In a groundbreaking and complex medical procedure, a 30-year-old woman with the extremely rare ‘Bombay’ (hh) blood group underwent a successful kidney transplant in India, marking the first such procedure in the country. The patient, from Shirdi, had been suffering from end-stage kidney disease due to diabetes and was on dialysis since 2022.
The ‘Bombay’ blood group, first identified in India, is exceptionally rare, affecting approximately one in 10,000 Indians and one in a million people globally. It lacks the H antigen, making individuals with this blood type incompatible with all standard blood types, complicating both transfusions and organ transplants.
Initially misdiagnosed with an ‘O’ blood group, her actual blood type was identified during transplant evaluations at Jaslok Hospital. Finding a suitable donor was a major challenge, as ‘Bombay’ blood group patients can only receive organs from others with the same blood type. With no compatible deceased donors available, her mother, a B-positive donor, stepped forward, despite the risks of a mismatch.
To lower the risk of rejection, doctors used a specialized desensitization protocol, including plasma exchange and immunosuppressive treatments, to modify the immune response. Securing compatible blood products was another challenge, as the hospital coordinated with rare blood donor registries for pre- and post-surgery blood transfusions.
The transplant was carried out by a multidisciplinary team and, after careful monitoring, the patient crossed the critical post-transplant phase. Long-term success will depend on continued immunosuppressive therapy and vigilant monitoring.
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