Mumbai: Nair hospital preps for heartwarming mother-daughter swap

The upcoming swap kidney transplant is Nair Hospital’s maiden attempt at the procedure. File pic

BYL Nair Hospital is preparing for its first-ever swap kidney transplant, with two young women as recipients, and each of their mothers serving as unrelated donors. Currently, Nair and KEM hospital are the only two civic-run tertiary care facilities where kidney transplants take place.

Swap kidney transplant occurs when two donors are incompatible with their intended recipients due to mismatched blood groups but match with relatives of others on the waitlist. As is the case with Nair, it involves a mutually beneficial exchange of kidneys between two separate families.

While this is Nair Hospital's inaugural attempt at the procedure, KEM hospital conducted one a few years ago and another just last month after a significant gap. "Transplants can also occur across blood groups, but their outcomes are not as favourable. Even though outcomes are gradually improving, the cost remains significantly high," said a doctor from KEM hospital.

The most cost-effective alternative is a swap, he added. "The procedure also reduces costs and the intensity of immunosuppressants, which would be higher when donors are from incompatible blood groups," explained the doctor from KEM's nephrology department. Further details about the patients undergoing the procedure at Nair in about a week's time have been withheld as the hospital wants the recipients to first stabilise.

"For blood groups A and B, a swap is a better option. However, for blood group O, it becomes very difficult to arrange a swap because they can only receive from their own category," said Dr M M Bahadur from Jaslok Hospital, where the first kidney swap transplant in the country took place with prior permissions from regulatory authorities in 2006.

Meanwhile, the two recipients at KEM who underwent the transplant recently were males in their early 40s, while the donors were their wives. The hospital has performed around 750 kidney transplants since 1998, with around 30 transplants taking place annually. However, as in the case of Nair hospital, in most kidney transplant cases, the donors are women because men are often reluctant to donate their kidneys.

"There is no reason to bar males from donating, apart from common factors like age and comorbidities like diabetes. The situation is slowly improving, but it is still largely true that most donors are women," the doctor said. Since the 2011 amendment to the Transplantation of Human Organs Act, there have been more than 70 swap transplants in the city, as prior to that amendment, unrelated living donors could not donate their kidneys.

750
No of kidney transplants performed at KEM since '98