Lifesaving kidney swap transplant unites 2 families in Karnataka

The surgery on all four people was successfully conducted by a team of eight doctors at the Institute of Nephrourology located within the premises of the Victoria Hospital in Bengaluru on Thursday, 5 January.

Dr Keshavmurthy, the director of the Institute of Nephrourology, headed the surgery with nephrologist Dr Sreenivas.

Institute of Nephrourology in Bengaluru where kidney swap transplant was done to save two lives. (Wikimedia Commons)

Confirming the swap, Keshavmurthy told South First, “In Karnataka, in a government setup, this kind of swap transplant of the kidney was done for the first time.”

He added: “The surgery was successful, and the patients are under observation.”

What is a kidney swap transplant?

Representational image to show kidney swap transplant. (Supplied)

For those suffering from end-stage kidney diseases, a kidney transplant is the only option.

Often, the donor — even if it is a relative — may not match the blood group of the recipient, and hence the latter would have to be on dialysis for a longer time.

Dr Pradeep, the HoD of Anaesthesia at the Institute of Nephrourology, was also a part of the team that operated on the four people.

Explaining the process, he said a swap transplant involves an exchange of organs between two families where the donor cannot give the organ to their own family-member because of blood-group mismatch.

“It’s like a paired exchange,” explained Keshavmurthy.

He said two patients with kidney failure, who under normal circumstances cannot undergo a transplant as their blood groups don’t match with any of their family members, can go ahead with kidney transplantation by doing a swap.

First such surgery for a public setup in Karnataka

While a majority of the private setups have done living-donor kidney swap transplants in cities like Chennai and Bengaluru, this was being done at a government hospital for the first time in the state.

A senior nephrologist who did not want to be named said swap transplants could actually be a potential solution for patients with kidney failure who have a family donor but cannot donate due to compatibility issues.

When such a swap is done, both patients get kidneys and they are expected to have a lower risk of rejection.

Performing this at a government setup would ensure they get their follow-up treatments almost free of cost.

It helped mother-son duo and couple bond for life

Tears of joy rolled down the eyes of relatives of 13-year-old Akshay (name changed) from Kadur and also those of 38-year-old Rajiv N from another village in Karnataka on Thursday after the successful surgery.

While the doctors requested the anonymity of the patients, they did give some other details of the procedure.

Keshavmurthy said, “This 13-year-old boy had an end-stage renal disease (ESRD), and was on dialysis for two years. The mother of the boy, who is 35 years old, was ready to donate her kidney. However, it was not compatible.

He went on to add: “In the other case, the 38-year-old man also had an ESRD and was on dialysis. His wife, who is 33 years old, was ready to be the donor, but her blood group was not compatible with that of the man.”

The couple and the mother-son duo registered for organ transplant after getting approvals from the authorisation committee from the hospital.

They registered for cadaveric transplants — the patient should register and wait for the allotment — from Jeevasarthakathe, the State Organ and Tissue Transplant Organisation (SOTTO), which is the nodal agency that facilitates cadaver organ donations in Karnataka.

The procedure

However, they had been waiting for almost a year.

Doctors normally put such cases on a watch list. When they find matching donors, they then take the consent of both families and the concerned authorities (as this has to be a legal process), and approvals from all the stakeholders, which is important.

“We found that the kidneys of these two donors from two families are matching the recipients. We decided to go through the legal process. After we received the approvals, we went ahead with the surgery,” explained Keshavmurthy.

Representational pic of organ donation.

Meanwhile, anaesthesiologist Dr Pradeep said all four of them were operated on simultaneously, and there were two doctors at each bed.

As the unit has four Operation Theatres, the surgeries were done on two floors and the patients are now in the post-operative ward, explained the doctor.

While the families refused to speak to South First, the doctors said it was better not to reveal their identities.

They added that the patients would be provided immunosuppressant medications and follow-up care after the surgery at the hospital for their lifetime.