Mother gives birth to 19-yr-old son

NAGPUR: While tears of joy rolled down the eyes of Manisha Thakre, her 19-year-old son Rahul narrated on Thursday how his mother had given him a new life, literally giving birth to him a second time. She donated a kidney to him, ensuring he lives a health life for many decades ahead.

The Thakres had been running pillar to post for four years after doctors said Rahul would need kidney and liver transplants. Their problems were more serious than other kidney failure patients, since the parents' kidneys didn't match due to different blood groups, and the city didn't have the facility for simultaneous kidney and liver transplants. However, thanks to developments in medicine, Rahul underwent an across (against) the blood group organ donation (medically called as incompatible blood type kidney transplant) from his mother at Fortis Hospital in Mumbai, a first for any city patient.

Rahul had just passed high school in August 2011 when he was diagnosed with a unique disease that caused kidney and liver failure simultaneously. He had to spend one year after that taking dialysis and another year after joining engineering college. After the kidney transplant, now he is determined to pursue a career in mechanical engineering.

Manisha said, "I have achieved everything in life. I am feeling so relieved and content, and can sleep peacefully. Till now, I couldn't sleep at night worrying. My son was registered for the two transplants at Chennai as well as Mumbai. But his name was very low in the wait list. I and my husband wanted to donate our kidneys but unfortunately my husband had some problem with one of his kidneys and my blood group (AB-ve) didn't match with Rahul's (A+ve). However, Dr Haresh Dodeja from Fortis Hospital in Mumbai did this against the blood group transplant, allowing me to donate a kidney to my son and see him back on his feet."

It was only in June 2014 that Dr Dodeja sent samples of liver biopsy to King's College, University of London, which revealed that Rahul may not need a liver transplant as the levels of oxalosis, a liver enzyme, may not hinder his kidney transplant. This, however, increased the overall expenditure for the family manifold (Rs2.5 lakh) for the test at London and another Rs3-4 lakh for the incompatible blood type kidney transplant.

However, the Thakres were lucky that Manisha was an employee of All India Reporter, and could get the basic transplant expenses under by the Employee State Insurance Scheme (ESIS). Her office colleagues pooled in Rs2.5 lakh to help out. The Masonic Lodge Cornith EC of Nagpur Freemasonary and the District Grand Lodge of Bombay too also extended financial support. The Thakres spent Rs2.5 lakh for the test at London themselves.

"I had to shut down my business to take care of Rahul and would have to continue like this for at least another year. But this hardly matters. I would try to re-establish the business. For now, our son's life is all that we are caring about," said Rajesh Thakre, Rahul's father.


HOW ACROSS BLOOD GROUP TRANSPLANT WORKS

* Conventionally, AB patients can get a kidney of any blood type. A type can get it from either O or A blood type, B from O and B type, while O patients can get kidney only from a O type

* But with blood type incompatibility kidney transplant programme, any blood type can donate to any transplant recipient.

* For ABO incompatible transplantation, a simple blood test is performed to determine the amount of antibody in blood stream. Most people have a level of antibody level which is treatable

* A two-step process of desensitization and immune modulation (a process of removing antibodies from donor's blood using a plasma exchange process) is done. This process may be done once or more

* Immuno-globulins are used to minimize the antibodies and then the transplant can be performed

What doctor says

Initially, we suggested both kidney and liver transplant due to the oxalosis levels of the patient. But then we saw that Rahul was doing well with dialysis, unlike other such cases. We thought of getting his AGT enzyme levels tested at London by sending his liver biopsy sample. This test showed he would not require liver transplant and so we proceeded with the incompatible blood type kidney transplant. This is being done by a few centres in the country since last few years. My teacher at Jaslok Hospital also does this.

Dr Haresh Dodeja, Fortis Hospital, Mumbai