The patient, who was undergoing transplant for the second time, faced incompatibility with the donor on two fronts

Doctors at Kauvery Hospitals here have managed to perform a second kidney transplant for a 51-year-old man despite the patient facing incompatibility with the donor on two fronts.

A release from the hospital said the patient underwent a kidney transplant 16 years ago. A viral infection that happened two years ago affected the transplanted kidney, leading to its complete failure, and the patient becoming dependent on dialysis.

When the doctors decided that another transplant was the best option, further complications emerged. He had a high levels of antibodies due to the previous transplant. “The antibodies were identified to be directed against HLA antigens, a type of molecule found on the surface of most cells in the body that play an important role in the body’s immune response to foreign proteins,” the release said.

Moreover, while his wife turned out to be the only available donor, their blood groups did not match. “This meant that he had antibodies against the wife’s HLA antigens as well as to her blood group,” the release added.

The release said a decision was made to proceed with the transplant after the family was counselled about the possibility of the patient’s body rejecting the transplant. The situation was further complicated by the patient undergoing treatment for tuberculosis for the past year.

The patient was administered immunosuppressants two weeks prior to the surgery in contrast to the drugs being administered just 24 hours ahead of the surgery in the case of normal transplants.

The release said the patient was also subjected to plasmapheresis, a process in which the liquid part of the blood (or plasma) is separated from the blood cells to remove the antibodies against the HLA antigens and the antibodies against the donor’s blood group and replace it with a plasma which did not contain the antibodies. The man was discharged 10 days after the surgery with no complications, the hospital said.

Congratulating R. Balasubramaniyam and his team for the surgery, Aravindan Selvaraj, co-founder and executive director, Kauvery Hospital, Chennai, said it was very rare for a person to have antibodies against two different components. “However, our finest team of nephrologists and medical experts coupled with the state-of-the-art-facility has made it possible to perform such complex conditions with better outcomes,” he added.

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