Two lives saved by Karnataka's first kidney swap transplant between hospitals

Bengaluru: In the State's first inter hospital two-way transplant swap, or paired exchange, 53-year-old housewife Lakshmi S Acharya and 39-year-old vehicle driver Rudra Prasad got life-saving kidney transplants. The one-of-a-kind procedure was carried out at BGS Gleneagles Global Hospital and Suguna Hospital.

Lakshmi was operated on by Dr. Anil Kumar B T, HOD and Sr Consultant - Nephrologist and Transplant Physician, Dr Narendra S, HOD and Sr Consultant - Urologist and Transplant Surgeon, while Rudraprasad was operated on by Dr. Sanjay S, HOD and Sr Consultant - Nephrologist & Transplant Physician, and Dr Govardhan Reddy Sr consultant urologist and Transplant surgeon.

Despite having a possible donor in the family—Shivashankarappa, the father of Rudraprasad—and Shreesha, the husband of Lakshmi—both were blood group matched with willing donors for kidneys—they were unable to donate because of the positive crossmatch findings of their receivers.

"Lakshmi was suffering from ESRD (End Stage Renal Disease). Her husband was the proposed organ donor. However, the crossmatch tests performed were positive therefore it was difficult to proceed with the transplant surgery. Hence, they were referred to our hospital for swap transplant. For us, there were three possibilities. One was to proceed with the same donor by performing the desensitisation treatment, the second alternative was to hunt for another incompatible matched pair and third was registration for cadaver transplant that takes another 3-5 years.

'We were fortunate that Suguna Hospital had another such pair. Coincidentally, the treating nephrologist was a close friend of mine. As a result, we interacted with one another and met with the two families to discuss a transplant swap. Both families agreed to move forward', said Dr Anil Kumar B T, HOD and Sr Consultant - Nephrologist and Transplant Physician, BGS GGH.

The HOD and Sr Consultant - Nephrologist and Transplant Physician, Suguna Hospital, Dr. Sanjay S said,"Swapping of donors for transplants between the two families from two different hospitals in the city was made possible by the innovative and forward-thinking action of the Karnataka state approval committee. In order to limit the risk of prolonged cold ischaemia, the receiver and corresponding donors had to have surgery at the same facility. This was the first time in the nation that a swap transplant permission between two institutions had been obtained for a cross match positive status."

After waiting for a year to complete the legal procedures, on December 21, the transplantation was completed. The transplant surgeries began and ended at the same time after the donors were swapped. Both beneficiaries were released from the hospital after seven days, and they are all doing great now.

Around the world, there is a gap between those who require organ transplants and those who have access to those organs. In Karnataka, there are more than 1 lakh registered patients waiting for an organ. With almost 10,000 kidney transplants performed year, India ranks second only to the United States. Karnataka is second only to Tamil Nadu in cadaver organ donations, with 152 donations in 2022.

In order to raise public knowledge of these treatments and their accessibility, both hospitals jointly organised a renal press conference to commemorate the successful execution of the state's first-ever such surgery.