Mumbai: HIV patient gets kidney transplant

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In rare op in India, HIV patient gets kidney transplant

Malathy Iyer, TNN, Mar 11, 2010, 01.14am IST

MUMBAI: Susheel Jha has had an unusual experience with the human

immunodeficiency virus (HIV). A resident of the central suburbs, he proudly

announces unlike many HIV-positive patients, he has never been bedridden by

frequent bouts of illnesses.

He credits his health to his family and his mployer, the Indian Railways, who

have been supportive ever since he was diagnosed with HIV while randomly

donating blood at a donation camp way back in 1997.

The unusual patient scaled another height three months back; he became the first

HIV-positive person in Maharashtra to undergo a kidney transplant. In the

stigma-ridden world of HIV/AIDS, 45-year-old Jha's story holds out hope for the

two-million-plus Indians living with HIV.

In Jha's case, his 64-year-old mother Sitara donated one of her kidneys to her

first-born son. " I just want to see my child living healthily next to me, " she

said over the phone from Benares.

The transplant is a milestone of sorts. Not surprisingly then, Jha's

nephrologist Dr M Bahadur, transplant surgeon Shailesh Raina and medical

consultant Dr Om Srivasatava are ecstatic with his progress since the transplant

was carried out at Jaslok Hospital last November 26.

" This is the first time in Maharashtra that a HIV-positive person has got a

transplant. It needs experienced specialists to manage the patient carefully so

as to ensure that his body doesn't reject the donor organ while ensuring that

the HIV infection doesn't flare up, " Bahadur, who has been treating Jha since

2006, said.

Admitting that it had indeed been a challenge to handle a HIV-positive patient,

Srivastava said that the right medical environment (as in a super-speciality

hospital like Jaslok), right protocol and medicines were needed for such

transplants. " If the HIV-positive patient's CD4 count is adequate and his viral

load is negative, then he can safely undergo a transplant, " added the Jaslok

doctors.

Worldwide, too, transplants for HIV-positive patients are a relatively new

concept. In 2004, the US reported about a 100-odd liver and kidney transplants

for HIV-positive patients.

The man himself is calm. " My HIV status was detected in 1997 and my kidney

failure in 2006. " He was on dialysis for three years before doctors realised

that transplant would be the only hope for him. " In my 13 years with HIV, I took

only 77 days of leave but I needed over three months of leave for the kidney

transplant and the minor problems that cropped up after it, " he said.

Jha also believes that his employer, the Railways, played a great role in his

" healthy but HIV " status. " I have had access to antiretroviral drugs for the

past 10 years. I was never discriminated against or passed up for promotion at

my workplace. My dialysis would cost tens of thousands of rupees but the

railways always paid up. They even paid for my transplant, " added the father of

two.

Dr Harsh Jauhari, one of the seniormost nephrologists in the country, said that

while a couple of HIV-positive patients had undergone transplants in India,

little was chronicled about these special patients. " There is a confidentially

clause with HIV-positive patients that cannot be tampered with. So it is likely

that we don't know about all the transplants that have taken place in this

category. But there is no denying that these patients need specialised care, "

added the Delhi-based Jauhari.

Another senior doctor said there were several issues about safety about the

medical staff involved as well that had not allowed HIV-positive transplants so

far.

Incidentally, a study published in the Archives of Surgery last year by the

s Hopkins University School of Medicine said that HIV-positive kidney

transplant recipients could have the same one-year survival rates for themselves

and their donor organs as those without HIV, if certain risk factors for

transplant failure were recognized and tightly managed.

According to the report, " HIV patients were earlier not considered transplant

candidates as researchers thought that the survival rates after transplantation

were greatly compromised by the disease, which cripples the body's immune

system. Also, transplant patients take drugs that suppress their immune systems

in order to prevent organ rejection, a regimen thought to further threaten their

already fragile immune systems. "

(The patient's name has been changed.)

http://timesofindia.indiatimes.com/city/mumbai/In-rare-op-in-India-HIV-patient-g\

ets-kidney-transplant/articleshow/5669455.cms