Two men, from Tanzania and India, donated kidneys to each other’s mothers, in a Swap Kidney Transplant at Nanavati Max Super Speciality Hospital & Sushrut Hospital, Chembur

In a life-saving swap organ transplant bridging international borders, two sons, one from Tanzania and the other from India, donated their kidneys to each other’s mothers. The milestone surgery is a rare instance of an International Swap Kidney Transplant in Maharashtra.

The donors and recipients are now on the path of recovery and are currently under the care of experts at Nanavati Max Super Speciality Hospital, Vile Parle and Sushrut Hospital, Chembur of Mumbai.

The Mother-Son Duos: 

58-year-old Francisca Zacharia from Tanzania travelled to Ahmedabad, India seeking treatment for chronic kidney disease (CKD) stage V in September 2023. Initially hoping for a clinical cure for the condition. She and her family were advised that a transplant was necessary.

“I was determined to donate my kidney so my mother doesn’t have to be on dialysis. But before going ahead with any treatment option, we wanted to take a second opinion and that’s when we were referred to Nanavati Max Super Speciality Hospital in Mumbai. And there after several tests and thorough investigation, we suffered a setback when we learnt that me and my mother are a mismatch for the transplant. My mother’s blood group was A and mine was B,” expressed her 32-year-old son Mr. Fred (name changed on request).

Dr Jatin Kothari, Director, Nephrology and Chief Consultant, Renal Transplant Medicine, Nanavati Max Super Speciality Hospital, who had also performed India’s first International swap kidney transplant in 2013, said “the alternative of an ABO incompatible kidney transplant was less optimistic. Especially in elderly kidney recipients, ABO-incompatible transplants carry a 35% risk of organ rejection. Even after successful surgery, the patient had to be on immunosuppressant, anti-rejection medication and plasmapheresis, affecting their quality of life.”

Dr Kothari counselled the family about the possibility of a Swap Kidney Transplant. Once they agreed and registered on the unique Apex Swap Transplant registry (ASTRA) established by the Apex Kidney Foundation, the Tanzanian duo found a compatible match at Sushrut Hospital in Chembur.

The news came as a new ray of hope for  57-year-old Sheela Chainani, a resident of Chembur, Mumbai, who had been undergoing dialysis for two years. Also grappling with chronic kidney disease 5^th stage. Sheela required dialysis multiple times a week. Similar to Francisca, she was unable to undergo a transplant as her son Aditya (30) was not a compatible donor.

The process:

After the patient’s consent and a satisfactory compatibility score, both hospitals followed a comprehensive documentation and interview process. The application was then sent to the State Authorisation Committee led by the Directorate of Medical Education and Research (DMER) which expedited the approvals considering the severity of the patient’s condition.

On December 4, Francisca’s kidney transplant, with Aditya as donor was performed at Nanavati Max Super Speciality Hospital. Simultaneously, Sheela underwent the surgery at Sushrut Hospital with Fred as her donor. With the success of both surgeries, the donors are now set to be discharged shortly, while the recipients remain under observation.

“After speaking with Francisca, I realised that both families overcame numerous obstacles prior to meeting each-other as a compatible match. I am relieved that the procedures were successful, and all four of us are on the path to recovery. This journey has forged a special bond between us, one that we will cherish forever,” said Aditya, who donated his kidney to Francisca.

Mangla Dembi, Senior Vice President and Head, Nanavati Max Super Speciality Hospital said “This successful surgery is a testament to our multi-organ transplant program that is backed by a highly skilled team of clinicians, state-of-the-art infrastructure and infection control protocols of international standards. It’s heart-warming to observe how, despite differences in nationality, race, or creed, we are united biologically and through compassion, we have the power to transcend these divides and save lives.”

Speaking about the procedure, Sonal Desai, Chief Operating Officer, Sushrut Hospital, Chembur, said, “We take pride in managing the SWAP registry at our hospital, facilitating matches for incompatible donor-recipient pairs, not only locally but also globally. The surgery marks a substantial clinical accomplishment and has the potential to raise awareness about swap transplants, extending hope to patients with end-stage kidney failure and those undergoing dialysis.”

BOX:

What is a Swap Kidney Transplant?

A swap kidney transplant is when a willing donor and recipient, who can’t donate to each other because they’re not a match, swap donors with another similar pair. So, each donor gives a kidney to the other pair’s recipient, who they are compatible with. The Apex Swap Transplant Registry (ASTRA), established by the Apex Kidney Foundation, helps these pairs who don’t match with each other find a pair they can swap with and match successfully.

Once the compatibility score is checked through clinical investigations, each pair undergoes a thorough documentation and interview process at respective hospitals, followed by a review of the State Authorisation Committee headed by DMER for final approval. Swap Kidney Transplant carries a significantly lower risk of rejection compared to ABO incompatible transplants, which involve high risk and increased treatment costs.