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New Delhi: An organ
transplant is not an easy job with the task of finding a
compatible donor often proving arduous. A new device, however,
removes the need for the donor to share the recipient's blood
group. Two operations using this device have already been
successfully carried out at a Hyderabad hospital.
Cross blood group organ donations were impossible a few years
back, but now the Swedish-developed device is set to change the
perspective in organ donation. The procedure - at around Rs.10
lakh (approximately $20,000 ) - costs at least two-and-a-half
times the normal transplants.
Developed by Swedish firm Glycorex, the device named Glycosorb ABO
uses a procedure similar to kidney dialysis and "cleans" the blood
to make transplant possible between people with different blood
groups, by removing those antibodies which resist an organ of
another blood group.
Explaining the device's functioning, Glycorex's Lars Hedbys says:
"It brings down the antibodies (substances in blood responsible
for immunisation against foreign bodies), which are responsible
for resisting the other blood group."
Hedbys was in Delhi recently for an exhibition at the Swedish
embassy.
The human blood groups are A, B, O and AB, with positive or
negative Rhesus factors (Rh). Blood group A has anti-B antibodies,
group B has anti-A antibodies, group O has both anti-A and anti-B
antibodies but the AB group has none. This makes AB groups
universal receivers, which can accept blood or organs from any
donor, while O is the universal donor.
The device works on a procedure called "immunoadsorption", in
which a dialyser column designed to "catch" only the relevant
antibodies like anti-A group or anti-B group -- which comprise
only one to two percent of the total antibodies in plasma which is
removed -- thus sparing the "good" antibodies.
"The device has two columns, one removes the anti-A antibodies and
the second the anti-B antibodies. Depending on the blood group,
the necessary columns is used," Hedbys told IANS.
Therefore, if the donor has blood group A, the A column is used to
remove anti-A antibodies, for a donor of blood group B, anti-B
antibodies are removed using the B column. The technique can be
used for liver, kidney, lungs, stem cells, skin and even heart
transplantation.
The first of such implants in India was done by doctors at
Hyderabad's Kamineni hospital in August this year.
"An ABO incompatible transplantation (non-matching blood groups)
is the best option for a patient who has no compatible donors in
the family and the waiting list is long," said the hospital's
Kamal Kiran, who has already done two kidney transplant surgeries,
from blood group A to O and AB to O.
The doctor said both were successful.
"Transplant patients walk on the second day of surgery, walk home
on the seventh. Both patients have gone home and come to my clinic
for a regular monthly checkup," Kiran told IANS on phone from
Hyderabad.
"The next surgery in line is from group B to O, and I have about
10 patients in line," he said.
ABO-incompatibility was been a major handicap for transplants so
far, he noted.
"Up to 30 percent of donors were deemed unsuitable earlier because
of ABO incompatibility. ABO-incompatibility was an absolute
contra-indication to transplantation," says Kiran, adding the
device has changed the scenario.
Across the world, ABO incompatible transplantation is being done
cautiously in Sweden, Germany, the US and regularly in Japan.
About 2,000 transplants have reportedly been carried out so far.
The cost difference between a normal transplant surgery and an ABO-incompatible
implant is however huge, though it works out to be more economical
in the long run.
"A normal ABO compatible transplant costs about Rs.3 to 4 lakh. An
ABO-incompatible one costs Rs.10 lakh. This is due to the cost of
the injections and the ABO columns which are expensive," Kiran
added.
The doctor, however, noted that the cost, specially in cases like
kidney transplant, is cheaper than a long-term expense for
treatments like dialysis.
(Anjali Ojha can be contacted at anjali.o@ians.in)
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