First Pediatric Incompatible Kidney Transplant

First incompatible blood group (ABO mismatch) pediatric kidney transplant without plasma exchange, was performed at Aditya Birla Memorial Hospital, Pune.

An incompatible kidney transplant was performed on a pediatric patient at Aditya Birla Memorial Hospital (ABMH), Pune. The patient is a nine-year-old named Girish Thorat, who was in the last stage of renal failure and was undergoing dialysis. The surgery took place in April; the patient is off dialysis and is currently stable.

Speaking about the case, Dr Tarun Jeloka, who performed the surgery, said, "The patient was diagnosed with kidney disease at the age of three and has been on dialysis since then. He was also far behind on the waiting list and had to wait for four more years. We decided to use this procedure and go forward with an incompatible donor, who is the child's maternal grandmother. In such surgeries, plasmapheresis technology is used, but we did not have to use the technique on Girish. His body has not rejected the kidney and his condition is stable."

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‘The 9-year-old patient received a kidney from his maternal grandmother, but their blood groups were incompatible (ABO mismatch). But, his body has not rejected the kidney after the transplant, and his condition is stable.’

Girish’s father Dr Jaywant Thorat, who is a medical officer at a primary healthcare center in Karad, took his son to ABMH in April. Girish was diagnosed with nephrotic syndrome, a condition where the filters in the kidney develop leaks and large amounts of protein flow from the blood into the urine, leading to kidney damage.

Later he developed non-responsive focal segmental glomerulosclerosis (FSGS), which is scarring of some tissue in the filtering unit of the kidney. He was put on peritoneal dialysis.

"Apart from the risk of transplant in such a young kid, there were other complications such as unavailability of a suitable donor. However, we decided to take the risk as we had earlier performed 20 such successful surgeries on adults. We planned an ABO-incompatible (ABOi) transplantation, which is a method of allocation in organ transplantation that permits a more efficient use of available organs regardless of the ABO blood type. The patient is off dialysis now," said Jeloka.

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Dr Suresh Patankar, director of ACE hospital, said, "It is a technology that has evolved in the past one year, and it is good that recipients no longer have to rely on cadaver donors. Generally, in non-compatible donors, the recipient's body rejects the kidney, but due to certain techniques like blood washing, the recipient can lead a normal life."

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Source-Medindia

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