A 37-year-old patient hailing from Jamtara, Jharkhand with end-stage kidney disease was successfully treated by doctors at the Virinchi Hospital, Hyderabad on Wednesday. According to the doctors, this marks the first-ever worldwide case of an ABO incompatible kidney transplantation in a patient with end-stage kidney disease due to Thrombotic Microangiopathy (TMA) with immediate post-transplant recurrence of TMA.
The patient, Raman Kumar Singh, required a kidney transplant due to end-stage kidney disease caused by TMA. However, the only available donor was his elder sister, Tinku Singh, who had a different blood group. Faced with the absence of a blood group-matched donor the doctors opted for an ABO incompatible transplant as the sole viable option.
In an ABO incompatible transplant, the donor’s blood type and the receiver’s blood type are not compatible.
The use of plasma exchange sessions and Rituximab was highlighted as a cost-effective approach for managing post-transplant recurrence.
Dr. Naveen Kumar Mattewada, Senior Nephrologist, highlighted the cost difference between this method and the only other reported case worldwide in the UK, which utilised the drug eculizumab. Eculizumab, a costly drug not available in India, requires regular lifelong administration, with an estimated annual cost exceeding Rs 1.2 crores in the first year and above Rs 75 lakhs per year from second year post-transplant onwards.
