Cross-Blood Kidney Transplant Performed on Bombay Blood Group Patient

Cross-Blood Kidney Transplant Performed on Bombay Blood Group Patient

Sub : Sci

Sec: Health

Why in News

• A groundbreaking medical procedure was performed at MIOT International in Chennai, where doctors successfully conducted a kidney transplant for a patient with the rare Bombay blood group. This marks the first known instance of a cross-blood transplant for a patient with this blood type, overcoming significant clinical challenges.

Details:

• A 30-year-old male patient with the rare Bombay blood group required a kidney transplant. His mother, who did not share his blood group, was willing to donate a kidney.
• Traditionally, organ transplants require blood group compatibility to prevent rejection. Doctors in Chennai, with expertise in cross-blood transplants, employed advanced medical techniques to make the transplant possible.

About Bombay Blood Group:

• First identified in Mumbai in 1952 by Dr. Y.M. Bhende.
• Lacks the H antigen, which is the foundation for A and B blood group formation.
• Cannot receive blood from ABO blood groups, including type O.
• Only compatible with blood from another Bombay blood group donor.
• Occurs in approximately 1 in 4 million people globally. More common in Mumbai (1 in 10,000) but remains highly rare in Europe (1 in a million).

Clinical Challenges in Cross-Blood Transplant:

• Cross-blood transplantation, also known as ABO-incompatible transplantation, involves performing organ transplants between donors and recipients with different blood types.
• This approach is particularly significant when a compatible donor is unavailable, expanding the potential donor pool and reducing waiting times for recipients.
• Overcoming Incompatibility: Doctors utilized Double Filtration Plasmapheresis (DFPP), a Japanese technique used to reduce blood incompatibility in ABO transplants.
• Key steps involved:
  • Measuring anti-H antibodies, in addition to standard anti-A and anti-B antibodies.
  • Administering monoclonal antibody injections to deplete B cells responsible for antibody production.
  • Conducting plasmapheresis to remove antibodies from the blood, lowering the rejection risk.
  • Using immunosuppressive intravenous immunoglobulin (IVIG) therapy to further suppress immune response.
• The patient underwent kidney transplant surgery after reaching a presumed safe antibody level.
• The transplant was successful with no complications during or after the surgery.

Blood Groups and Their Types:

• Human blood is classified into different groups based on the presence or absence of specific antigens on the surface of red blood cells.
• The two primary blood group systems are the ABO system and the Rh system.
• ABO Blood Group System:
  • Type A: Has A antigens on the surface of red blood cells and anti-B antibodies in the plasma.
  • Type B: Has B antigens on the surface of red blood cells and anti-A antibodies in the plasma.
  • Type AB: Has both A and B antigens on the surface of red blood cells and no anti-A or anti-B antibodies in the plasma; known as the universal recipient.
  • Type O: Lacks A and B antigens on the surface of red blood cells but has both anti-A and anti-B antibodies in the plasma; known as the universal donor.
• Rh Blood Group System:
  • The Rh blood group is one of the most complex blood groups known in humans.
  • It was named after the Rhesus monkey; it has become second in importance only to the ABO blood group in the field of transfusion medicine.
  • It has remained of primary importance in obstetrics, being the main cause of haemolytic disease of the newborn (HDN).
  • Rh Positive (Rh+): Presence of the Rh factor (D antigen) on the surface of red blood cells.
  • Rh Negative (Rh-): Absence of the Rh factor on the surface of red blood cells.
• The combination of the ABO and Rh systems results in eight possible blood types: A+, A-, B+, B-, AB+, AB-, O+, and O-. Understanding these blood types is crucial for safe blood transfusions and organ transplants.