Thai nephrologists prove that blood really is thicker than water with the first ABO kidney transplant

For Areejit Photales, a 34-year-old nurse from Si Sa Ket province, life as she knew it collapsed the day she was diagnosed with chronic kidney failure. Exhausted from twice weekly dialysis, she knew life could only return to normal if she had a kidney transplant. But where to find a donor? Her younger brother tested but was a different blood type. Her elder brother was Type O - a match - and agreeable but Areejit's hopes took another battering when tests showed he was infected with Hepatitis C.

"I felt desperate. Then I got a call from heaven," says Areejit.

That call was from Assoc Prof Yingyos Avihingsanon, a nephrologist at Chulalongkorn University's Faculty of Medicine. He asked whether Areejit wanted to be the first Thai to undergo the ABO incompatibility kidney transplant with her younger brother, whose blood type is A, acting as donor.

"She's a nurse so understands the procedure," says the nephrologist, explaining why he selected her for the country's first procedure.

"Also the donor needed to be someone very strong otherwise we risked having two patients as a result of the operation."

This innovative programme, introduced some 10 years ago in the West, allows patients to receive a kidney from living donors even though their blood types are incompatible. They must, however, undergo several treatments before and after the transplant to remove harmful antibodies that can cause organ rejection. That treatment is called plasmapheresis and is similar to dialysis.

The procedure has given new hope to patients with chronic kidney failure, whose number increases every year and for whom the wait for a donated kidney now stands at four years.

"Those with kidney failure who feel they cannot face life-long dialysis can consult about the possibilities for the surgery But, like for any organ transplant, the decision is made carefully under the supervision of the organ donation committee to prevent any problems with organ trafficking," says the doctor.

"Areejit's case needs more research and follow up so that future transplants are more effective."