For the first time in Telangana, kidneys were swapped between two unrelated families and organs were transplanted to patients admitted in two different hospitals. In earlier cases, the organs were swapped when the patients were admitted in the same group of hospital. This is first case of inter-hospital swap renal transplantation procedure. It was initiated between Krishna Institute of Medical Sciences (KIMS) and The Deccan Hospital.
Explaining significance of swapping organs between donors and patients in different hospitals, senior nephrologists from Hyderabad said when organ exchange is taken up in same hospital, number of donors will be less. But the donor pool increases when the swapping can be taken up between hospitals. One of the patients B Raju (37) from Jayashankar-Bhupalaplly district, got to know his kidneys failed in May 2016 and he consulted doctors at KIMS where he underwent dialysis too.
His blood group was A+ and his wife B Sunitha’s blood group is B+. Blood groups of donor and recipient should match for transplantation to be taken up. Since Raju’s and Sunitha’s blood group did not match, the process could not be taken up.
In another case, B Mallaiah (55) from Mancherial district suffered from Autosomal Dominant Polycystic disease and his kidneys had to be removed too. He was undergoing treatment at The Deccan Hospitals, Somajiguda. While his blood group was B+, his wife Padma’s has A+ blood. In their case too, there was mismatch of blood group between donor and recipient. According to The Transplantation of Human Organs (Amendment) Act,2011, in such cases, organs and tissue of both can be removed and transplanted after seeking permission from Authorisation Committee.
In this case, the process of swapping the organs started when Dr Pavan Kumar Rao, consultant nephrologist at The Deccan Hospital, who was attending Mallaiah, called up his friends who are nephrologists in other hospitals to ask if they too have a case of mismatch. Dr E Ravi, consultant nephrologist at KIMS informed that they too have a case where blood groups of donor and recipient did not match.
When checked, they got to know that blood groups of one set of donor-recipient is: Mallaiah (B+)-Padma(A+), and another couple Raju(A+)-Sunitha(B+). The doctors and the couples started paper work to get permission from Authorisation Committee, from June 2017. They received permission four months after application. Finally, the transplantation was taken up on March 14, 2018 and doctors started and ended the procedure at the same time. The patients underwent the procedure at hospitals where they opted for medical consultation.
Taking kidneys from donors and transplanting it to two patients had to be taken up at same time and communication had to be clear. “Lets say the procedure was started and completed on one patient and in another case it could not be taken up because of some problem. There is always a chance for the family (who did not benefit) to question why was the kidney harvested from them when they did not benefit from the procedure. To cut out this problem, we used Skype.
Every step in the procedure-giving anesthesia to donor and recipient, taking kidney out of donors, transplanting the organ in recipients was initiated at same and completed at same time,” said Dr SV Subhramanyam, consultant nephrologist at Deccan Hospital. Dr KS Nayak, chief nephrologist at KIMS said that if more hospitals take up this practise of swapping organs, more chronic renal failure patients will benefit from the procedure.
‘Diabetes, Hypertension prime reasons for kidney failure’
Diabetes and Hypertension are prime reasons for kidney failures, say senior Nephrologists. They urged people to keep a tab on the disease and undergo regular check-ups to avoid complications. Nephrologists say one can prevent kidney failure by ensuring regular exercise, eating fresh vegetables, consuming less junk and salt.