transplant is a relatively new concept with just a handful of cases having being done in India. Ivy Hospital, Mohali has started the ABO incompatible transplant programme. The doctors have done two such cases successfully in the last one month. Both the cases have been discharged successfully with normal Serum Creatinine. The first patient, Lakhwinder Singh, with failing kidneys, had been surviving on dialysis for almost a year and a half. Doctors had suggested a kidney transplant. Though his family members were ready to donate the organ, doctors found that none of their blood groups matched that of Lakhwinder, who was of blood group O.

 Unable to find a donor with a matching blood group, patient’s family had lost all hopes. But determined to give Lakhwinder a new life, Dr Raka Kaushal, Director, Department of Nephrology and Dr Avinash Srivastava Director, Renal Tranplant Surgery at Ivy Hospital Mohali, broke the barrier by conducting an ABO incompatible (non-matching) transplant successfully. It was Lakhwinder’s wife who had Blood group AB, donated one of her kidneys and saved her husband. This is rarest of cases even in incompatible transplants and few. Transplant programmes would accept the challenge of doing these cases from AB to O blood group donation.

 Dr Kanwaldeep, Medical Director, Ivy Hospital said, “Though countries like Japan and South Korea conduct such non-matching kidney transplants regularly, doctors in India have been shying away from their cumbersome procedure. With this milestone Ivy Hospital has become a part of the handful elite club of hospitals in the country providing  this cutting edge treatment.”

In normal transplants, a patient needs to be admitted to the hospital two days before the procedure. But Singh was admitted one week prior to the transplant, which took place on April 12. He had to undergo a special treatment for removal of antibodies. Doctors said that the first five days  post surgery were critical as rejection if at all normally happens within that period.

Addressing a press conference at Chandigarh Press Club here on Thursday, Dr Raka Kaushal said, "After filtering out the antibody, with a process of  Plasmapheresis, the patient was given injections to suppress antibody production. The transplant was conducted after the patient underwent this procedure to rule out chances of rejection.”

Doctors said that with new technologies, the result of cross transplant done under expert hands could be as good as that of a normal transplant. The only hiccup is that the cost is higher that a normal transplant since it entails special techniques and medicines. But, for a patient with no ABO matching donors, the costs of prolonged dialysis, while waiting for a cadaver transplant and the risks of dialysis, more than nullify the extra cost of an ABO-incompatible transplant. Also with time and increase in number of such procedures the costs are likely to come down significantly. Dr Varun Hatwal, MD (Pathology) and Mr Santosh Kumar Singh, Operations Manager, Renal Sciences Dept also addressed the media.