Man with rare blood group undergoes renal transplant at city hospital

A 30-year-old man from Madurai with a rare blood group recently underwent a renal transplant at MIOT hospital. The man, with ‘Bombay O’ group blood, was diagnosed with renal failure and was under dialysis at the hospital for over a year. His mother was willing to donate her kidney but because of blood group incompatibility, the transplant could not be done.  

Blood is usually classified as A, B, AB and O. While O is a universal donor, and AB is a universal receiver, when it comes to transplant there are restrictions.  

People of the ‘Bombay O’ group, also called HH blood group, require a donor from the same group. It was identified in 1952 in Bombay and the group is found in some tribes in Odisha. In India, one in 10,000 persons may have the group while in the European population it could be one in a million.  

In the blood, a factor called H determines the type of the group. The H factor is the precursor to developing antigens. Thus, A group develops antigen for A, and B develops antigen for B, while AB group develops antigens for A and B. O group develops only H antigen. The antigens determine the group that they can receive. ‘Bombay O’ group is a rare mutation in that it develops no antigen, explained Rajan Ravichandran, director of the MIOT Institute of Nephrology. 

The hospital, which performs many across-blood transplants, decided to apply the same rules for the patient, said Dr. Rajan while adding that one in four transplants in the hospital is across blood groups. According to him the patient was the second to present with ‘Bombay O’ group in his 40 years as a surgeon. The surgery was done three months ago. The challenge in the procedure was that there was no existing precedent or guideline for monitoring anti-H antibodies.  

The transplant procedure was similar to the across-blood group surgery, such as administering immunosuppressant drugs and monitoring of antibody titers.    

The patient, a software engineer who did not want to be named, said he had given up his job after being diagnosed with renal failure.