Dr. Sanjeev GulatiSr. Consultant , Nephrology

Department of Nephrology & Transplant Medicine, Fortis Hospitals, Vasant Kunj, New Delhi - 110070, INDIA

Mob No. +91-98716-00885Fax No. +91-11-4277-6221Ph. No. +91-11-4277-6221Log onto - www.kidneyklinic.com

ABO Incompatible

Kidney Transplant

The multidisciplinary transplant team- Fortis Institute of Renal Sciences and Transplantation (FIRST) of Fortis Flt Lt Rajan Dhall Hospital, Vasant Kunj, recently undertook an ABO incompatible transplant on Mr. Dwarika Prasad, 50 yrs Bihar resident. He was on dialysis with no blood group compatible donor.

Dwarka prasad with blood group O +ve is successfully transplanted with the kidney donated by his wife having blood group B +ve under the observation of Dr S C Tiwari, Director Nephrology and Renal Transplantation & Dr. Sanjeev Gulati, Additional Director Nephrology and Renal Transplantation.

Routinely successful transplants are where both the blood group of the donor and recipient are compatible. However if the person receiving the kidney has an incompatible blood group with the donor, the kidney is usually rejected by antibodies to the donor’s blood type. This has meant that transplants could not be performed between blood group incompatible donor and recipients. ABO incompatible transplant has allowed certain patients to receive a blood group incompatible kidney transplant with good initial survival of the kidney transplant. Two latest techniques which made it possible are use of Immuno suppressions & Plasmapharesis where the plasma is exchanged on alternate days for around 10 days suppressions & Plasmapharesis where the plasma is exchanged on alternate days for around 10 days before the transplant and for 2-5 days after the transplant takes place to maintain the antibodies to avoid the rejection to the kidney by the body.

According to Dr. Sanjeev Gulati Additional Director Nephrology and Renal Transplantation at Fortis Flt. Lt. Rajan Dhall said “The only risk involved is losing the kidney immediately at the time of the operation due to rejection. This does happen occasionally in ABO incompatible transplantation. The risk is higher than with an ordinary transplant. The risk of rejection after surgery applies to all transplants, but we expect this risk to be slightly higher in ABO incompatible transplants. Again it is difficult to be certain about the exact risk, but we would expect that at least 70 out of 100 of transplants would be working a year after surgery (compared with 90 or 95 out of 100 after ordinary living donation).Though the cost goes up by three times (compared with 90 or 95 out of 100 after ordinary living donation).Though the cost goes up by three times than a ordinary transplant but still it’s a permanent solution for patients on dialysis”.

As per Human Organ Transplant Act, donors should be close relatives of the recipient. There is a vast gap in the number of patients awaiting transplant and the number of kidney donors’ available. Around 35% of patients have a close relative who is willing to donate a kidney however is not able to donate as blood group is different. Donor unavailability due to the reasons often forces patients to remain on dialysis so ABO incompatible transplantation has shown a new ray of hope for the patients living on Dialysis.

Successful ABO Incompatible Kidney Transplant

Dr. Sanjeev GulatiSr. Consultant , Nephrology

Department of Nephrology & Transplant Medicine, Fortis Hospitals, Vasant Kunj, New Delhi - 110070, INDIA

Mob No. +91-98716-00885Fax No. +91-11-4277-6221Ph. No. +91-11-4277-6221Log onto - www.kidneyklinic.com