A paired kidney exchange, also called kidney swap, has saved two lives, one in Mumbai and another in Uttar Pradesh. While the Mumbai recipient is as young as 11 years old, the recipient from UP underwent a transplant for the second time in 10 years.
Aaryan Jadhav, 11, was admitted to Nanavati Max Super Specialty Hospital and couldn’t receive the organ from any of his parents owing to a rare genetic condition.
His 60-year-old grandmother, Shanta, therefore offered to give her kidney to 40- year-old Ashok Mishra, whose wife Aarti became a donor for Aaryan. Both Mishra and the young boy were discharged within a week of surgery and are recovering well.
While kidney transplant is the ideal, long term clinical solution for patients with end stage kidney disease, its limitation is the availability of a compatible organ donor.
Prior to the success of swap or domino transplant, donor availability was restricted to family members or diseased cadaveric donors. As a result, many patients, who could not find an outside donor or did not have any compatible familial donor, continued to be dependent on dialysis.
A swap or domino transplant has created a legal framework under the Transplantation of Human Organs Rules, 1995, for two willing families, each with a pair of donor and recipient, to undergo paired kidney exchange.
Aaryan’s mother Nitya Jadhav said, “He has been on dialysis since he was four years old as his kidneys failed due to a rare kidney disorder called thrombotic microangiopathy (a condition that damages blood vessels of vital internal organs and causes failure of mostly kidney and brain). Due to the same genetic predisposition, despite having willing individuals in the family, we couldn’t donate.”
The family was appraised about the option of swap transplants in January 2020 and the documentation was almost done when the pandemic struck. “Once the pandemic subsided, we started the process again,” Jadhav added.
Dr Jatin Kothari, Director of Nephrology and Chief Consultant for Renal Transplant Medicine at Nanavati, spearheaded both the transplant surgeries.
