Kidney failure has been a major healthcare issue. End-stage renal disease (ESRD) is the last stage of chronic kidney disease is the damage caused by high blood sugar. High blood pressure and other disease cause permanent damage to kidneys, slowly over time.
Paired kidney exchange has gained popularity worldwide as a via
Swap Transplant Procedure
Dr. Mangala Kumar of Kovai Center & Hospital, Coimbatore explains Kidney exchange is a simple barter system. It is a give-and-take deal between two pairs of recipients and donors where each benefits by receiving a suitable kidney. These pairs could not donate each other due to blood group incompatibility or cross-match incompatibility.
Eligibility – Donor
The law permits only first relatives which include parents, children, grandparents, sibling, spouse to become a donor. No other family person or member is permitted for a swap kidney transplant. The donor should have strong mental health with normal kidney function. Diabetic, Hepatitis B or C positive, HIV positive and pregnant women are not permitted for kidney swap transplant.
A kidney donor needs to have a compatible blood type with the recipient. The RH factor of blood does not matter in a transplant. A cross-match test (HLA-Human Leukocyte Antigen) is done to check if the recipient has antibodies against the donor’s cells. If it’s negative, the pair is considered compatible.
Nearly 20-30% of donor-recipient pairs are not able to undergo transplants due to blood group mismatch or cross-match positive. In such cases, a technique called plasmapheresis, a recipient can receive a kidney from an incompatible donor. It filters blood and removes harmful antibodies from the plasma part of the blood. The patient is at a higher risk of infection as it weakens the immune system more than usual. This procedure is much more expensive than a compatible transplant.
Kidney Sharing Scheme
It is a collective term to describe the scheme in which donated kidneys are shared. In the UK and USA, all donors and recipients are registered on the national transplant list. Living donor kidney matching run is performed 4 times per year, where a computer algorithm identifies optimal donors-recipient combination.
Currently, in a primitive stage in India, Dr. Mangala Kumar is working on a similar altruistic donor chain in India on www.c-star.in, as a part of his trust in India. Basic details about the patient will be entered by the hospitals, improving accessibility, affordability, and longevity of the treatment. Starting on city level registry will upscale on a national level after clearing all legal procedure.