In a rare and challenging case, a team of doctors at Max Super Specialty Hospital, Noida successfully performed an ABO-incompatible Kidney transplant that also involved the removal of a tumor from the donor’s kidney, a combination scarcely attempted in transplant surgery.
The 60-year-old recipient, with a B+ blood group, had been on dialysis for two years and was in urgent need of a kidney transplant. The only suitable donor was his 58-year-old wife, who had an incompatible A+ blood group. Despite this mismatch, the transplant team decided to proceed, given the absence of other donor options.
During the pre-surgical evaluation, doctors discovered a 4.2 cm (roughly size of a golf ball) benign tumor in the donor’s left kidney, adding another layer of complexity.
“In most cases, such tumors are removed after the kidney has been harvested, using a technique called bench surgery. But combining this with an ABO-incompatible transplant required an extremely high level of precision and coordination,” said Dr. Amit K Devra, Senior Director – Urology, Robotics & Kidney Transplant, and Head – Kidney Transplant Surgery at Max Hospital Noida.
“ABO-incompatible transplants require plasmapheresis to reduce the recipient’s blood antibodies, lowering the risk of rejection. However, this process also diminishes platelet levels and clotting factors, increasing the risk of bleeding. The recipient underwent two rounds of plasmapheresis before the surgery. Throughout the procedure, we had to carefully monitor clotting profiles to manage bleeding risks,” Dr. Devra explained.
The donor kidney was successfully removed, the tumor carefully excised on the bench, and the organ transplanted into the recipient—all within a tightly coordinated surgical timeline. The transplant was successful, with the new kidney functioning immediately post-operation. The recipient was discharged on the sixth day, and both patient and donor are now doing well.
Dr Vijay Sinha, Director - Nephrology and Kidney Transplant, Max Super Speciality Hospital, Noida, under whose care the patient was managed pre- and post-transplant, highlighted the critical role of careful monitoring and medical management.
“ABO-incompatible transplants come with higher immunological risks and require extensive preparation, desensitization, and close follow-up. What made this case remarkable was the added complexity of a donor kidney tumor. It was a true team effort—from immunological workup and risk assessment to perioperative care and post-transplant immunosuppression. The outcome is a testament to what multidisciplinary collaboration can achieve,” said Dr Sinha.
Max Hospital Noida continues to be at the forefront of advanced transplant procedures, pushing boundaries to offer new hope to patients with limited options.