Paired Exchange Transplantation

Kidney transplants are a revolutionary medical procedure that has changed the way people deal with kidney problems, but they have a glitch. The traditional kidney transplant requires a donor with a matching blood type as the recipient. This article will take you through this unavoidable problem and provide solutions for the same. The article will also explore the best hospitals for surgeries, especially in Bangalore.

Kidney transplants are used for patients suffering from end-stage kidney problems, though finding a competent donor remains the biggest challenge to this day. This is why two revolutionary solutions, namely ABO-incompatible and swap kidney methods, two groundbreaking inventions in medicine and the field of transplant, have paved the way in kidney transplant, providing a beacon of hope to patients who could not find a suitable donor for themselves. Both the procedures, though helpful in the treatment of serious kidney problems, need the finest of care and years of expertise for the treatment, both of which can be provided by Gleneagles Hospital in Bangalore, a leading hospital in nephrology and kidney transplants.

In Organ Transplants, one of the key factors in determining the success of the transplant is the blood group of both the donor and the recipient. Blood groups are decided by antigens, which are basically the small proteins or sugars on the surface of red blood cells. There are four major types of these antigens: A, B, AB, and O, which are also the four types of blood groups.

The mismatch of blood groups between the recipient and donor leads to the activation of the immune response of the body - the production of antibodies. The Immune system identifies a foreign element in the body and releases antibodies into the bloodstream; these antibodies are the essential proteins that fight the foreign element which enters the body.

Why is the ABO Blood Group Crucial for Kidney Transplant?

Blood Groups, as mentioned earlier, are used to determine the compatibility of a recipient with the donor. For example, if the patient has blood group A, then he also needs a donor with blood group A. Apart from this, for certain blood groups, it is difficult to find a compatible donor. For instance, patients with blood group O face a lot of difficulty finding a compatible donor. Although the "O" doesn't have any antigens that are A or B, it does have antibodies for both the Blood groups A and B.

An ABO-incompatible kidney transplant is when the donor and recipient have incompatible blood groups. In the past, this would have been a cause for rejection, as the body would identify the new kidney as foreign and mount an immune response that would result in immediate rejection. However, with the development of immunosuppressive therapy, plasmapheresis, and other medical methods, this obstacle can now be overcome.

The procedure for ABO-Incompatible Kidney Transplant in Bangalore is the same as anywhere in the world, which is performing immunosuppressive therapies to suppress the immune system of the body from fighting against the foreign kidney. Mainly three types of therapies are used which include:

1. Removing the fighters of the body "Antibodies": The process of removing the harmful Antibodies, "not all of them" from the recipient's blood, is also known as Plasmapheresis. The antibodies can attack the newly transplanted kidney, causing rejection. The process helps in reducing the levels of these antibodies, eventually eliminating the risk of rejection.
2. Intravenous Immunoglobulin (IVIG): This includes injecting infection-resistant antibodies into the bloodstream of the recipient to protect him/her from infections. It also reduces the risk of rejection by the immune system of the recipient after the surgery.
3. Medications to suppress the immune system: Once the transplant is done, immunosuppressive drugs are given to ensure that the body does not reject the new organ. These drugs slow down the immune system's activity, preventing it from rejecting the transplanted kidney.

There is a wide range of Risks and complications associated with ABO-Incompatible Kidney Transplants in Bangalore or other parts of the world, which can sometimes be cured with proper medications but sometimes pose a threat to life. These risks include:

• Rejection: Rejection of transplanted organs is the biggest threat faced by any organ transplantation procedure. The reason for this rejection can be failed immunosuppressive therapy or medications, infections, or insufficient dosage of immunosuppressant medications.
• Infection: Proper isolation is required after kidney transplantation as people who have undergone kidney transplants have a higher risk of getting infected, which results in cold, cough, seasonal flu, and frequent pus formation in the area of sutures.
• Surgical Complications: As the kidney transplant is already a complex procedure, Incompatible blood groups make it an even more complex procedure to handle.

A Swap or Paired Kidney Transplantation in Bangalore and the world is another pioneering method that has revolutionised organ donation. Through this procedure, two or more pairs of donors and recipients are allowed to swap kidneys so that every recipient can get a compatible organ despite having an incompatible blood group. For Better understanding, imagine two donors/recipient pairs, say Donor and recipient A and Donor and recipient B, where: Donor A would give an organ to the recipient, similar to Donor B would then give an organ to recipient A.

In a standard Paired Exchange Transplantation in Bangalore or anywhere in the world, two patients with incompatible blood types (typically a relative and the patient) sign up for a paired kidney donation program. Both individuals have a willing family member who can donate a kidney, but because of blood group incompatibility, the transplant is not possible. That's where the swap happens:

1. Matching the Recipients: One donor will donate their kidney to the recipient of the other pair. The first recipient, who had an incompatible donor, will receive the other donor's kidney, and the same will happen for the second pair of donor and recipient. This is a win-win situation for both the pairs of donors and recipients.
2. Multiple Pair Exchanges: In such complicated situations, an exchange in a chain pattern is possible between more than two pairs. It has a greater chance of offering a suitable donor to every recipient, particularly for those areas lacking organs.

Although the SWAP or Paired kidney transplantation in Bangalore comes with its own set of benefits, certain challenges follow it. First, the procedure involves a delicate matching and coordination process, as it constitutes more than one donor-recipient pair. Second, the waiting time for compatible matches can be anywhere from as soon as two months to two years or beyond, depending on the number of donors available and the severity of the recipient's condition. Furthermore, transplant programs are restricted to particular areas, and it is not always possible to find a matching program covering the entire nation, although initiatives are being pursued to establish wider national and international networks by government as well as public agencies.

Gleneagles Hospital is a premier hospital not only for kidney transplantation but also for its complex versions, such as ABO or SWAP kidney transplant. The hospital has achieved various feats in the transplantation of not only kidneys but also different organs, which makes it the most successful hospital in Bangalore and across India. Here is why the hospital is the most trusted choice for many and can be yours too:

• Expert care and advanced treatment with the best and latest surgical tools available.
• Gleneagles is the home to some of the most famous and highly skilled nephrologists and surgeons who are determined to give their patients the best possible care and treatment.
• The hospital uses a personalised approach for each patient, as when it comes to complex treatment like organ transplants, a one-size-fits-all approach can not give the best results.
• Gleneagles has branches in different cities across India, providing a large network of patients, which makes it easier to find a donor in paired exchange transplantation in Bangalore or all over India.