Organ donation hits rejection hurdle

When family of Sovona Sarkar donated the 71-year old’s organs in June, her kidneys gave new life to two young renal-failure patients. A month and-a-half later, the body of one of the recipients rejected the donated kidney. The other’s condition is also a cause for concern, but doctors at SSKM Hospital have not yet given up hope. Experts though, stressed that one rejection, or even two, should not mean the end of the road for cadaver organ donation.

“Any transplant operation always carries the risk of rejection. It is also not limited to deceased organ donations. Even in live donations, about one in 10 patients experience rejection.Hence, two rejections in a cadaver transplant case should not be viewed with skepticism,” said Dr Rajendra Pandey , nephrology head at SSKM Hospital.

Sovona Sarkar died on June 23. Her son Prosenjit had to run from pillar to post to honour her last wishes and was finally able to donate the organs. Both the kidney transplants took place on June 27 -one at Belle Vue Clinic and the other at SSKM.Keya Ray underwent the transplant at the former; Sk Ferozuddin at the latter.

Despite all the efforts, Keya’s body rejected the kidney . She began to experience pain in the transplanted kidney . Her body began to bloat and there was swelling at the ankle. The signs were unmistakably that of organ rejection. She has to now undergo a surgery to remove the transplanted kidney and return to dialysis. Prasenjit Sarkar, whose tireless efforts had led to the Keya’s kidney trans plant is disappointed but not dejected. “A beginning has been made in organ donation in the state and there should be no stopping to it. One case might have failed but my mother’s multi-organ transplant has already inspired two other families to donate the organs of their loved ones. I hope the state government streamlines the process so that it happens quickly and without harrassment,” Prasenjit told TOI. Dr Pratim Sengpta, who had played a major role in the three donations that took place within a span of 30 days, said the nephrology team had made all efforts to make the transplant a success but acknowledged that it had failed. “We wanted this transplant to succeed because it would be a huge step forward for deceased organ donation. Even though recipient’s body has rejected the donated kidney , it should not send out any negative message. Organ rejections can happen in any transplant case,”he reasoned.

There are different types of rejections in organ transplants. An acute rejection might happen between a week and three months after the transplant. About 30% patients experience acute rejection within the first three months for which doctors use anti-rejection medication. Chronic rejection can take place over years after the transplant as the body’s constant immune response against the transplanted new organ damaging it in a slow process.

“With quality medication available these days, 90% acute rejection cases can be treated. Unfortunately this particular patient happen to fall in the remaining 10%. It would be unfair to conclude that this transplant failed because deceased organ transplant though the rate of rejection is slightly higher in this,” said Dr Deepak Shankar Ray, nephrology head at RN Tagore International Institute of Cardiac Sciences. In organ transplants, the quality of the organ, age of the donor and the overall health condition of the recipient contribute to the success of the operation. In this case, Sovana was 71 years when she expired.Doctors assessing the kidneys found them to be healthy and fit for transplant.