Blood of donor and recipient won’t clot, but Coimbatore hospital performs successful kidney transplant

COIMBATORE: Doctors in a Coimbatore hospital transplanted a kidney in a 12-year-old boy suffering from haemophilia, a blood disorder that does not allow it to clot like it is supposed to.
What makes the case rare is that the kidney donor, who was the boy’s maternal uncle, also suffers from haemophilia.
The surgery was performed by replacing the missing protein, which would restore clotting mechanism temporarily, for 10 days, by which time the wound healed reasonably.
Doctors in Kovai Medical Centre and Hospital, where the surgery was performed, said they were yet to come across a case of renal transplant in medical literature where the kidney recipient and donor both suffer from haemophilia. “So far, nowhere in the world, a kidney transplant has been done in a recipient with haemophilia from a donor who also has haemophilia as these cases are considered to have a very high risk for bleeding after surgery,” said nephrologist Dr V Mangalakumar.
Doctors say the main risk of operating on such patients is uncontrollable bleeding and the burden of maintaining two patients with the issue. However, faced with no other viable option, they decided to go ahead.
It was around five months ago that a 12-year-old boy, who was suffering from advanced kidney failure, was brought Dr Mangalakumar. The boy has a rare genetic condition called Alport syndrome, which led to the kidney failure. The boy was advised an immediate transplant and his maternal uncle, whose HLA type and blood matched his, came forward to donate one of his kidneys.
However, during evaluations, the doctors found that both the boy and his uncle also had haemophilia.
In haemophilia cases, replacing the missing protein will restore the clotting mechanism temporarily and stop the bleeding. This should be continued for at least 10 days after the surgery to minimise late bleeding complications.
The team, which included Dr Mangalakumar, urologists Dr Barani Kumar and Dr Kuppurajan and vascular surgeon Dr Bala Sundaram, performed the transplant. Both the donor surgery and the recipient surgery went well without any complications.
The donor was discharged five days after the surgery and the recipient went home 10 days after the surgery, with normal kidney function.