Star Hospitals, Hyderabad IntroducesIndia’s First National-level Paired (Swap) Kidney Donation Registry

23 Feb’2024, Hyderabad: India’s kidney donor shortage is worrying, in a year over 2,00,000 patients need a kidney transplant in India. But, only roughly 8,000 to 12,000 kidney transplants are happing. Inspite of best treatment options only 3% to 5% of patients under going Kidney Transplantation now. The main reason is the lack of donors, as per the National Organ & Tissue Transplant Act only family donors can donate the kidney to their relatives. Inspite of some situation where donors are available within the family but their blood groups are not matching this is the reason for 40% of the donor rejections. For this set of patients, the available option is ABO Incompatible Kidney Transplant & Paired (Swap) Kidney Exchange.

With Paired (Swap) Kidney Exchange we can increase the donor poll from 5% to 40%. But, now in India only few numbers of Paired (Swap) Kidney Exchange are going on compared to western population or other developed countries where 30% to 40% of transplants are because of Paired (Swap) Kidney Exchange. In India in last few years very few Paired (Swap) Kidney Exchanges have happened, this is because of lack of awareness.

Widespread awareness amongst the community is that for a Kidney Transplantation blood group matching is a must. But, in case of not matching there are two solution ABO Incompatible & Paired (Swap) Kidney Transplantation which 90% of the common people are not aware.

To improve that awareness if they have family donors and not matched, they decide that donor is not available. Unless they are aware ABO incompletable or Paired (Swap) Kidney Transplantation, where blood group match is not must.

Diabetes, malnutrition, overcrowding, and poor sanitation all contribute to the high prevalence of Chronic Kidney disease (CKD) in India, which affects approximately 17% of the population. CKD frequently progresses to end-stage renal disease (ESRD).

Star Hospitals has achieved remarkable success in performing Swap Kidney Transplants and ABO Incompatible Kidney Transplants, revolutionizing the landscape of organ transplantation. Kidney Swap Transplants involve exchanging kidneys among incompatible donor-recipient pairs, facilitating life-saving matches that might otherwise be unattainable. This innovative approach significantly expands the pool of potential donors, providing a solution for patients facing compatibility challenges. Star also excels in ABO Incompatible Kidney Transplants, where the transplant occurs between a donor and recipient with different blood types. This pioneering technique transcends traditional barriers, allowing patients to receive kidneys from donors who may not share the same blood type. These advanced procedures represent a beacon of hope for individuals in need, reducing dependency on cadaver donors and offering a transformative solution to the pressing challenges of kidney failure.

Dr. Gandhe Sridhar, MBBS, MD, DM (Nephrology) Senior Consultant – Nephrologist & Transplant Physician, Director – Nephrology & Transplant at Star Group of Hospitals, Hyderabad stated, “The Kidney Paired Donation Registry is a paradigm shift in Kidney transplantation. It places the power in the hands of those in need, allowing them to actively engage in finding a suitable match. This initiative has the potential to revolutionize the way we approach kidney transplants in India.”
 

Dr. Jyothsna Guttikonda, MBBS, MD; AB Nephrology (USA), Sr. Consultant Nephrologist & Transplant Physician Head of Department – Nephrology & Transplant says, “Our holistic approach to transplantation reflects our unwavering commitment to patient-centric care. By offering a spectrum of innovative solutions, we aim to address the diverse needs of our patients and foster a sense of hope and empowerment.”

 

Embarking on a transformative journey, Star Hospitals remains resolute in its commitment to reshape the narrative of organ transplantation in India.
 

Dr. Swarna Latha, In-charge  Jeevandan, stated that the multifaceted approach adopted by the Star Hospitals Team, will increase donor percentage. She also stated that kidney disease in India has reached alarming proportions, with a significant number of individuals grappling with the debilitating effects of the condition while anxiously awaiting a suitable cadaver donor.

 

Dr Gopichand Mannam, Managing Director, Star Group of Hospitals, emphasized the hospital’s commitment to innovation, saying, “Star Hospitals is dedicated to pioneering initiatives that go beyond conventional approaches. The Kidney Paired Donation Registry aligns with our mission to provide advanced healthcare solutions and ensures that patients have a proactive role in their journey to receiving a transplant.”

To facilitate seamless registration and participation, Star Hospitals has launched a dedicated web page. This user-friendly interface will enable individuals to register for the Kidney Paired Donation Registry, providing a centralized hub for potential donors and recipients to connect. The web page will also serve as an informative resource, guiding users through the process and educating them about the benefits of paired donations.

The hospital believes that this online platform will not only streamline the registration process but also serve as a hub for education and awareness regarding kidney transplants and the options available to patients.

What is paired kidney exchange 

Dr. G. Sridhar, Director of Nephrology & Transplant, Star Hospitals talks in detail about the Paired Kidney Exchange / Kidney Swap.

The most valuable gift that can be given is, arguably, a living organ to someone who needs it replaced due to organ failure. Kidney transplantation remains the best form of renal replacement therapy, and there is a growing need for organ donation.

One-third of healthy, eager living kidney donors are turned down due to ABO blood type incompatibility and donor-specific antibodies. This prolongs pre-transplant dialysis, increasing morbidity and death on the kidney transplant waiting list.

Living renal transplant is a treatment in which a healthy adult donates one of his or her kidneys to a patient with end-stage renal disease. The person providing the kidney (donor) must have the same blood group as the patient (receiver), known as an ABO compatible transplant. An exception to this rule is that an O blood group donor can donate a kidney to a recipient of any blood group (A, B, AB, or O), as O group individuals are considered universal donors, and an AB blood group patient can receive a kidney from donors of any blood group, as AB group individuals are considered universal recipients.

However, because our systems naturally produce antibodies against foreign blood group antigens, a donor with A blood group cannot donate an organ to a patient with B blood group, and vice versa. Transplantation across such blood group barriers is known as ABO incompatible transplantation, and it includes the elimination of anti-blood group antibodies from the recipient via specific procedures such as plasma exchange. When compared to an ABO compatible transplant, such methods not only raise the expense of transplant surgery, but they also increase the chances of graft rejection and infection in the recipient after surgery.
 

Over the last decade, kidney paired donation has been the fastest growing source of living kidney donors.

Paired kidney exchange or kidney swap is the exchange of kidneys between two or more ABO incompatible living donor recipient pairs such that the recipients receive compatible kidneys.

Case	Recipient	Donor	Plan
Case No-1	Mr. Maheswar Reddy  Blood group:  A Positive	Mrs. Ramanamma Blood group: A Positive	Left donor nephrectomy
Case No -2	Mr. Raghunatha Reddy    Blood group:  B Positive	Mrs. Meena   Blood group: B Positive	Left donor nephrectomy

How does it work:
Assume there is a PAIR 1 with Recipient 1 in blood group A and Donor 1 in blood group B, as well as a PAIR 2 with Recipient 2 in blood group B and Donor 2 in blood group A.

In a two-pair exchange, Donor 1 with blood group B can donate to Recipient 2 with blood group B, while Donor 2 with blood group A can contribute to Recipient 1 with blood group A. This results in two transplant surgeries occurring simultaneously.

Similarly, several paired exchanges can be undertaken, which is known as a Domino Kidney Paired Exchange.

Aside from ABO incompatible transplants, paired kidney exchange can be considered in HLA incompatible donor recipient pairs, in which the donor and recipient share the same blood group but the recipient has anti-HLA antibodies against the donor tissue, resulting in a positive tissue cross match, and transplantation in such donor recipient pairs is usually not recommended.

When to consider Paired Kidney Exchange

It should be considered for all transplant candidates who have a living donor who is medically fit but unable to give a kidney to the intended recipient due to ABO or HLA incompatibility. It is also worth considering whether a kidney switch allows the patient to have a better matched transplant in terms of HLA, kidney size, and donor age.
 

Kidney Paired Donation Registry 
It is a groundbreaking initiative that empowers individuals to actively participate in their search for a compatible kidney donor. Through this registry, potential donors and recipients are intricately connected, enabling paired donations and eliminating the often-lengthy wait for a cadaver donor. This not only expedites the transplantation process but also significantly broadens the pool of potential matches, increasing the chances of successful transplantation.

a free platform where individuals can seamlessly connect with potential kidney donors and recipients. This groundbreaking registry empowers users by intricately linking donors with recipients, facilitating paired donations and eliminating the often-protracted wait for a cadaver donor. By leveraging this innovative platform, individuals can expedite the transplantation process and dramatically broaden their pool of potential matches, significantly enhancing the prospects of successful transplantation. This revolutionary approach not only accelerates access to life-saving treatments but also fosters a supportive community where individuals can find hope, solidarity, and renewed health.

For Free Registration on Star Hospitals Paired (Swap) Kidney Donation Registry: 
https://starhospitals.in/lp/swap-kidney-transplant-registry/ 

For more details please contact:  07969250191