2 SWAP Transplants in a week, on patients with chronic kidney disease

Kidney Transplant

BGS Gleneagles Hospital, a pioneer in transplants successfully performed 2 Swap kidney transplants in a span of 7 days, saving the lives of 4 patients with end stage renal failure. All 4 patients were under dialysis within the span of 2 years, due to which each of them was facing their own set of challenges and issues. The only way out for them was to undergo kidney transplantation. The expert team of renal sciences team of doctors then proposed a SWAP transplant to the patients (Swap 1 - Mr Mahendra (name changed) and Mr Syed, SWAP 2- Mr Siddaraj Patil and Mr. Satyanarayana), and their families.

Mr Mahendra (name changed), a 46 year old Hindu pharmacist, hailing from Tiptur, Karnataka was diagnosed with end stage kidney disease in the month of November 2020 and was on dialysis since then. He was a diabetic patient and suffered from hypertension for the past few years, which are known to be the risk factors of CKD. Mr Mahendra’swife was willing to donate her organ to save her husband’s life, however she could not because of the differences in the blood group.

In the midst of finding a solution to this problem, another patient in the hospital was going through the same dilemma.

Mr. Syed Irfan Ullah a 36-year-old Muslim, who resides in Bangalore,was also going through the same predicament. He was diagnosed with end stage kidney disease in the month of June 2020 and was on dialysis since then. He was not doing well on dialysis and the doctors listed his name for a cadaver transplant which would take a minimum time of 4-5 years. After understanding Mr Syed’s health condition and the incompatibility of his wife’s organ, doctors decided to find an immediate solution to his deteriorating health condition.

While studying both the cases and looking at saving their patients’ lives as their priority, doctors decided to go ahead with Swap Kidney Transplantation with approvals from both the families. Both the donors (wives of both the patients) went through blood and tissue tests, which were within normal limits.

Sandeep Kumar, CEO, BGS Gleneagles Hospital:For the past 2 years pandemic has halted the process of organ donation and transplants, which to an extent has affected the health of patients with end stage diseases. The entire health infrastructure was dedicated to take care of Covid 19 patients, and all elective procedures were stopped. 

All the transplant patients were put on immunosuppressive drugs which is a high-risk factor for covid infection. Hence, all the surgeries were put on hold till the situation was under control. Now as the COVID spread is stabilizing the organ donation and the transplant surgeries has picked up its pace.”

The expert team meticulously planned the complicated surgery to avoid any infection and saved both the lives. Both the surgeries were performed successfully onSeptember 7th, 2021, at the Kengeri Hospital. Mr Mahendra’s wife donated her kidney to Mr Syed and Mr Syed’s wife donated her kidney to Mr Mahendra (name changed) saving both the families from a dreaded future.

A similar duo, Mr Siddharaj Patil, 29-year-old and Mr. Satyanarayan, 39-year-old were diagnosed with end stage kidney disease. They were listed for deceased donor transplant as well since they did not have any matching donor in the family. On the other hand, ABO incompatible transplant comes with a higher risk and cost. The doctors studied their cases and saw that their donors' organs were matching to the other patient.

Mr Siddaraj Patil, a 29-year-old Agriculturist, hailing from Yadagiri in Karnataka was diagnosed with CKD since 2019, secondary to IgA nephropathy for 2 long years. IgA nephropathy, also called Berger’s diseases is caused, when there is deposition of IgA protein in the kidneys, resulting in inflammation. He was under dialysis since his diagnosis and was not coping well. He was listed for a cadaver donor for the past 2 years, soon after learning incompatibility of his 52-year-old mother’s (Kamala Devi) organ who was willing to donate.

Mr. Satyanarayana, a 39 year, working in a private company from Madakasira in Andhra Pradesh was diagnosed with end stage kidney disease and was on dialysis since March 2021. He was also suffering from Berger’s diseases, which progresses slowly until the kidney loses its function. As his condition was also deteriorating, the doctors were trying to find a quick solution to his problem. His sister Lakshmakka, a 50-year-old, was willing to donate her organ, unfortunately, it was incompatible.

The department of renal science counselled both families to undergo a swap transplant that would save both the patients. After discussing internally with the family members, who were willing to donate their organs for their own family members, agreed to SWAP their organs. After doing a few rounds of tests to check the compatibility rate of the organs, Lakshmakka, sister of Satyanarayana agreed to donate her kidney to Siddaraj, and Siddaraj’s mother Kamala Devi gave her kidney to Satyanarayana.

The same team who meticulously performed the 1st SWAP transplant got ready to do the 2nd SWAP transplant on September 14th, 2021, at the BGS Gleneagles Hospital.

All 4 surgeries were successfully spear headed by Dr Anil Kumar BT, Senior Consultant, Nephrologist and Transplant Physician along with the Urology team led by Dr Narendra S, Senior Consultant, Chief Transplant Surgeon. The team was supported by an expert team of Anaesthesia, critical care department and Nursing staff.

Dr Anil Kumar BT, Senior Consultant, Nephrologist and Transplant Physician, BGS Gleneagles Hospital said Kidney transplantation is the best form of renal replacement therapy for patients with end-stage kidney disease but there is a huge demand and supply gap. The waitlist for kidney transplantation is increasing by every passing year. Paired kidney exchange (PKE) or ‘Swap’ transplantation is an innovative process whereby kidneys are exchanged between two or more ABO-incompatible or HLA-incompatible living donor kidney pairs and recipients receive better compatible kidneys.”

“Though one in three potential kidney donors are deemed incompatible due to blood group or human leukocyte antigen (HLA) incompatibility the complexities involved in doing these transplantations are more. So far only 12 swap transplantations have been done in Karnataka.”

Our experienced nursing staff team monitored the vitals and provided accurate medication to all the patients with absolute precision, resulting in immediate discharge. Currently, all 4 patients are doing well and are out of danger.

Dr Narendra S, Senior Consultant, Chief Transplant Surgeon: “Chronic Kidney Disease (CKD) is the most highly prevalent health condition in India. Early diagnosis and effective treatment at the right time is the only solution to beat this disease, however in most cases patients detect this illness in the last stage due to asymptomatic nature of the disease. Therefore, it’s essential to do routine blood and urine check-ups after the age of 40, especially those with diabetes and high blood pressure.”

“This can be curbed to an extend by adopting healthy lifestyle and appropriate diet.”

About BGS Gleneagles Hospital, Kengeri, Bengaluru:

BGS Gleneagles Hospital at Kengeri, Bengaluru is one of Karnataka’s most renowned multi-organ transplant and tertiary care multi-specialty hospital with a key focus on Gastroenterology, Cancer Care, Neurosciences, Renal Sciences and Cardiac Sciences. The NABH and NABL accredited hospital operates 100+ beds. A modern Cath Lab, 6 operation theatres, advanced imaging services (Trubeam STX and Tesla MRI) offer cutting edge emergency and critical care management following internationally approved clinical protocols.

Over 10 years of clinical excellence has earned the hospital tie-ups with all major cashless health insurance players and is the preferred choice hospital by all major corporates in the neighbourhood. The hospital also offers Video Consult services to its patients in India, Africa and SAARC nations.

BGS Gleneagles Hospital is a part of IHH Healthcare, one of the world’s largest healthcare providers. With its full spectrum of integrated services, dedicated people, reach and scale, and commitment to quality and safety, IHH aspires to be the world’s most trusted healthcare services network, united by a single purpose: to touch lives and transform care.

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