Mumbai: When a 48-year-old cotton trader from Aurangabad needed a kidney transplant, his 45-year-old wife did what many in similar circumstances do: offer one of her kidneys.
But two factors made this transplant different from other kidney transplants: both were HIV-positive and their blood groups didn’t match. The wife had B blood type, while the husband’s blood group was A. “We did a complete search of medical literature before concluding that this is perhaps the first HIVto-HIV and ABO incompatible (when the donor’s and recipients’ blood types are not compatible) transplant,” said nephrologist Dr Sachin Soni from Medicover Hospital, Aurangabad. The transplant was carried out on January 18. There have been a handful of instances in the world, including India, of HIV-to-HIV transplants. “But the challenge was to prepare an HIVpositive recipient to receive a kidney from a donor with a different blood group,” said Dr Soni. In ABO incompatible transplants, the recipients have to be preconditioned with immunosuppressants and a type of blood plastreatment before the operation to prevent the body from rejecting the foreign organ. As HIV-positive persons are already immune-compromised due to the virus, giving them immunosuppressants and ensuring they are well is not easy.
“Thankfully, both my parents are doing well,” said his son.. My father used to eat half a bhakri (chapati) a day during the three years of his kidney failure, but he has been managing to eat three meals a day since his discharge on January 31,” said his son. The family got Rs 2 lakh from the CM’s Relief Fund, and raised the remaining Rs 4 lakh from family and friends. Incidentally, an HIVto-HIV transplant was carried out in Mumbai’s Global Hospital on June 25, 2020, during Covid lockdown. Nephrologist Dr Bharat Shah said the recipient was a 24-yearold woman who didn’t want to undergo dialysis and her HIVpositive father donated one of his kidneys. “The patient has been doing extremely well,” said Dr Shah.
“Recent advances in therapeutics have ensured HIVpositive persons can be prepared well for transplants,” said Dr Tukaram Jamale, head, nephrology department, KEM Hospital, Parel.
In 2010, an HIV-positive person underwent a kidney transplant for the first time in Mumbai after his mother donated an organ. Jaslok Hospital’s Dr Madan Bahadur, who was treating that patient, said in the Aurangabad HIV-toHIV transplant “the risk is the donor’s health in the future.”