India's first domino kidney transplant tomorrow

Come Tuesday, country’s first ever domino kidney transplant — involving five donors and five recipients — will be performed at three Mumbai hospitals after the State Government Authorisation Committee gave its nod for the procedure last week.

A domino transplant is a series of surgeries where each donor gives an organ to a recipient not related to him/her, while the donor’s relative needing an organ gets it from a recipient’s relative. Legal issues are involved in organ donation cases when the donor and recipient are not related.

As the transplant is to be conducted in city hospitals — Hinduja hospital, Bombay hospital and Hiranandani hospital — and four of the five donor-recipient pairs are from Maharashtra, permission of the State Authorisation Committee was must.

On May 19, dna had reported that the Rajasthan government had refused to give permission for the procedure as the fifth pair belonged to that state.

They had applied for permission from the Rajasthan state authorisation committee, a body mandated to clear such transplants to prevent illegal trade of organs. The Rajasthan panel denied permission citing the Supreme Court guidelines that said nothing about a ‘domino’ procedure.

When the same pair recently approached the government again with detailed statistics about domino kidney transplant procedures in the western countries, the panel said that there was no need for a further No-Objection Certificate (NOC).

“The interesting thing about domino transplant is that despite blood group not matching, with the help of five way swap exchange, they are able to undergo kidney transplant. Otherwise, they have to wait for a long. All credit goes to the Apex Swap Transplant Registry (ASTRA) that addresses the issue of mismatch in blood groups or tissues in couples who need transplants,” Said Dr Jatin Kothari, Nephrologist, Hinduja Hospital.

“All the transplants will be done on the same day in different hospitals in the city. Everything — surgeons, paramedical team, operation theatres — is in place,” Kothari added.

What is it?
For an organ transplant, blood and tissue of donor and recipient must match. If they don’t, a domino transplant is necessary. It is a series of surgeries where each donor gives an organ to a recipient not related to him/her, while the donor’s relative needing an organ gets it from a recipient’s relative. A previous attempt to perform a five-pair domino transplant failed when a recipient died while waiting for permission from the state.