Swap kidney transplant, one way to meet demand

The difference in blood groups between a patient in dire need of a kidney and relatives willing to donate one, is one of the main factors responsible for the enormous demand-supply gap in kidneys in the country. 

With barely around 6,000 kidneys known to be available for an average annual demand of 2,00,000 of the organs, (according to Health Minister J P Nadda), the need of the hour is to reduce the gap. As a possible solution to the same, the concept of ‘Swap Kidney Transplant (SKT)’, though not very common, is slowly being practiced in the state.

With a SKT having been successfully done at Sri Ramachandra Medical College and Hospital and another in Christian Medical College, Vellore, this month, nephrologists say the practice can help bring down the demand-supply gap in kidney transplants. 

“When the blood group of the wife of an individual in need of a kidney does not match with his, we avoid the spousal transplant. 

However, if we come across another couple also facing the same problem, but manage to meet the requirement for a Swap Transplant (with the blood group of the wife of couple A matching the patient in couple B, and that of the patient in Couple B matching the blood group of the wife in Couple A), we put forth the idea for the transplant,” explained Nephrologist Dr Anna V. 

Stating that guidelines for the same are yet to be put in place, nephrologists say that SKT is an excellent way forward. “Spousal transplant is what is usually done. However, many a times, they end up having different blood groups. In such cases, swap would serve as a better option,” she said. “Doing a transplant across blood groups increases the risk factors. 

A swap is ideal as the donors and recipients are selected carefully, with factors like their age being taken into account,” she added. 

Stressing on the need to ensure there is a proper way forward, Dr Sunil Shroff, a Urologist and MD, Multi Organ Harvesting Aid Network (MOHAN) Foundation, said, “As the concept of nuclear families is very common today, the possibility of a compatible donor in the family is low. Therefore, the option of swap proves to be apt for a country like India.”

“It is a way forward. We must follow certain rules and regulations. The surgery must be done simultaneously, so that the other pair does not drop out in the last minute. 

It should be well matched. We should do more swaps in India, as it is one way to reduce the shortage in kidneys in the country,” he stated. 

Opining that 10 to 15 of the transplants can go through swaps when there is no match, he added that Tamil Nadu is well equipped to perform these surgeries and it must be encouraged in the country.