In a milestone medical achievement, doctors at Gleneagles Hospital, Parel, Mumbai, led by Dr Bharat Shah, Dr Shruti Tapiawala, Dr Pradeep Rao, and Dr Jitendra Jagtap, successfully performed the city’s first domino kidney transplant of the year. This intricate procedure involved six surgeries across multiple hospitals and states, uniting three donors and three recipients in a coordinated effort to save lives.

Tackling the Challenges of Sensitized PatientsThe transplant addressed the needs of sensitized patients, who account for only 7-10 per cent of the transplant population but face significant challenges. These patients often develop antibodies due to prior transplants, pregnancies, or blood transfusions, increasing the risk of rejection to 30-35 per cent even with standard desensitization protocols. Advanced transplant immunodiagnostics and acceptable mismatch techniques in HLA (Human Leukocyte Antigen) medicine were key to overcoming these hurdles.

“A domino transplant creates a chain of donors and recipients, where each donor matches a different recipient. This approach is crucial for patients who face rejection risks with their available family donors,” explained Dr Shruti Tapiawala, Consultant Nephrologist.

The Patients' Stories

The domino transplant saved three lives, each patient battling unique challenges:

- A 55-year-old woman from Hyderabad had multiple donor-specific antibodies, making her ineligible to receive kidneys from her husband, brother, or other relatives.

- A 17-year-old boy had a failed first transplant during the COVID-19 pandemic and was sensitized due to antibodies against his potential family donors, including his father and aunt.

- An 18-year-old girl lost her kidney due to infection and faced additional challenges from congenital abnormalities and HLA antibodies against her mother, her potential donor.

Months of waiting, extensive HLA matching, antibody profiling, virtual and physical cross-matching, and counselling culminated in the life-saving surgeries on December 19th. Over 18 hours, three donors and three recipients underwent complex procedures, marking a milestone in Indian medical history.

Teamwork and Innovation

Dr Bharat Shah, Director of Renal Science at Gleneagles Hospital, expressed his pride in the achievement:

“This success shows the power of teamwork and innovation. Domino transplants create a life-saving ripple effect for patients who once had no options. It’s a privilege to lead such groundbreaking efforts that transform lives.”

Dr Pradeep Rao, Director of Urology and Kidney Transplant, emphasized the importance of advanced solutions like domino transplants:

“Traditional donor-recipient matching isn’t always possible for sensitized patients. Paired exchanges and domino transplants, though legally and logistically challenging in India, are game-changers. Without them, many patients would remain on dialysis indefinitely.”

The Impact on Patients

One of the recipients, a 55-year-old woman from Hyderabad, expressed her gratitude:

“After years of waiting and failed attempts, I feel healthy and hopeful again. This miracle wouldn’t have been possible without the expertise of my doctors and the selflessness of my donor.”

Dr Bipin Chevale, CEO of Gleneagles Hospitals, said, “This domino transplant underscores our commitment to pushing boundaries in medical science. We are proud to provide hope and healing to patients with limited options.”

The success of this procedure shows the potential of advanced transplant techniques to address the unique challenges of sensitized patients. This landmark achievement not only saved three lives but also offered hope to countless others awaiting transplants in similar circumstances.

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