Click here to join Express Pune WhatsApp channel and get a curated list of our stories
© The Indian Express Pvt Ltd
Tags:
Journalism of Courage
“Mala majhi bayko pahije (I wanted my wife back),” says 43 year old Rahul Mashale from Tathawade who despite challenges of a different blood group and triple renal arteries was able to donate his kidney, “My wife Aarti’s condition had deteriorated and she needed an urgent kidney transplant,” says Mashale. Three weeks after the transplant, Mashale cannot believe that they have defied the odds and his wife is now steadily recovering.
The rare and challenging transplant was performed by a team of doctors at Manipal hospital, Baner on July 18. For Aarti it is a 9-year struggle that she prefers to forget but gratefully acknowledges the role of the Manipal hospital doctors and her husband. “It was a difficult time as my daughter was in Std X and could not focus on her studies due to my illness,” Aarti told The Indian Express.
According to Dr. Tarun Jeloka, Consultant Nephrology and Transplant, Aarti suffered from a series of severe health issues since 2015.
“Her struggles began with a diagnosis of SLE (Systemic Lupus Erythematosus) and lupus nephritis, a debilitating autoimmune disease. Despite trying five different forms of medications, her severe hypertension remained uncontrolled. In 2020, her health further deteriorated with the onset of herpes zoster and diabetes. By April 2021, she had developed early signs of kidney failure, which rapidly progressed, culminating in the need for dialysis by 2023,” Dr Jeloka said.
However, the transplant was challenging due to ABO incompatibility. Rahul’s Blood group was AB+ while Aarti’s blood group was A+ Further evaluation revealed an additional challenge that Rahul had triple renal arteries, a rare anatomy occurring in only 10% of the population.
Dr. Anand Dharasakar, Consultant, Urology who led the transplant team said, “Performing a transplant was complicated as the donor had three renal arteries, while the recipient had only one. Suturing the three arteries was difficult in the donor’s case, therefore, we performed a laparoscopic surgery to harvest the kidney, which is less invasive, quicker to heal, and more cosmetically preferred for the donor. However, transplanting the kidney into the recipient with only one artery was equally daunting, requiring precise vascular reconstruction to ensure proper blood flow,” he pointed out.
To overcome the challenge of mismatched blood groups, Dr Jeloka said that they performed the transplant using a special protocol for incompatible blood types. To reduce the risk of rejection, they gave the patient a monoclonal antibody medication two weeks before the transplant, followed by additional medications a week before.
“We also did a procedure called plasma exchange to remove harmful antibodies from the blood until they reached a safe level. Despite the higher risks, the transplant was successful, just like a matched transplant. The patient’s kidney function became normal within two days, and was able to go home without any complications,” Dr Jeloka said.
The transplant team also involved Dr. Saurabh Khiste, Dr. Shrirang Ranade, Dr. Nilesh Warwantkar, Dr. Ranjeet Maheshgauri. Anaesthesia support was provided by a team headed by Dr. Ashish Pathak.
“The donor was discharged within 7 days, while the recipient was discharged within 9 days of the procedure. The recovery period for both will be the same as for matched transplants: 2-4 weeks for donors and 6-12 weeks for recipients. Both donor and recipient can expect to live normal lives, with the recipient required to take transplant medications lifelong,” Dr Chinmay Erram, Chief of Medical Services, Manipal Hospital said.
Meanwhile, according to Anand Mote, Cluster Director, Pune Operations, Manipal Hospital said that this case should become an example for male donors, particularly as according to recent data, 71 per cent of donors are female and among spousal transplants 90 per cent are wives.
