AHMEDABAD, GUJARAT | 13th NOVEMBER 2026 | When a spouse is willing to donate a kidney but is medically incompatible with the intended recipient, a kidney swap transplant can offer a life-saving alternative. At Naroda Shalby Hospital, two couples successfully underwent a paired kidney exchange, enabling both patients to receive compatible kidneys from living donors.
As part of the kidney swap, the husband from one couple donated a kidney to the husband from the other, while the two wives similarly exchanged donations. One recipient had been undergoing dialysis for six months, while the other was at an advanced stage of kidney disease and nearing the need for dialysis.
The procedure involved two complex cases. One recipient had undergone a kidney transplant in 2013, and the transplanted kidney had functioned for approximately 13 years. A history of antibody-mediated rejection, post-transplant infection, recurrent anaemia and multiple blood transfusions made the second transplant particularly challenging, requiring careful immunological assessment and planning.
The other recipient had autosomal dominant polycystic kidney disease (ADPKD), with an enlarged kidney measuring over 22 cm, leaving limited space for the transplanted organ. Surgeons first removed the enlarged right kidney to accommodate the new organ.
Both patients showed encouraging early graft function. The recipient undergoing a second transplant achieved a serum creatinine level of 1.3 mg/dL, while the ADPKD recipient reached 0.6 mg/dL. Continued follow-up will be essential to monitor graft function and recovery.
A kidney swap, also known as a paired kidney exchange, is considered when a willing donor is incompatible with the intended recipient. Following detailed medical, blood group and immunological evaluations, two compatible donor–recipient pairs are matched. All four procedures — kidney retrieval from both donors and transplantation into both recipients — are performed simultaneously. This requires four operating rooms and close coordination among surgical, anaesthesia, nephrology and nursing teams.
The transplant team included Dr Mahendra Mulani, Consultant Nephrologist and Kidney Transplant Physician, and surgeons Dr Kirtipal Visana, Dr Raghvendra Kashyap, Dr Shrenik Shah and Dr Tejanshu Shah.
Kidney swap transplantation is legally recognised under the Transplantation of Human Organs and Tissues Act (THOTA). Patients facing donor incompatibility may explore registration in kidney swap programmes following appropriate medical evaluation.
Dr Praful Dharani, Chief Administrative Officer, Naroda Shalby Hospital, said, “Donor incompatibility should not mean the end of a patient’s search for a transplant. Paired kidney exchange offers an important alternative, and our responsibility is to ensure that patients receive the right guidance, evaluation and coordinated care.”
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