By Dr Somnath Chattopadhyay
Human beings have unique blood groups (A, B, AB and O). Until recently, liver transplantation was only possible between blood group-compatible donors and recipients (either identical blood groups or blood O which is a universal donor blood group), limiting the number of available donors and prolonging waiting times for patients in need. However, with the development of medical therapies, it is now possible to perform liver transplants between incompatible blood groups with comparable success rates to compatible transplants.
The medical therapy used in crossing blood group barriers in liver transplantation involves the use of immunosuppressive drugs (e.g. Rituximab) and plasma exchange. Rituximab suppresses the formation of B cells in the recipient, which form the antibodies which would otherwise rapidly reject the transplanted liver due to its incompatible blood group. Plasma
exchange is a technique that removes the already formed antibodies in the recipient’s blood that would otherwise attack the transplanted liver. Together, these therapies allow the liver to function normally in the recipient’s body, despite the blood group mismatch.
The benefits of crossing blood group barriers in liver transplantation are significant. It expands the donor pool, allowing more patients to receive life-saving liver transplants. This is particularly important for patients with rare blood types or those who have been waiting for a transplant for a long time. It is also important for patients who have liver cancer and need a liver transplant for cure but do not have a compatible donor in the family. It also benefits, patients from neighbouring countries, who come to India for a lifesaving liver transplant.
As they are very unlikely to get a cadaver organ, ABO incompatible transplants become the only hope for them, if they do not have a compatible donor in the family. However, it is important to note that crossing blood group barriers in liver transplantation is not without risks. The use of these strong immunosuppressive drugs can increase the risk of infection and other complications. Especially in very sick liver patients, it may not be a suitable treatment option as the risk of infections become very high. Additionally, these novel medical treatments and plasma exchanges increases the overall cost of the therapy. Especially in a country like India, the increased cost may put extra burden on the patient and his family.
Despite these potential risks, the benefits of crossing blood group barriers in liver transplantation are clear. With medical therapy and by carefully selecting patients, it is now possible to perform liver transplants between incompatible blood groups with similar success rates when compared to compatible blood group liver transplantation. As the medical community continues to develop new therapies and improve our understanding of these techniques, we can hope to see even greater success in liver transplantation and other areas of medicine.
(The author is a Consultant and Head of Department, hepato-pancreato-biliary surgery and liver transplant, Kokilaben Dhirubhai Ambani Hospital Mumbai. The article is for informational purposes only. Please consult medical experts and health professionals before starting any therapy, medication and/or remedy. Views expressed are personal and do not reflect the official position or policy of the FinancialExpress.com.)
