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HIV no bar as Jharkhand woman donates kidney to husband

A couple living with HIV have managed to put their life back on track after the wife turned donor for the man, who has been battling chronic kidney disease for some years. Doctors at Apollo Hospitals, where the 52-year-old man underwent a kidney transplant early this year, claim this was the first time in the country that a living donor kidney transplant was done from a donor with HIV to a recipient with HIV.

A last-minute refusal to perform the transplant surgery at a private hospital sent the couple from Jharkhand down south in search of help. A search on the internet brought them to a nephrologist in Apollo Hospitals, Chennai, and they were referred to Anil Vaidya, senior consultant and transplant surgeon.

Dr. Vaidya performed the kidney transplant on May 3, 2018.

“Several years ago, I underwent a master health check-up when the doctor found that I had a cyst in my kidney. But he said it would not cause any trouble immediately. In 2013, I started to develop symptoms such as swelling in the legs and difficulty in breathing. It was then that I was diagnosed with chronic kidney disease (CKD),” Praveen (name changed) said. He was put on dialysis in 2015. He came to Apollo Hospitals in April with Stage 5 CKD.

“Organ transplant from a HIV-positive cadaver to HIV-positive recipient has been done elsewhere. What is unique in this case is that the patient had his wife as donor. The couple are under Anti-Retroviral Therapy (ART). The previous hospital could have refused to perform the transplant considering that, in the long-run, the wife could get HIV-associated nephropathy,” Dr. Vaidya said.

However, he explained that though anti-HIV drugs are toxic to the kidneys, not everybody is affected. “This long-term effect is widely debated in nephrology circles. We went ahead as evidence pointed to the probability of her kidney being affected by HIV-associated nephropathy is low. She was eager to help her husband and put her family dynamics back to normal,” he said.

The couple was put through psychiatric counselling to enable them decide if this was a well-thought of decision.

“The aim is to dissociate stigma from transplantation. Persons may be on ART, but he/she can still have a transplant, and he/she can still donate to his/her loved one,” Dr. Vaidya said.

Earlier, doctors believed that in persons living with HIV, the dosage of immunosuppresants should be kept low but this was not the case, he said, adding: “He needs the normal amount of immunosuppresant drugs but has to check the count of CD4 cells regularly.”

For Praveen, his wife’s donation helped him get back to a normal life. “I walk 8 km every morning and I am going to work after surgery,” he said.

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