Swap kidney transplant gives new lease of life to two patients

 New Delhi: A 43-year-old woman from Aligarh and a 58-year-old man from Kushinagar received new lease of life following a paired exchange of kidney transplants at a hospital in Faridabad.

In a swap transplant, two incompatible pairs become compatible if their donors are swapped, making it beneficial for both patients,and it is legally allowed.

The procedure makes use of two donors to give organs to two transplant candidates as the original recipient or donor pairs are unable to do so with each other, said Reetesh Sharma, Director, Nephrology, and Kidney Transplant Medicine at Asian Institute of Medical Sciences (Asian Hospital), where the surgeries took place.

The patient, Dharamwati (name changed), suffering from chronic kidney disease for the past few years started dialysis in March 2021. She visited the hospital for a second opinion, a statement issued by the hospital said.

After reviewingher condition, the doctors explained to her the benefits of a kidney transplant over dialysis. During this time, her mother came forward as a wilful blood group matched donor. However, destiny had it otherwise as her mother’s medical evaluation revealed a subnormal kidney function, hence, she was rejected on medical grounds, the statement said.

Thereafter, her husband offered to donate his kidney, but his blood group was B against Dharamwati’s A which made the transplant blood group incompatible.

The doctors explained that either a blood group incompatible or a paired exchange (swap) transplant can be performed. While AIMS routinely performs blood group incompatible transplants, the procedure entails higher costs and a slightly increased risk of organ rejection in the initial days following surgery. The family opted to wait for a swap kidney transplant, it stated.

Reetesh Sharma said the swap transplant procedure makes use of two donors to give organs to two transplant candidates as the original recipient or donor pairs are unable to do so with each other.

Luckily for Dharamwati, the wait was not too long. Jitendra Tiwari, who hailed from Kushinagar in UP, came to AIMS with his wife seeking a kidney transplant and also as a prospective donor.

The couple shared blood groups that were opposite of Dharamwati and her husband making them a perfect swap pair.

Post completion of the necessary medical evaluation, the hospital sought approval from appropriate government agencies, and these unique transplants were performed in the first week of January, the statement said.

Sharing details about the procedure, Rajiv Kumar Sethia, Associate Director and Head, Urology and Kidney Transplant said the surgery was highly complicated and it took nine hours to complete both transplantations, involving two laparoscopic donor nephrectomies and two recipient allografting in which one donor was having two renal arteries instead of one.

A month after the transplant, both the patients and their donors are doing well, the statement said.

According to the transplant team, both the patients will be able to lead a normal life without any more worries about regular dialysis.