The nation’s biggest domino kidney transplants will take place in the city on Saturday. Six people will donate a kidney each to six others. Neither the donors nor the recipients are related to each other. The state government authorisation committee gave the final nod for the serial surgeries on Thursday.

The biggest domino transplants, involving 30 pairs, were done in the US.

The last domino transplants consisting of five donors and five recipients were held on June 25, 2013, in Mumbai. Saturday’s transplants will be carried out across Bombay, Hiranandani and Hinduja hospitals. The medical exercise will involve 12 urologists, six vascular surgeons, 24 assistant surgeons, five nephrologists, six assistant nephrologists, 12 anaesthetists, 24 nursing staff, and 12 operation theatres.

For a transplant, it is necessary that blood and tissue of a donor and recipient match. When they don’t, the domino procedure is followed — the donor of one pair donates a kidney to the recipient of another pair (they are unrelated to each other). The transplant is then carried out in a series till the last donor in the chain donates to the first recipient in the lineup. Legal issues are involved in organ donation cases when the donor and recipient are not related to each other.

Dr Vishwanath Billa, nephrologist, Bombay Hospital, and coordinator of Saturday’s domino transplants, told dna on Thursday: “The success of the earlier procedure has set a precedent. It encourages people to opt for it as it reduces a patient’s waiting time for the organ. We are thankful to the state government for speeding up the process. We have got all legal permissions from the government.”

For a transplant, the blood and tissue of a donor and recipient must match. In the case of one of the recipients, Manish Yashwantrao, his father was ready to donate a kidney but there was a mismatch in blood group. Manish’s blood group is O, his father’s A. Doctors advised Manish to register with the Apex Swap Transplant Registry (ASTRA), which addresses the issue of mismatch in blood groups or tissue among those who come for a transplant.

ASTRA identified those suffering from kidney problems and could be lined up for domino transplants. One of the candidates was Kalyan resident Sucheta Jere (AB) who has kidney ailments, and is on dialysis. Her husband, Nanda, a universal donor (O) could have donated his kidney to her but they agreed to domino transplants to help save five more lives.

“It is very easy to be selfish... But when we came to know that not one but five lives could be saved by domino procedure, we decided to exchange kidneys by mutual agreement,” Nanda Jere said.“In the absence of the domino method, patients would have had to wait for at least 10 years,” Dr Ganesh Sanap, who maintains the swap registry at Shushrut Hospital in Chembur, said. “It is a simple out of the box idea to find suitable kidneys for our patients.”

According to Dr Jatin Kothari, a nephrologist from Hinduja Hospital who is part of this domino procedure, most of the patients have a medical history of blood pressure. “High blood pressure (hypertension) is one of the most common causes of kidney failure in India and around the world.”

It is like the chicken and egg story. It is unclear if hypertension causes kidney failure or kidney failure leads to hypertension. But it is seen that kidney diseases can be reduced or even avoided by controlling blood pressure.”

Talking about the country’s first-ever domino transplants, performed in the city on June 25, 2013, Dr Shrirang Bichhu, one of the Bombay Hospital nephorologists part of Saturday’s exercise, said last time they had a trying time in getting government permission.

“One of the pairs was from Rajasthan; so the government was not ready to give permission. But we managed to convince government officials by citing examples of domino procedures carried out across the world,” he said.

“But this time it was very smooth. Also the success rate is cent per cent. All the patients who were part of the first domino procedure are doing well.

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