Innovative Surgery Helps Patient Get a Fresh Lease of Life at Global Hospitals

Hyderabad: Currently there are About 200,000 patients suffering from end stage renal disease (ESRD) in India. Approximately 7,000 patients suffer from ESRD in Telangana and 16,800 patients suffer from ESRD in Andhra Pradesh, so approximately there are about 23,000 to 24,000 patients are suffering from ESRD in both the states.

The treatment options for ESRD include renal (kidney) transplantation, hemodialysis, and CAPD (Home Dialysis). Out of these, renal transplantation is the treatment of choice. But unfortunately only 5-10% of patients are getting renal transplantation, rest of them are on one or the other forms of dialysis.

Kidney transplantation is the treatment of choice because transplanted kidney performs 100% of the native kidney function and the person can lead almost a normal life. Whereas, Dialysis can replace 50-60 per cent of the native kidney functions and the quality of life on dialysis is poor. Cost of renal transplantation is also lower compared to long term cost of Dialysis over a period of time.

“Even though the transplantation is the best option available, only 5-10% opt for it and remaining 90-95% are on dialysis. The reason for this is lack of donors. Source of the kidney for transplantation is either cadaver donor or live related donor. But, most patients on cadaver list die waiting for a kidney. For successful renal transplant the routine protocol is that the blood group matching between donor and the recipient is must, otherwise, it leads to rejection of the graft immediately. In some families, even though the related donor is willing to donate kidney and is deemed to be medically fit, they are rejected because their blood groups do not match. This happens in approximately 30% cases.” Dr. Gandhe Sridhar, Chief Consultant – Nephrologist and Kidney Transplant Physician, Global Hospitals said while addressing a press conference.

“One of the answers to address this problem is to promote paired (swap) renal transplantation and transplantation with no blood group matching. Recent advances in transplantation has lead to the successful outcome of transplantation even without blood group matching by method of plasmapharesis and using medications like rituximab. Renal transplantation without blood group matching has been very successful in Japan and few European countries. In India, very few centers are doing incompatible renal transplantation. Global Hospitals is now proud to announce the incompatible renal transplantation by using plasmapharesis and rituximab,” Dr. Sridhar added.

Global Hospitals, Hyderabad received a case of a 24-year-old software engineer, Kranthi who was suffering from chronic kidney failure, with blood group O+ve. Her father’s blood group was B+ve and mother’s blood group was B-ve. No suitable blood group matched donor is available in the extended family too.

“Father has requested for incompatible renal transplantation seeing the results in Japan and some other countries. We prepared the patient for transplantation two weeks before surgery by using plasmapharesis and rituximab injection. Once her antibody titres came down to the permissible limits we did the renal transplantation. It has been one month post transplantation and her renal function is good and also her kidney is functioning as a compatible kidney. The renal transplantation without blood group matching is as good as the compatible renal transplantation, much better than the dialysis,” Dr. Sridhar said.
 
“Until recently blood group matching was a major barrier in the renal transplantation, rejecting many potential donors and unfortunately keeping many patients away from the transplantation just for the reason of unmatched blood group. This new option gives them the opportunity to utilize the best possible treatment available,” Dr. Sridhar concluded.

Addressing the press conference, Dr. K Ravindranath, Chairman and Managing Director, Global Hospitals Group, said, “Global Hospitals has always been a pioneer in treating complex cases since inception. The growing incidence of various problems and high level of complexities has made it imperative for us to further raise the benchmarks of our clinical programs significantly. This is yet another example of the cutting edge and unique solution we are offering for the treatment of a complex problem.”