A
multidisciplinary team led by Dr Bharat Shah, Dr Shruti Tapiawala, Dr Pradeep
Rao and Dr Jitendra Jagtap at Gleneagles Hospital, Parel, Mumbai, successfully
performed the city’s first human leukocyte antigen (HLA) compatible, acceptable
mismatch domino kidney transplant of the year. This extraordinary procedure
involved six surgeries across hospitals and states, uniting three donors and
three recipient families in a synchronized chain to save lives.
A
domino transplant involves a chain of donors and recipients where each donor matches
a different recipient, creating a life-saving chain. The procedure was
essential for patients battling kidney failure and inability to get
transplanted due to high risk of rejection with their available family donors.
Dr
Pradeep Rao, director of urologist & kidney transplant, explained, “Kidney
transplants for sensitized patients often require solutions beyond traditional
donor-patient matching. Paired exchange or domino transplants, though legally
and logistically challenging in India, are game-changers for such cases.
Without these options, many patients would remain on dialysis indefinitely.”
Leveraging
advanced transplant immunodiagnositics and acceptable mismatch techniques in
HLA medicine, the domino transplant addressed the unique challenges of highly
sensitized patients which is only 7-10% of transplant population, marking a new
milestone in renal transplantation for our state and country.
Dr
Bharat Shah, director of renal Science at Gleneagles Hospital, remarked, “This
achievement exemplifies the power of teamwork, precision, and innovation in
modern medicine. With domino transplants, we are creating a life-saving ripple
effect for patients who once had no options. It is a privilege to lead such
groundbreaking efforts that transform lives.”
Dr
Shruti Tapiawala, consultant nephrologist, highlighted, “Sensitized patients,
often due to prior transplants, pregnancies, or blood transfusions, face
immense difficulties finding compatible donors. With the help of advanced
transplant immunodiagnositics and acceptable mismatch techniques in HLA
medicine, the domino transplant addressed the unique challenges of highly
sensitized patients which is 7% to10 % of our population seeking transplants
are highly sensitized, with antibodies increasing their risk of rejection to
30% to 35% even with desensitization protocols.
A
55-year-old lady from Hyderabad, with multiple donor-specific antibodies
against multiple family donors, due to which she faced rejection risks from all
her relatives, including her brother, aunt, husband, and maternal uncle.
A
17-year-old boy, whose first transplant failed during the Covid-19 pandemic,
required specialized care to overcome sensitization from his earlier transplant
and antibodies against his aunt and father precluding him from receiving a
kidney from them.
An
18-year-old girl, previously lost a kidney due to infection and faced
additional challenges due to congenital abnormalities and HLA antibodies
against her mother who was her potential kidney donor.
Months
and years of waiting to find an acceptably mismatched donor with whom the
rejection risk would be minimal with lesser immunosuppression and cost,
rigorous HLA matching and antibody profiling, virtual and physical
cross-matching, and extensive counselling culminated in this life-saving
procedure. On December 19th, three donors and three recipients underwent
complex transplant surgeries lasting 18 hours.
One
of the grateful recipients, a patient from Hyderabad, shared, “After years of
waiting and failed attempts, I feel healthy and hopeful again. This would not
have been possible without the expertise of Dr. Shruti Tapiawala and my
nephrologist, Dr Anuradha, who collaborated to make this miracle a reality. I
am immensely thankful to the donor for their selfless act.”
Dr
Bipin Chevale, CEO of Gleneagles Hospitals, Parel, Mumbai, concluded, “This
successful domino transplant is a testament to our hospital’s commitment to
pushing boundaries in medical science.”
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