The team of kidney transplant doctors at Burjeel Medical City in Abu Dhabi succeeded in performing a complex robotic surgery to transplant a kidney to a forty-year-old woman whose blood type differs from that of her donor husband. This is an important medical achievement that challenges the traditional standards in the approach to organ transplantation, which requires that total matching is usually a basic condition to prevent… The recipient’s body rejects the organ given to him by the donor.
When the 32-year-old patient learned that she would have to undergo a kidney transplant to save her life, she did not imagine that the journey to find a donor would be such a complicated journey. The patient and her husband’s journey is a reminder that offering our loved ones our support to face life’s challenges can be a true healer. , where the generous husband played a crucial role in his wife’s journey to recovery by donating his kidney to save her life and end her suffering.
Unexpected diagnosis
The patient had suffered from kidney failure since 2018, and her symptoms developed until last year she reached a late stage of the disease, where she began to undergo dialysis continuously, and at a critical juncture that required a kidney transplant, she faced an additional challenge at that time when she suffered a heart attack, which fortunately was resolved. She was treated immediately, which added new suffering to her, while the couple discovered that the option of transplanting organs from a deceased donor made hope diminish when no suitable donor was found in their country. After a family discussion, the patient’s father volunteered to donate a kidney, but unfortunately he was excluded because he suffers from… Minor health problems with the heart and high blood pressure, while initial tests showed a difference in the husband’s blood type with the patient.
The decision was made to proceed with the transplantation procedure at Burjeel Medical City after numerous discussions with the medical team and Dr. Ishtiaq Ahmed, a kidney and transplant specialist, who emphasized the complexity of the case, highlighting the development of research and medicine over the past 25 years that has made transplantation ABO-mismatched organs between recipient and donor are possible and safe, with a high survival rate similar to other cases of identical organ transplants. The patient in a completely ABO-mismatched kidney transplant undergoes medical treatment before and after the kidney transplant to reduce levels of antibodies. antibodies in the blood, thus reducing the risk of antibody rejection of the donor kidney.
Dr. Ishtiaq Ahmed explained that in the case of this patient, plasmapheresis was performed to eliminate pre-existing antibodies, and the formation of new antibodies was prevented through special injections before the transplant. After that, it was decided to proceed with the completely mismatched kidney transplant after explaining the positives. The negatives were for the family, but the patient and her family were enthusiastic about going ahead with the surgery.
Dr. Rehan Saif, Consultant General Surgery and Director of the Organ Transplantation and Robotic Surgery Program at Burjeel Medical City, explained that the matching of tissues and blood types between the recipient and the donor is essential in organ donation operations, so the difference in blood types of the donor and recipient is rare, and in the context of organ transplant operations. Not compatible with the ABO blood group, evaluating the antibody titer is crucial, as high antibody titers constitute an increasing factor in the patient’s body rejecting the new organ, while the nephrectomy from her donor husband was performed using a robot, which provides significant advantages compared to traditional open methods. Laparoscopic, as this method ensures that the surgery is performed in less time, reduces the possibility of bleeding, and has a faster recovery period, while the kidney transfer and transplant surgery took four hours.
The multidisciplinary team also included Dr. Venkat Sinaresh Vilanki, Consultant in Nephrology and Transplantation, Dr. Ramamurthy Ganesan Bhaskaran, Consultant in Anesthesia and Transplantation Anesthesia, and the ICU team led by Dr. Nicholas Wyon, Consultant in Anesthesiology and Critical Care Medicine, with support from the nursing team, the surgical team, and the Transplantation Director and Coordinator. organ transplant.
“In an ABO-mismatched kidney transplant, intraoperative immunosuppression was carefully designed to address the specific circumstances,” Dr. Ramamurthy said. “To complicate matters, the patient faced challenges during surgery related to difficult central venous access. Efforts were also made to improve blood pressure.” “She receives blood to ensure that the transplanted kidney begins to function effectively before she leaves the operating room.”
Both the donor and his wife then underwent post-operative rehabilitation and were under close supervision by the specialized medical team at Burjeel Medical City. This pioneering procedure is considered a remarkable achievement in the field of medicine and brings renewed hope to families hoping to overcome the challenges of chronic kidney disease.
The patient and her husband expressed their deep gratitude to the dedicated team at Burjeel Medical City for their exceptional care. The patient said: “I went through one of the most difficult periods in my life. I cannot thank my husband enough for his continuous support and love. I am also very grateful to my children and my family because they provided me with With courage and they stood by me steadfastly.”
According to the doctors, the patient will undergo regular follow-up, twice a week at first, and this frequency will be adjusted to monthly visits after six months, including continuous monitoring, a specific diet, lifestyle modifications and routine laboratory examinations.
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