Blood type incompatibility key factor for kidney exchange transplant in India, finds study

Blood group 'ABO' incompatibility could be a major factor driving kidney exchange transplants in India, where living donor transplants face numerous challenges, a study published in ‘The Lancet Regional Health Southeast Asia’ journal has found.

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ABO incompatibility occurs when a donor's blood group differs from that of a recipient, leading the recipient's immune system to reject the transplanted organ.

The study conducted by researchers, including those from Smt. G R Doshi and Smt. K M Mehta Institute of Kidney Diseases and Research Center (IKDRC), Ahmedabad, noted that a third of healthy and willing living donors in India are incompatible with their intended recipients, largely due to blood group mismatches.

The team said that no large-scale data is available on kidney or liver exchange transplants in low and middle-income countries, including India.

Kidney exchange transplants involve two or more donor-recipient pairs swapping donors to enable recipients to receive compatible kidneys.

The IKDRC's website explains, a donor of one pair of donor-recipient could donate a kidney to a recipient of a second pair while the donor of the second pair could donate to the recipient of the first pair. The exchange allows two ABO incompatible recipients to receive healthy, more compatible kidneys.

The study analysed 1,839 kidney exchanges from 65 centres across India, revealing that ABO incompatibility was the main reason for entering such exchanges in 1,610 (87 per cent) of the cases.

The remaining exchanges were due to compatible pairs 126 (seven per cent) and sensitisation 103 (six per cent), according to the authors of the study.

A notable gender imbalance was found, with more men (82 per cent) being recipients in kidney exchanges, and more women (80 per cent) being donors. The researchers also looked at 259 liver exchange transplants from seven centres across India.

"The majority of (liver exchange transplants) were 2-way swaps (125 two-way versus 3 three-way swaps), predominately involving male recipients (222 male versus 37 females) and for ABO incompatibility," the authors wrote.