India’s first kidney transplant for a patient with rare ‘Bombay’ blood group successfully performed in Mumbai hospital

The recipient, a 30-year-old woman from Shirdi, had been suffering from end-stage kidney disease due to diabetes and had been on dialysis since 2022. Initially misdiagnosed as having ‘O’ blood group, her actual blood type was only identified when she was being evaluated for a transplant at Jaslok Hospital. A misdiagnosis in such cases can lead to catastrophic outcomes, including graft rejection or fatal transfusion reactions.

Since individuals with this rare blood type can only receive organs from donors with the same blood group, finding a suitable match was nearly impossible. With no compatible deceased donors available and multiple hospitals declining the case due to its complexity, her mother, a B-positive donor, stepped forward. However, the mismatch introduced significant risks, requiring doctors to modify the recipient’s immune response before transplantation.

Dr Rishi Deshpande, director of nephrology (academics) at Jaslok Hospital, highlighted the unprecedented nature of the transplant. “To the best of our knowledge, there are no documented cases of a kidney transplant for a patient with the ‘Bombay’ blood group worldwide. The key to success was the accurate identification of the patient’s blood type—had this been overlooked, the consequences could have been catastrophic,” he said. “This case underscores the importance of precise blood typing in transplantation and demonstrates how meticulous planning and advanced immunological protocols can overcome even the most challenging medical barriers.”

To lower the risk of rejection, doctors employed a specialised desensitisation protocol, including plasma exchange therapy and immunosuppressive treatment. These measures helped reduce antibody levels, increasing the chances of a successful graft acceptance.

Another major hurdle was securing compatible blood products. Since ‘Bombay’ blood group patients cannot receive blood from standard donors, Jaslok Hospital had to coordinate with rare blood donor registries across the state to source blood before and after surgery. Unlike other transplants where emergency blood transfusions are readily available, this case required extensive pre-planning explained doctors.

The transplant was carried out by a multidisciplinary team of nephrologists, urologists, anesthesiologists, and transfusion specialists, who worked together to mitigate risks. Dr Ashwin Patil, a consulting nephrologist, emphasised the importance of accurate blood typing in such cases. “A misdiagnosis could have led to severe complications or even graft failure. This case highlights the importance of precise immunological assessment before transplantation.”

Following the procedure, the patient was closely monitored for early signs of rejection. “We have successfully crossed the critical post-transplant phase, but long-term success depends on continued immunosuppressive therapy and careful monitoring,” said Dr J G Lalmalani, a senior urologist.

Expressing gratitude, the patient said, “When multiple hospitals turned me away, I lost hope. But this transplant has given me a second chance at life.”