When a 30-year-old daughter needed a kidney transplant, her mother did what many in similar circumstances do, offered one of her kidneys.
But three factors made this transplant different from any other regular kidney transplants: the daughter was first diagnosed with Tuberculosis (TB) and secondly their blood groups didn't match and third, the recipient had antibodies against her mother’s kidney. The mother had a B+ blood type, while the daughter’s blood group was A+.
Neha Singh, a 30-year-old female from Vashi, Navi Mumbai, was detected with end-stage Chronic Kidney Disease (CKD) back in August 2021. She was getting her dialysis treatments but was experiencing frequent bouts of fever. This is when she consulted the doctors at Medicover Hospital where she was diagnosed with Tuberculosis which was the cause behind her frequent fevers.
Recipient diagnosed with TB
"She was diagnosed with Tuberculosis due to which we had to postpone her kidney transplant as there was a risk of spread of infection. She was then put on her Tuberculosis medications and completed her 1-year treatment course. After that she was moved on to kidney transplant where her mother donated the organ” said Dr Amit Langote, Nephrologist and Kidney Transplant Specialist at Medicover Hospital, Navi Mumbai.
"But the challenge was to prepare a Tuberculosis recipient to receive a kidney from a donor with a different blood group and also to remove the pre-existing antibodies that she had against the donor's kidney," said Dr Amit.
TB increased transplant risk
It was even more difficult to convince her to wait to complete her TB treatment and then undergo a transplant. In ABO incompatible transplants, the recipients have to be preconditioned with immunosuppressants and a type of blood plasma treatment before the operation to prevent the body from rejecting the foreign organ. As tuberculosis has already immune-compromised her health, giving her more immunosuppressants was risky and hence, the transplant was done at a later date after her TB treatment was completed.
Patient fully recovers after surgery
Dr Amit Langote along with Dr Amol Patil, Kidney Transplant Surgeon performed an ABO-incompatible kidney transplant successfully, and now the patient is fully recovered. The transplant was carried out on January 3, 2023.
“We counselled the parents and informed them that she needed a transplant for survival. Her mother immediately came forward to donate her kidney. Neha was given immunosuppressant medications before and after the transplant and was discharged after a week with an excellent functioning new kidney.” Neha’s mother said, “As a mother, it was unbearable to see my daughter in such a condition. I donated my kidney without any fear and the surgery was performed really well by doctors at Medicover. I’m happy that both of us have recovered well.
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