Blood barrier no more

After four years of painful dialysis sessions, Deepak Chhutani (42) was all set for a kidney transplant. Since his father had passed away and mother was ill, Chhutani’s elder sister Aarti Keswani had offered to donate one of her kidneys, reports Neha Bhayana.

After four years of painful dialysis sessions, Deepak Chhutani (42) was all set for a kidney transplant. Since his father had passed away and mother was ill, Chhutani’s elder sister Aarti Keswani had offered to donate one of her kidneys.

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But tests revealed that while Keswani had AB-positive blood group, Chuttani’s was B-positive. Since blood group compatibility is essential for a kidney transplant, they were found ineligible for the procedure.

Dharamchand Bandi (62) was also shattered when his blood group (A-positive) did not match his wife’s (B-positive) blood group. “I felt I was doomed to suffer for the rest of my life,” said the Goregaon resident, who suffered sudden kidney failure last year.

Both Chhutani and Bandi have benefited from a recent medical advancement, the ‘ABO Incompatible transplant’ procedure, which allows a patient to receive a kidney from donor with a different blood group.

A team of doctors led by nephrologist Dr Bhupendra Gandhi — the only Mumbai doctor who performs the procedure — conducted Chhutani’s transplant in January and Bandi’s in February at Jaslok Hospital.

If not for the procedure, both Chhutani and Bandi would have had to live with dialysis or wait for years for cadaver kidneys (over 1,400 Mumbaiites are on the waitlist). Dr Gandhi has conducted 21 such cross blood group transplants, most of them in the last three years. Nineteen of them have been successful. “My life is back to normal,” said Chhutani, a manager in an insurance firm.

To ensure that a patient’s body accepts the foreign kidney, plasma (a component of blood) is drained from his body using a special device for five consecutive days. The spleen (an abdominal organ that produces antibodies) is removed shortly before the transplant. “Plasma contains antibodies which attack organs from a non-matching donor so we have to remove it,” said Dr Gandhi, adding that the body can manage without a spleen.

When ABO incompatible transplants were first done in the US in the 1970s, they were considered “experimental”. But with advancement in technology and more potent immunosuppressive drugs, the success rate has become comparable to that of regular transplants.

“It is a safe option for people who don’t have family members with matching blood group,” said Dr Gopal Basu from Christian Medical College, Vellore. Some doctors still don’t recommend it. “The procedure is gaining acceptance but it is still under scrutiny,” said Dr Sanjay Agarwal, head of nephrology at AIIMS.