Rare Feat: JIPMER Transplants Kidney in Patient with Bombay Blood Group
A 34-year-old man with the extremely rare ‘Bombay’ blood group underwent a successful kidney transplant at the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) in Puducherry. The patient, who had been suffering from kidney failure, was referred to the hospital for a renal transplant. His mother was willing to donate her kidney, but initial evaluations revealed that he had the Bombay blood group, a rare condition that poses significant challenges for transplantation.
The Bombay blood group, first described in a patient in Mumbai, is seen in approximately one in 50,000 to one lakh individuals. Unlike the four common blood groups, people with this blood type lack the H antigen, which is present in all other blood groups. Consequently, they develop antibodies against the H antigen, which can cause immediate rejection of a transplanted kidney. To manage this risk, specific drugs and a procedure called therapeutic plasma exchange are required. Additionally, finding compatible blood for transfusion is extremely difficult.
To address these challenges, JIPMER’s Transfusion Medicine Department collaborated with the Puvi Foundation, a philanthropic organization that promotes blood donation. Three units of Bombay blood group blood were arranged from Nashik and Anantapur and stocked at JIPMER’s blood bank. As a backup, a person with the same blood group was brought from Karaikal and remained at the hospital until the operation was completed.
The surgery was conducted successfully. The patient’s anti-H antibody levels were monitored daily for a week after the transplant. The kidney functioned immediately, and the patient had normal kidney function upon discharge. This marks one of only four reported cases of organ transplantation involving the Bombay blood group in India. The previous cases include a kidney transplant in Chennai, a mother-to-daughter kidney donation in Hyderabad, and a liver transplant in a patient with liver failure.
The transplant was performed free of cost under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana. JIPMER has a strong record in renal transplantation, having performed 439 kidney transplants to date, including 319 from living donors and 120 from deceased donors. The institute has also conducted 15 ABO-incompatible kidney transplants in the past three years. Additionally, JIPMER runs an active deceased donor organ transplantation programme, procuring organs from 60 brain-dead donors over the last 12 years.
