Aug 22, 2023, | Dr. Chinta Rama Krishna M.D, D.M (NEPHROLOGY), Vedanta hospitals
Kidney Transplantation is the treatment of choice for patients with End Stage Kidney Disease. About 11 crore people are suffering from kidney disease in India. 300000 patients require Kidney Transplantation annually. But only 16000 transplants were done in 2022. 50% of remaining patients die within two years on dialysis. There are multiple reasons for the low number of kidney transplants.
1) mismatched blood groups in the family member.
2) Medical issues like Diabetes make donation difficult.
An advanced treatment option to undergo Kidney Transplant when there is no blood group match in the family members is ABO incompatible Kidney Transplantation. generally, we have four blood groups O, A, B, and AB. O is a Universal donor who can donate to different blood groups. AB is a universal recipient where they can receive from other blood groups. Patients with the O group can receive blood or Kidney only from the O group because anti-B and anti-A antibodies will cause immediate rejection when we transplant B or A group Kidney in patients with the O group.
In ABOi Kidney Transplant, We remove all anti-A and anti-B antibodies from the blood by “Immunoadsorption” well before surgery and make the transplant successful. Treatment will be started 28 days before surgery by giving specific medication to precondition the patient. We do Immunoadsorption 2-3 days before surgery to bring anti-A and anti-B antibody titers to less than 1:4.
Chandu Sai Kumar, a male aged 20, developed Kidney failure following Covid vaccination in December 2021. he is getting dialysis since then. He has been suffering from several health issues like lung infection, high blood pressure, etc, requiring multiple hospital admissions. He doesn’t have a blood group-matched donor in the family. He was also waiting for a cadaver transplant, but the waiting time is over 3 years without any assurance. He lost his education and productivity on dialysis, and his family is crumbling financially. Subsequently, we have given the option of ABO incompatible Kidney Transplantation. His mother is B Positive. We did a Transplant on 28th July. He started treatment on the 5th of July, and Immunoadsorption was done on the 26th and 27th of July. His anti-B Antibody titres were initially 1:128 and declined to 1:4 after the procedure. then we took him for surgery on 28th July. His postoperative period is reasonable, and he has no complications. He was discharged on the 12th day after surgery. He is doing well with the serum creatinine of 1.2 mg/dl
ABO-incompatible Kidney Transplantation is a good option for patients with kidney failure who does not have a family member with matched blood group. Thousands of patients can be benefitted from this surgery without relying on complicated lifelong dialysis, which has high mortality and morbidity