Pune: Doctors at Manipal Hospital in Baner successfully performed a kidney transplant on a 40-year-old woman with mismatched blood types and complex vascular anatomy.
Aarti Mashale, a homemaker from Pune, had been battling severe health issues since 2015, starting with a diagnosis of Systemic Lupus Erythematosus (SLE) and lupus nephritis.
Her condition worsened over the years, complicated by uncontrolled hypertension, herpes zoster, and diabetes. By April 2021, Aarti's kidneys began to fail, necessitating dialysis by 2023.
Facing an urgent need for a kidney transplant, Aarti's husband, Rahul Mashale, stepped forward as a donor. However, the procedure was complicated by their blood type incompatibility—Rahul is AB+ while Aarti is A+. Additionally, Rahul's kidneys had a rare anatomical condition of triple renal arteries, present in only 10% of the population.
Dr. Tarun Jeloka and Dr. Anand Dharaskar, leading the transplant team, performed the complex surgery on July 18, 2024.
Dr. Dharaskar explained, "The presence of three renal arteries in the donor and only one in the recipient made the surgery challenging. We used laparoscopic surgery for kidney harvesting, which is less invasive and allows quicker recovery. The transplant itself required meticulous vascular reconstruction to ensure proper blood flow."
To address the blood type mismatch, Dr. Jeloka implemented a special protocol involving monoclonal antibody medication and plasma exchange to reduce the risk of rejection.
"We administered medication two weeks before the transplant and conducted plasma exchange to remove harmful antibodies. Despite the higher risks, the transplant was as successful as a matched transplant, with the recipient's kidney function normalizing within two days," he noted.
Both Aarti and Rahul were discharged within days of the procedure—Rahul after seven days and Aarti after nine. Their recovery periods are expected to be similar to those of matched transplants, with donors recovering in 2-4 weeks and recipients in 6-12 weeks.
The transplant team included Dr. Tarun Jeloka, Dr. Anand Dharaskar, Dr. Saurabh Khiste, Dr. Shrirang Ranade, Dr. Nilesh Warwantkar, and Dr. Ranjeet Maheshgauri, with anesthesia support from Dr. Ashish Pathak's team.
In India, where 71% of kidney donors are female and 90% of spousal donors are wives, this successful surgery highlights that kidney donation does not compromise health.