Mumbai: Even as the world grapples with the dreaded Delta and Delta-plus variants of Covid-19, doctors at the P D Hinduja Hospital are beset with a new challenge - a 22-year-old IIM student, recipient of a kidney transplant six years ago, contracted corona and now his body is rejecting the renal transplant. According to doctors, this is the rarest of rare cases in which Covid has caused the rejection of a transplanted kidney, despite the patient being asymptomatic and the case will be documented in medical journals for its uniqueness.
Dr Jatin Kothari, the patient Krishna’s attending physician and nephrologist at Hinduja, said Krishna had undergone a routine check-up, which had included a kidney profile test. However, the report revealed that only 10 per cent of his kidney was functioning. “Six years ago, Krishna had undergone a kidney transplant, with his father donating a kidney. The kidney was functioning normally despite the patient testing corona-positive. But later, he developed post-Covid complications, which left him with only a 10 per cent functional kidney,” he said.
At Hinduja Hospital, his Covid antibody levels were checked and found to be very high. “Transplant patients have poor immunity and we have seen that they do not develop antibodies easily. His case is unique,” said Dr Kothari.
Krishna was immediately hospitalised as it was the rarest of rare cases and the doctors needed to understand the reason for the sudden rejection of the kidney, all these years later. They conducted a biopsy to determine whether Covid was the main reason for the rejection or if there were other factors involved. They also referred his case to experts in New Delhi and abroad and the consensus was that Covid-19 was the only reason.
“We have seen many cases where a rejection of a transplanted organ happens only when the patient stops taking medications or within the first week of transplant. But in this case, we closely monitored all the medication he was taking and we knew that the patient was constantly on immunosuppressants and did not miss any doses,” said Dr Kothari.
Krishna is presently undergoing plasmapheresis, a process similar to dialysis, in which the blood is filtered out and harmful antibodies are removed. “He has also been given a drug to stop further rejection and prevent further damage. However, he is not on dialysis now and plasma treatment will stop next week, after which it is a wait-and-watch situation,” said Dr Kothari.