A bond through triple swap' kidney donation

New Delhi: Three couples, strangers until recently, will now share a life-long bond — thanks to their kidneys. In perhaps a first-of-its-kind case in Delhi, a ‘triple-swap’ of kidneys came to the rescue of three men, who needed kidney transplants, but were found medically incompatible to receive the organ from their wives.

Instead, they received the kidneys from each others' wives, in back-to-back transplant surgeries lasting 14 hours at Pushpawati Singhania Hospital and Research Institute (PSRI).

Delhi-resident Sana Khatun (26) gave her kidney to Ajay Shukla (40) and her husband, Md Umar Yusuf, (37) received it from Lakshmi Chhaya (40) of Bihar's Madhubani.

Chhaya's husband, Kamlesh Mandal, (54) got the kidney from city-resident Maya Shukla (37), whose husband received the organ from Sana.

"After the surgeries, the three couples, who were strangers to each other, have now become friends and emotionally very connected. Some people talk of Hindus and Muslims as being different people, but we are all humans, and have the same blood and kidneys," said Dr Sanjiv Saxena, chairman, PSRI Institute of Renal Sciences.

The surgeries took place on July 8, led by Dr P.P. Singh, head of kidney transplant surgery at PSRI, from 8 am and 10 pm, with a team of seven surgeons, six anaesthetists, 18 staff nurses and 20 operation theatre (OT) technicians.

"Two couples had blood group incompatibility. Only Sana Khatun had a blood group of O+ and thus she could donate to anybody, but there came another catch. When we performed the cross-match of the couple, it was found positive, so even she could not donate to her husband Yusuf," Dr Saxena said.

In cross-match testing, blood from the donor and recipient are mixed. If the recipient's cells attack and kill the donor cells, the cross-match is considered positive. This means the recipient has antibodies against the donor's cells. If the cross-match is negative, the pair is considered compatible for kidney donation.

"The three couples were incompatible for donation separately, but we realised if they swapped kidneys with one another (triple-swapping), the issue could have resolved. So, we went for it. But, that meant adequate preparations and back-to-back three transplants," Dr Saxena said.

He said the three couples by agreeing to benefit each other, saved the high cost that they would have otherwise incurred, did they go with the antibody removal protocol. Swapping of kidneys with mutual agreement is an exception.

The couples were incompatible for donation separately, but we realised if they swapped kidneys, it would be less costlier for them, Dr Singh said