Mumbai’s First Domino Kidney Transplant: A Groundbreaking Milestone

Mumbai recently witnessed a life-changing medical breakthrough with its first domino kidney transplant, performed by a multidisciplinary team at Gleneagles Hospital, Parel. This innovative procedure brought new hope to patients battling kidney failure, especially highly sensitized individuals who face immense challenges finding compatible donors.

What is a Domino Kidney Transplant?

A domino kidney transplant involves a carefully coordinated chain of donors and recipients. If a family member is not a suitable donor due to incompatibility, they can donate to another patient in the chain, allowing their loved one to receive a compatible kidney from another donor. This ripple effect creates life-saving opportunities for multiple patients.

On December 19, three donors and three recipients participated in this complex procedure involving six surgeries across multiple hospitals and states. The entire operation lasted 18 hours and was a testament to precise planning and coordination.

Overcoming Challenges for Sensitized Patients

Sensitized patients, who develop high levels of antibodies due to prior transplants, pregnancies, or blood transfusions, often face higher rejection risks. These antibodies make finding a suitable donor extremely difficult, with rejection rates rising to 30-35% despite desensitization protocols.

By leveraging advanced HLA (Human Leukocyte Antigen) medicine, including acceptable mismatch techniques and transplant immune diagnostics, the team successfully minimized rejection risks for these patients.

Stories of Hope

  • A 55-year-old woman from Hyderabad had antibodies against multiple family members, including her husband and brother, making traditional transplants impossible.
  • A 17-year-old boy sensitized after a failed transplant during the COVID-19 pandemic, could not receive donations from his father or aunt.
  • An 18-year-old girl who lost her kidney to an infection faced rejection risks due to congenital abnormalities and antibodies against her mother.

Through rigorous HLA matching, virtual and physical cross-matching, and months of counseling, the domino transplant provided a lifeline for these patients.

Expert Insights

Director of Renal Science, emphasized the transformative impact of domino transplants, calling them a “life-saving ripple effect.” It also highlighted how advanced diagnostics and acceptable mismatch techniques have become game-changers for sensitized patients.

Why It Matters

For many patients, traditional transplant options are not feasible, leaving them on dialysis indefinitely. Procedures like domino kidney transplants offer a second chance at life, reducing risks, costs, and dependency on heavy immunosuppression.

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