A team of doctors in Chennai has accomplished a groundbreaking medical feat by successfully performing a kidney transplant for a patient with the extremely rare Bombay blood group. This achievement, previously considered impossible, marks a new milestone in medical history.
In mid-2024, a 30-year-old man underwent a kidney transplant at MIOT International Hospital in Chennai. What made his case unique was his rare Bombay blood group, which made it nearly impossible for him to receive blood transfusions or organ transplants from donors with any other blood type. However, his mother was willing to donate her kidney, despite having a different blood group.
While doctors at MIOT had performed cross-blood transplants for nearly two decades, they had never attempted one on a patient with the Bombay blood group. This transplant became the first-ever successful procedure of its kind, turning what was once thought impossible into reality.
The Bombay blood group, also known as the HH blood group, was first discovered in Mumbai in 1952. It differs from the common ABO blood groups because it lacks the H antigen, which is the foundation for A, B, and O blood groups. As a result, individuals with this blood type can only receive blood or organs from another Bombay blood group donor, making transplants extremely difficult.
Since the patient’s mother had a different blood type, doctors had to find a way to prevent his body from rejecting the transplant. The team, led by senior nephrologist Dr. Rajan Ravichandran, used a technique known as double filtration plasmapheresis (DFPP), originally developed in Japan. This procedure removes antibodies from the blood to reduce the risk of rejection.
Before the transplant, the doctors measured the levels of anti-H antibodies in the patient’s blood. These antibodies are particularly strong and could trigger immediate rejection of the organ. To lower the risk, they administered a monoclonal antibody injection to suppress the patient’s immune response. Plasmapheresis sessions were then conducted to further reduce antibody levels.
Finding the right balance of antibodies was challenging because no previous data existed for anti-H antibody thresholds. The doctors had to make calculated assumptions, continuously monitoring and adjusting antibody levels to reach a safe point for transplantation.
Once the antibody levels were deemed safe, the transplant was performed. The hospital had arranged for Bombay blood group units as a backup in case the patient needed a transfusion during surgery. However, the procedure went smoothly, and the patient did not require additional blood.
The crucial two-week post-surgery period, where the risk of rejection is highest, passed without any complications. Six months later, the patient has fully recovered and resumed his normal life. His successful transplant has now opened new possibilities for other Bombay blood group patients who may need organ transplants in the future.
