We don’t know how strong we are, until being strong is the only choice. What lies behind us and what lies ahead of us are tiny matters, compared to what lies within us. Having to face a situation where you might need a kidney transplant surgery, is one such occasion, where your inner strength will be truly tested, especially, when the blood group of the patient (recipient)doesn’t match with the blood group of the donor(ABO Incompatible kidney transplant).
Before we get into a little more detail about ABO Incompatible kidney transplant, it would be wise to begin by understanding a bit about what ABO is all about.
ABO Compatibility
In simplest of terms, ABO refers to the blood groups of an individual. As both donor and recipient are involved in a kidney transplant process, it is important that the ABO status of both the recipient and the donor should match. This is referred as ABO Compatibility. However, a situation may arise when the blood group of the donor does not match with the blood group of the recipient. The process of kidney transplant can take place in such situation too. This process, adopted by Nephrologists is termed as ABO Incompatible transplantation.
ABO Incompatible Renal Transplant
In an ABO Incompatible renal transplant, the blood group of the donor, does not match with the blood group of the recipient. The preliminary test to ascertain this is through an ABO Compatibility test which involves finding out whether the blood groups of the donor and recipient match.However, even if there is a mismatch in the blood groups, the transplant process can still be taken forward. Over the past few decades, ABO incompatibility has been addressed consciously and credibly, with doctors from formidable nephrology research institutes across the world, conducting in depth research and successfully exploring the option of having a living donor, even with a different blood group. This method has expedited the process and thereby reduced the time for those patients who continued to wait for a proper match. In India, the transplant team from NU Hospitals, one of the premier hospital with over 20 years of experience of having solved complex cases involving Nephrology, Urology, Andrology and Reproductive Medicine, have now been successful in conducting ABO incompatible kidney transplant surgeries, to the fullest satisfaction of its patients. In ABO incompatible renal transplantation, the transplant team focuses on reducing the risk of rejection of donor kidney from pre-existing antibodies in the recipients blood due to blood group mismatch.
The ABO Incompatible transplant procedure
ABO Incompatible living donor kidney transplant procedure has been successfully used by doctors at NU Hospitals, to increase donor utilization for living donor kidney transplantation programs. Since the past couple of decades, desensitization protocols for ABO Incompatible living donor kidney transplant, have undergone major changes, as new immunosuppressive agents have been developed, with a view to minimize pre-transplant requirements and achieving better graft survivals with lesser unfavourable events.
The ABO Incompatible kidney transplant procedure entitles the recipient to receive medical treatment (desensitization process), both in pre and post-transplant period(if needed), to reduce the antibody levels in the blood, thereby minimizing chances of rejection.
Titers Test for Kidney Transplant
The Titers test assumes lot of significance for a kidney transplant procedure as it helps your doctors in identifying the presence of antibodies in a patient’s blood. Antibodies are nothing but proteins which are found circulating in the body. Detecting the types and amount of circulating antibodies will help doctors in ABO incompatible kidney transplantation and management. The ABO incompatible transplant involves a couple of important procedures;
Plasmapheresis
Plasmapheresis is a process which filters the blood and removes harmful antibodies in the recipient’s blood stream, before a blood group incompatible kidney transplant. Though this process is similar to dialysis, it is specifically adopted to remove antibodies from the plasma portion of the recipients blood. This process is increasingly being adopted by doctors in almost all kidney transplant centres. The number of plasmapheresis sessions required by each patient is decided by the doctors, depending on the antibody titers in the recipients blood.
Immuno-adsorption
This process is quite commonly used by nephrologists in the ABO Incompatible kidney transplantation. This is done to remove the antibodies from the recipients’ blood during ABO Incompatible renal transplantation to reduce the risks of kidney rejection. Immuno-adsorption is also considered for highly sensitized kidney transplant patients. It is considered to have a higher ability to produce the desired result with lesser side effects. Teamwork makes dreams work and that’s what our doctors at NU Hospitals in Bengaluru, India, have been able to achieve. The percentage of patient graft survival rate at 6 months follow up in India stood at an inspiring 94%, while rejection of transplant was noticed in about 8% of the patients. Drawing inspiration from these healthy ratings, NU Hospitals continues to provide the best medical treatment by solving complex cases, using the latest available technology.
Conclusion
Sharing Kidneys is Caring
The world is now gradually but surely endorsing ABO-incompatible kidney transplantation (ABOiKT) as a safe procedure. Since the last 2 decades, there has been a visible difference in the outcome of a kidney transplant procedure. The acceptable outcomes of the ABO Incompatible kidney transplant procedure in the recent past should inspire patients and believe that losing is not an option.
This procedure should be more promoted to close the widening gap between demand and supply for kidney transplant and expand the living donor pool. According to a recent survey report, appearing in the American Nephrology Society Journal, the One-year uncensored graft survival of patients who were ABO-incompatible was 96% versus 98% in ABO-compatible controls. The ABO Incompatible kidney transplant process has proved that kidneys from living donors tend to last many years longer than kidneys from deceased donors.
