India's First Kidney Transplant in a Rare ‘Bombay’ Blood Group Patient Performed at Jaslok Hospital

Mumbai: Jaslok Hospital & Research Centre has successfully performed India's first kidney transplant for a patient with the extremely rare ‘Bombay’ blood group. This complex procedure highlights the hospital’s commitment to delivering advanced healthcare solutions.

The ‘Bombay’ blood group (hh) is one of the rarest in the world, occurring in only 1 in 10,000 individuals in India and 1 in a million worldwide. Due to the absence of the H antigen, which is present in all other blood types, even O-negative blood can trigger a severe reaction in these individuals. This makes finding a compatible organ donor extremely difficult.

For 30-year-old Pooja from Shirdi, who had been battling kidney failure due to diabetes since 2022, the challenge of finding a matching donor seemed impossible.

Initially misdiagnosed with an 'O' blood group at another hospital, it was at Jaslok Hospital that her blood group was accurately diagnosed as the rare 'Bombay' blood group. An accurate blood group diagnosis is essential for any medical procedure, especially in major surgeries like a kidney transplant.

A proper understanding of the blood group is crucial for a successful transplant, as the blood group plays a significant role in the organ's acceptance by the recipient's body. Her rare ‘Bombay’ blood group presented a significant obstacle to finding a compatible donor.

Individuals with this blood type lack the A, B, and H antigens on their red blood cells, making them universal plasma donors but extremely difficult recipients. After being turned away by multiple hospitals, she found hope at Jaslok Hospital.

Despite the odds, Pooja's mother, with a different and incompatible blood type (B positive), bravely stepped forward as a donor. The transplant team, led by nephrologists and urologists, meticulously planned the procedure, including specialized treatments to minimize the risk of organ rejection.

This involved closely monitoring and managing antibody levels, a critical aspect of incompatible transplants. The hospital's blood bank also played a crucial role, sourcing rare “Bombay” blood products from across the state to ensure patient safety during the surgery.

The team responsible for this procedure included Nephrologists Dr. Rushi Deshpande and Dr. Ashwin Patil; Urologists Dr. A. A. Raval and Dr. J. G. Lalmalani; Anaesthetists Dr. Dipankar Dasgupta and Dr. Savi Shah; Blood Bank officers Dr. Asha and Dr. Tejaswini; and Transplant Coordinators Mrs. Ruchita, Mr. Nilesh, Mrs. Pradnya, and Mrs. Sheetal. Their combined expertise and coordination played a key role in the success of the transplant.

Dr. Rushi Deshpande, Director of the department of Nephrology (Academics) at Jaslok Hospital stated, “Performing this transplant was a formidable challenge, given that no similar cases had been undertaken anywhere in the world to the best of my knowledge. Further, it was at Jaslok Hospital that her correct blood group was diagnosed and knowing this before the transplant was crucial; otherwise, it could have resulted in a catastrophe. The expertise of our highly trained team of doctors and nurses, coupled with the top-notch infrastructure and laboratory support at Jaslok Hospital, played a pivotal role in ensuring the success of the procedure.”

"Jaslok Hospital is a pioneer in ABO-incompatible renal transplants," stated Dr. Milind Khadke, Medical Director, Jaslok Hospital. "However, performing an incompatible transplant with a 'Bombay' blood group recipient is exceptionally rare and complex, requiring meticulous planning and a precise desensitization protocol."

Dr. Ashwin Patil, Consultant Nephrologist, added, "While we routinely monitor ABO titres and perform plasma exchange in incompatible transplants, this case required additional monitoring of 'Anti-H' antibody titres, further highlighting the complexity of the procedure."

Pooja, 30-year-old patient with tears of joy, said, "Dr Deshpande, his team and everyone at Jaslok Hospital looked after me like a family. I had given up on living but today I am thankful to all at Jaslok Hospital for giving me this new lease of life when so many hospitals turned down my case."