Nagpur: A 23-year-old IT professional and a 57-year-old railway worker have found new life after an exchange kidney transplant – a trend that is rapidly emerging in central India.
The quick decision of the two families – who had met in hospital – ended this week the eternal wait for a cadaveric organ donation and the dependence on frequent dialysis.
The IT professional had been on dialysis since August 2020 while the railway worker had taken more than two years since 2019 to replace his kidney. The youngster’s father, 54, was ready to donate a kidney to his son, but their blood type did not match. The railway worker’s 54-year-old wife’s blood type did not match despite donating her kidney to her husband. However, the blood type of the female donors matched that of the youngster and that of the railroad employee matched the 54-year-old man.
Dr. Prakash Khetan, a transplant physician and nephrologist at Kingsway Hospitals, said the exchange transplant was the best possible option in this scenario. “Graft exchange is performed when the blood group of the recipient does not match that of the same donor in the family. We are looking for another donor-recipient pair that matches the other pair,” he said.
Although ABO (blood groups) transplant can be done now, it carries a lot of risks. “It is now possible to transplant a kidney even if the blood type does not match. But this requires special treatment before the transplant. There are also increased risks of infection and rejection. Due to the inconveniences, we prefer the exchange transplant over the other options,” said Dr. Khetan.
Dr Shivnarayan Acharya, a transplant doctor and nephrologist at the hospital, said due to the small size of families, organ donation becomes difficult between relatives. “Previously, it was easy to find a compatible donor with the same blood group in large families. The three options – joining the corpse donation waiting list, through ABO and the exchange transplant – were told to the families. They accepted the exchange option,” he said.
Dr Acharya added that families are properly informed of the risks. “Sometimes it may not be successful in a patient. Families are therefore asked to accept all these possibilities, in case they arise,” he said.
Dr Khetan added that families also need to understand each other. “Yet it also emotionally brings together two families who support each other,” he said.
Dr. Vishal Ramteke, a nephrologist and transplant doctor, said the central India nephrologist group keeps a record of those pairs whose blood types do not match. “Swap is governed by an authorization committee led by the Dean of GMCH, legal counsel, nephrologists, DHOs and urologists,” he said.
Dr Ramteke said sometimes families are reluctant because of the age difference between donors and recipients.