Gurgaon hospital ready with blood group mismatch liver transplant

Overcoming the odds of blood group mismatch, a team of doctors of Medanta Hospital in Gurgaon have successfully completed three liver transplants where the donor's blood group did not match that of the receiver.

Doctors believe this medical breakthrough, which is called ABO-incompatible transplant, will increase liver transplant rate by 30 per cent. Until now, the procedure was performed for patients needing kidney transplant at several hospitals, including AIIMS.

At Medanta, the three patients — Zuana (3), Karthikey (18 months) and Khushwinder (43) — belonged to blood group 'O' and did not have a compatible donor in the family.

Doctors said its has been 15 months since Zuana underwent the surgery, a year for Karthikey and five months for Khushwinder.

Zuana found a donor in her grandmother with a blood group A, Karthikey's donor was his mother with blood group B and Khushwinder's brother-in-law, who has group B, stepped in as donor.

Dr A S Soin, chief liver surgeon and chairman of Medanta Liver Institute, antibodies in a patients usually work against an organ transplanted from a different blood group. In order to make a patient accept a liver of a different blood group, antibodies are removed through a three-pronged strategy, which starts one month prior to transplant.

"First, the antibodies are removed by washing patient's entire blood by several plasma exchanges. Second, we use drugs to suppress the antibody-producing plasma cells, and third, intravenous IVIg is given to neutralise any remaining antibodies. This is then followed by the transplant with zero-error precision surgery to avoid blood vessel and bile duct problems, to which these patients are very susceptible," Soin said.

Dr Naresh Trehan, chairman and MD of Medanta, said it a complex procedure and requires a combination of high-level expertise, technology, zero-infection environment and laboratory services.

Dr Neelam Mohan, director of paediatric hepatology and transplantation, said Zuana was in terminal liver failure stage, with no hope of survival without a transplant. She was in coma and on ventilation for 10 days.

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