A Perfect Marriage of Convenience for Swap Kidney Transplant in AIMS

Faridabad / New Delhi:  It was a perfect marriage of convenience between two unknowns, so to speakThe desperate quest of patients for kidney ended most happily in Asian Institute of Medical Sciences (AIMS), with swap transplant coming in handy.

A 43-year-old lady from Aligarh and a 58yrs old gentleman from Kushinagar receive a new lease of life at the hands of a highly experienced kidney transplant team of India at the Asian Institute of Medical Sciences (Asian Hospital), Faridabad.

Mrs. Dharamwati (name changed) suffering from chronic kidney disease for the past few years was initiated on dialysis in the month of March 2021. The patient visited Asian Hospital for a second opinion. After reviewing the patient’s condition, the doctors explained to her the benefits of a kidney transplant over dialysis. Convinced, 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. Thereafter, her husband offered to donate his kidney, but his blood group was B as against Dharamwati’s A which made the transplant blood group incompatible.

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

Speaking about the swap kidney transplant, Dr.Reetesh Sharma, Director, Nephrology, and Kidney Transplant Medicine, Asian Hospital said, “In a swap transplant, two incompatible pairs become compatible if their donors are swapped, making it beneficial for both patients and is legally allowed.” The procedure makes use of two donors to give organs to two transplant candidates as the original recipient/donor pairs are unable to do so with each other, he further added.

Luckily for Dharamwati, the wait was not too long. Jitendra Tiwari hailing from Kushinagar (UP) seeking a kidney transplant came to AIMS with his wife as the 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 2022.

Sharing the details about the procedure, Dr. Rajiv Kumar Sethia, Associate Director & Head, Urology and Kidney Transplant said, the surgery was highly complicated and took nine long hours to complete both transplantations involving 2 laparoscopic donor nephrectomies and 2 recipient allografting in which one donor was having 2 renal arteries instead of one. A month after the transplant, both the patients and their donors are doing wonderfully well.

According to the transplant team, both the patients will be able to lead a normal life without any more worries about regular dialysis. The patients’ families expressed their gratitude towards Dr. Sharma, Dr. Sethia, and their team at Asian Hospital.

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