Sachin (name changed) a 33-year-old working at a private company in Bangalore was diagnosed with chronic kidney failure in 2016 and remained on dialysis for 3 years. He did not go for a kidney transplant despite his mother being ready to donate a kidney due to lack of awareness about blood group incompatible transplant. Looking at the challenges and pain of the patient during dialysis Dr. Girish N S advised him to undergo ABO Incompatible kidney transplant. The family was impressed to know about ABO Incompatible kidney transplant and agreed to undergo the transplant.
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The patient’s father had expired and he had a younger sibling who was too young and studying hence the family did not want him to donate. Sachin’s 50-year-old mother, Subbalakshmi (name changed), seeing the agony of her son, willingly came forward to donate kidney. Subbalakshmi was found to be healthy and the doctors decided to do the transplant.
The patient’s blood group was A positive and his mother was AB positive. After extensive counselling on ABO incompatible transplant they were taken up for the surgery. The patient was evaluated by Dr. Girish N S and was advised to undergo preliminary tests followed by antibody levels estimation against his mother’s blood group. Looking at this level of antibodies, he was counselled and evaluated extensively and then decided to go ahead with the transplant.
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“The main challenge for us was that the patient’s antibody B titres were too high and blood count was low. The antibody had to be reduced and removed before proceeding with the transplant. We had to use special technique with imported filters for this and then proceed with the transplant. Post transplant the patients kidney function was normal and the patient was able to walk within 3 days of the transplant” said Dr Girish N S, Consultant – Nephrologist and Transplant Specialist, Columbia Asia Hospital Hebbal.
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Dr. Girish N S and Transplant physician along with a team of Doctors took up the transplant surgery. The transplant surgery was successful and after the surgery the patient’s antibody levels were monitored for next 5 days to look for any rebound. He was also given medication to control and prevent antibody levels from rebounding after the transplant. Sachin is doing well and has been discharged from the hospital and looking forward to a productive life.
“I couldn’t see my son suffering due to dialysis and deteriorating health. The doctor’s at Columbia Asia Hospital Hebbal explained us about ABO Incompatible kidney transplant. We had no second thought and agreed to go ahead with the transplant. After all the tests were done, and the results came out to be positive, we decided for the transplant, and now post the surgery seeing my son recovering I feel happy and relieved” saysSubbalakshmi, mother of the patient.
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“I am extremely grateful to my mother for saving my life. When I was going through dialysis my family went through a very tough time. My mother stood strong and supported me emotionally throughout the treatment. My heartfelt thanks to Dr Girish and team at Columbia Asia Hospital Hebbal for helping me lead a normal life again.”, Said Sachin.
ABOi transplant is a rare type of transplant done only by very few centre’s in India, Columbia Asia Hospital has specialisation in such transplants for last 10 years. This involves complexities in the procedure and requires to be done in well-equipped hospital setup and specially trained team of doctors.
Due to the shortage of organ donors and rise in number of people suffering from end stage renal disease has made ABOi transplantation a preferred option. This involves:
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Recipient receives desensitization treatment before and after kidney transplant to lower antibody levels in the blood and reduce the risk of antibodies rejecting the donor kidney.
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Desensitization is usually achieved by apheresis and B cell-depleting therapies that are accompanied
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Several studies show comparable long-term graft and patient outcomes with that of ABOI compatible kidney transplants
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