Following the rejection of transplanted organs in three recipients last week, the Zonal Transplant Coordination Centre (ZTCC) has set up a technical expert committee to probe what led them to reject the organs from the same donor.
The committee has to submit a report within 15 days after studying the histopathology report of the two kidneys and one liver of the donor as well as samples preserved by forensic experts in the case of one kidney recipient who died.
On September 4, the family of a 59-year-old brain dead patient had given consent to donate both his kidneys and liver at the PD Hinduja Hospital. While the liver was donated to a 73-year-old man at Global Hospital, one kidney was transplanted by Hinduja Hospital for a 31-year-old patient and another sent to Jaslok Hospital for a 60-year-old woman patient.
Doctors at Hinduja Hospital had to remove the transplanted kidney from the 31-year-old’s body after he suffered complications. He died hours later. Samples of his old shrunken kidney, spleen, liver, brain and lungs have been preserved for histopathology examination.
In the other two cases, the transplanted kidney and liver had to be removed from the recipients’ bodies after the organs were rejected. Such a rejection is rare, especially in a situation where the human leukocyte antigen test was normal and other parameters were also as per transplantation requirements.
“There is existing medical literature on such rare instances of multiple organ rejection from a donor’s body in the West. The factors may be immunological. We will go through histopathology reports to ascertain what went wrong,” said Dr Avinash Supe, dean at KEM Hospital, who is chairing the committee.
Other members of the committee include Dr N K Hase, former head of nephrology department at KEM Hospital; Dr Darius Mirza, liver transplant expert; and Dr Dilip Karnad, intensivist at Jupiter Hospital.
In the case of the liver recipient, after the organ was rejected, another urgent liver transplant was conducted on September 7. In the case of the 60-year-old kidney recipient at Jaslok Hospital, the patient remains on ventilator support after doctors removed the failed kidney from her body. “Her condition is stable. We are hoping she will be able to undergo a second transplant soon,” her son told The Indian Express.
The family of the deceased, a Bhuleshwar resident, says he was on dialysis since he was in Class X. He was waitlisted for kidney transplant a year ago.
While Jaslok Hospital has maintained there was no rejection of kidney by recipient’s body, doctors at Global Hospital has said this was a case of acute hyper rejection. The recipients suffered low blood pressure and low platelet count apart from internal bleeding.