Nephrologists at Virinchi Hospital; successfully transplanted kidney in an End Stage Renal Disease (ESRD) patient suffering with Thrombotic Microangiopathy (TMA) syndrome, in a first of its kind procedure in this part of the country, at an economical cost with excellent graft outcome.
This case turned out to becomplicated due to ABO incompatibility. But Specialists led by Dr K S Nayak,Head, Department of Nephrology; overcame the challenges and the patient is due for discharge.
Thrombotic Microangiopathy (TMA) syndrome involves destruction of red blood cellsand organ damage due to the formation of microscopic blood clots in capillaries and small arteries.When the kidney donor’s blood type and recipient’s blood type are different the transplant is called ABO incompatible kidney transplant. Such incompatibility in bloods leads to rejection of the foreign kidney used for transplant.
The complexity of TMA, which can arise from various causes, necessitates careful evaluation and management to minimize the risk of recurrence post-transplant.This complexity increases manifold in cases where ABO incompatibility exists between the donor and recipient. ABO incompatible kidney transplantation itself is associated with risk of TMA. This risk is very high in cases of End Stage Renal Disease(ESRD) due to TMA.
In a recent case, Raman Kumar Singha 37-year-old patient from Jamtara, Jharkhand State with end-stage kidney disease caused by TMA required a kidney transplant, with the only available donor being an elder sister, Ms Tinku Singh, with a different blood group. Given the absence of a blood group-matched donor, an ABO incompatible transplant was the sole option.
The patient was specifically referred to us at Virinchi Hospital, because of our considerable experience in handling complicated cases. Despite the heightened risks associated with this approach, including the potential for TMA recurrence and graft failure, the patient’s strong desire for transplantation and robust familial support prompted a strategic discussion between the Nephrology team and the patient’s family.
The Virinchi HospitalNephrology team which performed this complex procedure consisted ofDr K S Nayak: Head, Department of Nephrology; Dr Naveen Kumar Mattewada, Senior Nephrologist and Dr Naveen Medi, Senior Nephrologist.
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