Noida/Ghaziabad, Sep 21 (PTI) For 28-year-old Morifat Rashid, her husband’s decision to donate a kidney brought hope after years of battling an autoimmune disease, kidney failure and repeated health complications. But transplant brought two major challenges — high risk of blood clots and antibodies that could attack the donated kidney.
Rashid, who had been diagnosed with Antiphospholipid Antibody Syndrome (APLA) linked to Systemic Lupus Erythematosus (SLE), also had donor-specific antibodies (DSA) because of pregnancies in the past and multiple blood transfusions.
She underwent the kidney transplant, with her husband’s kidney, on August 18. Doctors at Yashoda Medicity said the combination of risks made the procedure particularly challenging.
“Maintaining blood flow through the transplanted kidney was critical,” said Dr Vaibhav Saxena, Senior Director, Urology, Uro-Oncology, Robotics and Renal Transplant.
APLA makes the blood more likely to form clots, raising the risk of blockage in the blood vessels of the transplanted kidney. At the same time, DSA can increase the risk of the body’s immune system attacking the donated organ.
To reduce the antibody-related risk, Rashid underwent three sessions of plasmapheresis, a procedure that removes harmful antibodies from the blood, along with intravenous immunoglobulin (IVIg) therapy before the transplant.
Her regular blood-thinning medicine, warfarin, was stopped five days before surgery and replaced with heparin to manage the clotting risk around the operation.
“Both risks were carefully managed through planned anticoagulation, plasmapheresis and IVIg therapy,” said Dr Prajit Mazumdar, Senior Consultant, Nephrology and Renal Transplant.
Rashid had good urine output and stable kidney function after the surgery. She was later shifted back to warfarin, with its dose adjusted through regular blood tests.
She was discharged with stable kidney function and continues to remain on immunosuppressive medicines and warfarin. Her latest serum creatinine was reported at 0.9 mg/dL. PTI COR KIS SKY SKY
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