For O-positive, organ swap may be the only way out…

Mumbai: It’s the irony of having O-positive blood flowing through one’s blood vessels. One can donate blood for all other groups but can receive only from a fellow O group-positive donor. Dev Sareen knows the feeling all too well.

If not for an altruistic couple from Ajmer and doctors with the knowhow in Mumbai’s Jaslok Hospital, he possibly wouldn’t be back at work as a railway engineer in Ujjain. He is now an advocate of swap-kidney donations, an emerging trend that the Union government has already taken note of and announced its decision to include them in the soon-to-be-upgraded Organ Transplant Act.

He got a kidney from Ajmer resident Madhu Sharma, the O-positive wife of another kidney patient Mahinder, who, in exchange, got a kidney from Dev’s wife Vimla. The couple will meet at their doctor’s clinic again on April 14 to learn about each other’s progress. A railway engineer presently based in Ujjain, Dev knows the pain of looking for a kidney, especially in a comparatively smaller town that doesn’t have the infrastructure like Mumbai. That is when he came to Mumbai’s railway hospital looking for solutions. He met nephrologist Dr Madan Bahadur in Mumbai.

‘‘My son is O-positive and he was willing but doctors said he was too young to give me a kidney,’’ said the 56-year-old, who had been enduring painful dilaysis for almost three years. The doctors had another railway employee on their list, Mahinder Sharma, who — after being on dialysis for two years — had come to them with a request to transplant one of his wife’s kidneys.

‘‘We had a peculiar situation here. Mahinder’s blood group was B-postive, his wife Madhu’s was O-positive. She was willing to donate one of her kidneys to him which was medically perfect. But we had the exactly opposite situation with the Sareens; while Dev was O-positive, his wife Vimla was B-positive,’’ said Bahadur. A solution — if the Sharmas were willing, that was — would have been swap transplants between the couple. ‘‘But the point is that Sharmas did not need to go out of their way to donate their O-positive kidney to others. Madhu could well have given her kidney to her husband,’’ said Bahadur.

But the Sharmas didn’t need a second counselling. ‘‘We both know what a struggle it was to undergo dialysis every week and wonder about our children’s future,’’ said Madhu and Mahinder.

The decision made, the inter-city swap operation took place in Jaslok Hospital on Peddar Road on January 14.

The significance of this swap, according to Bahadur, lay in the fact that it involved an O-positive recipient. ‘‘About 50% of the Indian population has O-positive blood group. Hence, most of kidney failure patients too have O-positive blood group. They are disadvantaged because they can receive kidneys only from O donors who have to be their relatives. But this doesn’t always happen. Hence, if swaps become common, it would obviate the need for any unrelated transplants,’’ he said.

Apart from altruism, there also is a strong underlying medical message in the Sharma-Sareen swap story. It is about the need for HLA matching between donors and recepients. Human leukocyte antigen (HLA) are protiens found on most cells of the body. The body’s immune system uses these protiens to recognise which cells belong to the body and which don’t. ‘‘So a closer HLA matching would be mean less chance of a rejection,’’ said Dr Bahadur.

In the Sharma-Sareen swap, the HLA matching between the O recepient-donor and the B recepient-donor was good. ‘‘In fact, the government should make guidelines that should also include HLA matching as a criteria for swap dinations,’’ he added.

Malathy Iyer | TNN

Publication: Times Of India Delhi | Date: Apr 6, 2010
Section: Times Nation | Page: 11

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