Kolkata, February 2024: Fortis Hospital, Anandapur successfully treated a young man aged 24 originally hailing from Jharkhand, who had been undergoing dialysis for the past three years at a different hospital in Kolkata. Additionally burdened with cardiomyopathy (a condition characterized by a weakened heart with an alarmingly low pumping rate) the patient was admitted to Fortis Anandapur for a renal transplant. However, Dr. Upal Sengupta, Director, Nephrology, Fortis Hospital, Anandapur who led the charge in this complex case first sought assistance from Dr. Priyam Mukherjee, Consultant, Cardiology, Fortis Hospital, Anandapur and his team. Dr. Mukherjee lent his expertise to address the patient's cardiac challenges, which enabled the heart pumping rate to improve, reaching 40% from 25%. Post this, Dr. Sengupta performed a renal transplant procedure on the patient. 

Talking about the challenges posed by this case, Dr. Sengupta said, “The patient's blood type, B, didn't match his mother's, AB+, who was initially considered as a donor. Traditionally, matching blood types are crucial for successful organ transplants. However, advancements in medical science have introduced the possibility of conducting kidney transplants across blood groups while ensuring the patient's heart health, which was crucial in this case. This situation required careful checking of the transplant's compatibility because transplants across different blood groups often have a higher chance of rejection.”

“To address blood group mismatch, we typically resort to a temporary change in the patient's blood group using plasmapheresis. This procedure involves drawing blood, filtering out harmful antibodies (anti-ABO antibodies), and then returning it to the patient's bloodstream. Plasmapheresis requires multiple sessions to lower antibody levels adequately. However, in this instance, we discovered a more efficient solution called Glycosorb, which was employed for the first time at Fortis Hospital, Anandapur. Although Glycosorb has been used limitedly in Eastern India due to its novelty, it's gaining global popularity for its ability to remove the necessary antibodies in just one session, unlike plasmapheresis. This procedure was performed a day before the transplant, successfully reducing the level of anti-blood group antibodies to a suitable level for surgery,” he further added. 

Speaking about the difference in kidney sizes between donors and recipients, Dr. Sengupta said, “It's a common understanding that mothers generally possess smaller kidneys compared to younger individuals. However, in this case, monitoring of creatinine levels post-transplant revealed a gradual decrease, indicating successful adaptation of the transplanted kidney despite initial concerns about size disparities.”

When asked about the recovery time and the decision to choose transplant as a solution, he explained, “A standard transplant procedure typically requires 10 days and if plasmapheresis is involved, it may extend to 20 days. In this case the recovery time was notably quicker, and the patient was discharged on the 8th day. This can be attributed to his young age of 24, which usually leads to better outcomes after a transplant compared to ongoing dialysis. Despite initial hesitation due to a blood group mismatch with potential donors at home, we emphasize transplant as the preferred solution for patients due to its superior life expectancy and improved quality of life compared to ongoing dialysis treatments."

Talking about his contribution in giving the patient a new life, Dr. Priyam Mukherjee, Consultant, Cardiology, Fortis Hospital, Anandapur, said, “The patient's kidneys were in bad condition, which made it necessary to opt for an urgent transplant. On top of that, he also had a condition called cardiomyopathy often seen in renal patients, stemming from compromised kidney function. In such cases, proceeding with a transplant becomes extremely risky due to the potential for cardiac arrest, sudden death, or heart failure. 

However, with recent advancements in medical treatments we have new molecules targeting heart failure which were administered promptly. This helped improve the heart's pumping rate from 25% to 40% and the transplant procedure was successful. This will ultimately help reverse the cardiac issue.

I also learned that the kidney donor was none other than the patient's mother - a testament to the bond between a mother and her child.”

Mr. Ashish Mukherjee, Facility Director, Fortis Anandapur, Kolkata, expressed his pride in the accomplishment of his medical team, stating, "I am proud of our medical team who completed this high-risk and challenging surgery. This will not only treat the renal deficit but will also allow the patient to live a normal, stress-free life."