An ABO-incompatible kidney transplant occurs when the donor and recipient have different ABO blood types. Traditionally, kidney transplants required blood type compatibility (for example, a type O donor to a type O recipient). However, recent medical advancements have made it possible for patients to receive a kidney transplant from a donor with aa different blood group, offering new hope for patients who might otherwise have been excluded from the transplant list.
As a nephrologist, Dr Kosha Patel and her team offers hope and a chance for a better life to patients suffering from kidney failure by providing options for patients in need of a kidney transplant is the ABO-incompatible kidney transplant, which has transformed the way we approach organ donation and transplantation.
The human body’s immune system recognises and fights against foreign invaders like bacteria and viruses. One of the key ways the immune system does this is through blood group antibodies. When a donor and recipient have incompatible blood types, the recipient’s immune system can react to the donor kidney as a foreign object, which can lead to hyperacute rejection or organ failure soon after transplantation.
However, advancements in immunosuppressive therapy and other medical treatments have enabled us to overcome this challenge by removing these blood group specific Antibodies. Plasmapheresis, a treatment that removes harmful antibodies from the bloodstream, along with other immunosuppressive drugs, allows patients to receive an ABO-incompatible kidney transplant while minimizing the risk of rejection.
The process of ABO-incompatible kidney transplantation typically involves the following steps:
Plasmapheresis removes harmful antibodies, while immunosuppressive therapy helps prevent rejection and protect the transplanted kidney.
Once the recipient’s antibodies have been sufficiently reduced, they undergo the transplant surgery to receive the ABO-incompatible kidney.
After transplant, ongoing immunosuppressants and close monitoring help ensure the new kidney functions well and rejection risk stays low.
One of the most significant advantages of ABO-incompatible kidney transplants is that it expands the pool of potential kidney donors. Making possible for patients who may have previously been excluded due to blood type incompatibility can now receive a life-saving transplant, reducing their wait time and offering a higher chance of survival.
Eligibility for ABO-incompatible kidney transplantation is determined on a case-by-case basis. Several factors are considered, including:
The Role of Plasmapheresis and Immunosuppressive Therapy
In ABO-incompatible transplants, plasmapheresis removes harmful antibodies before surgery, making it safer to receive a kidney from an incompatible donor. Multiple sessions help lower rejection risk. After the transplant, immunosuppressive medications continue to protect the new kidney. These drugs are essential but require close monitoring to balance preventing rejection with minimizing side effects and infections, ensuring the best possible outcome for the recipient.
Frequently Asked Questions:
An ABO incompatible kidney transplant is when the donor and recipient have different blood types, which normally wouldn’t match. Today, with special medicines and treatments, doctors can prepare the recipient’s body by removing certain antibodies, making it possible to safely receive the kidney and reduce the risk of rejection.
“ABO incompatible” is simply another term for two individuals’ blood types not matching. For instance, someone who has blood type A cannot normally accept a kidney from a blood type B individual, since the body will see it as foreign and reject it. But through proper medical treatment and care, some of these transplants are now being offered in selected cases.
An ABO incompatible kidney transplant in India is more expensive than a regular transplant. This is because special medicine, antibody removal procedures (plasmapheresis), and longer hospital stays are required. The cost ranges from ₹12 to ₹20 lakhs depending on the city and hospital. This is more than a regular transplant, which ranges from ₹5 to ₹10 lakhs.
Most kidney transplants last about 10 to 15 years, though some last longer. Over time, the immune system may slowly reject the kidney, or it may wear out due to other health issues. With proper care and regular check-ups, many people enjoy a long and healthy life with their transplant.
Creatinine is a waste product filtered by your kidneys from the blood. During a kidney transplant, the normal creatinine level is typically 0.6 to 1.3 mg/dL but varies slightly from person to person. A high level of creatinine might be a sign that the kidney is failing and needs to be tested by the doctor. Blood tests regularly help to test for this.
A kidney transplant can improve life, but it has some downsides. The main risk is organ rejection, which requires lifelong medication that can weaken the immune system. There are also surgery risks and it may take time to find a matching donor. Still, for many, a transplant offers a better and more active life than dialysis.
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