New Delhi: A team of doctors led by Dr Sunil Prakash, senior consultant and director of renal sciences and transplant centre at the BLK Super Speciality Hospital has successfully performed renal transplant on a HIV affected patient.

According to BLK Hospital, the 30-year-old Nigerian patient, Ben Agande (name changed), was transplanted a kidney donated by his brother. Agande, who was earlier bed ridden due to a kidney ailment and had almost given up hope, is now leading a normal life.

Dr Sunil Prakash

Agande was admitted to the hospital in December last year and the treatment continued for a month. He was provided with induction therapy with Simulect and pulsed with Solu Medrol and put on triple immunosuppressant with steroids, mycophenolate and tacrolimus. He required higher doses than normal because of this drug with antiretroviral therapy.

“Transplanting these patients requires tight rope walking. On the one side immunity suppressive medicines which are given to keep the transplanted organ safe, triggers replication of HIV and flares HIV disease and on the other hand HIV medicines interact with transplant medicines and worsen the graft. No wonder very few such patients have been successfully transplanted in our parts of the world,” said Dr Prakash.

According to Dr Prakash, till very recently HIV positive patients were contra indicated for transplantation. Thanks to the discovery of new medicines for the HIV patients due to which they have long-term survival, these patients can now be offered organ transplants.

In recent years renal transplant has been performed in HIV positive patients worldwide. The outcome of human immunodeficiency virus (HIV) positive patient has improved dramatically with the advent of combined antiretroviral therapy. The mortality of HIV positive patients with chronic kidney disease (CKD) stage 5 is similar to those without the infection.

Almost 95 per cent of such cases are successful. However precaution needs to be taken for both the patient and the doctors performing the surgery as minor cuts can spread infection and vice versa.

“Operating HIV patients carry a significant risk to all healthcare providers of contracting HIV virus themselves. Universal precautions have to be taken at all times. Waste and biomedical disposal needs full attention. We are glad that we successfully transplanted this patient with very gratifying outcomes. And this should be a bench mark for all enterprising transplant teams,” added Dr Prakash.

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