NOW BLOOD GROUP MISMATCH LIVER TRANSPLANT
After Kidney, now blood group mismatch liver transplants are being done successfully.
Liver transplant involves replacement of diseased liver of the patient by a new liver which is obtained either from a brain dead donor i.e. a cadaver or from a living donor. Liver is a unique organ in human body as it has a special capacity of regeneration and can easily be donated by a living person. Any person above the age of 18 years can legally donate a part of his/her liver. In India, as per Human Organ Act 1996, donor can be from the family only (brother, sister, father, mother, son, daughter, spouse) or close relatives. It is essential that the liver donor has a compatible blood group (same blood group as patient or O group), should not be more than 55 years of age and should be medically fit and psychologically sound. Many patients face difficulty when they do not have a matched donor.
Overcoming the problem of blood group mismatch, a Hospital in Gurgaon has successfully completed three liver transplants where the donor's blood group did not match that of the receiver. Such ABO-incompatible transplant, is a medical breakthrough and will prove beneficial to all those patients who were denied a transplant due to ABO mismatch.
Three patients — Zuana (3), Karthikey (18 months) and Khushwinder (43) — belonged to blood group O and did not have a compatible donor in the family. Zuana found a donor in her grandmother with a blood group A, Karthikey's donor was his mother with blood group B and Khushwinder's brother-in-law, who has group B, stepped in as donor. For such transplants to be successful, antibodies are removed from patient blood so that they no longer act against the transplanted organ. The process is started one month prior to transplant. First, the antibodies are removed by washing patient's entire blood by several plasma exchanges. Then drugs are used to suppress the antibody-producing plasma cells, and finally, intravenous IVIg is given to neutralise any remaining antibodies. This is then followed by the transplant. Being a complex procedure, it requires a combination of high-level expertise, technology, and infection free environment. These transplants are less complicated for children less than 2 years as compared to adults since their ABO antibody levels are lower, increasing their acceptance of ABO-i liver. The antibody levels are measured periodically post surgery also and the blood is cleaned with more plasma exchanges if necessary. The body usually adapts to the ABO-i liver in approximately three weeks.
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