Mumbai: HIV-positive patient Susheel Jha's 64-year-old mother Sitara donated one of her kidneys to her firstborn 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 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 superspeciality 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.” Jha was on dialysis for three years before doctors realised that transplant would be the only hope. “In my 13 years with HIV, I took only 77 days of leave but I needed over three months for transplant and the minor problems thereafter.”
    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 10 years. I was never discriminated against or passed up for promotion. My dialysis would cost tens of thousands of rupees but the railways always paid up,” said the father of two.
    Dr Harsh Jauhari, one of the senior-most nephrologists in the country, said that while a couple of HIV-positive patients had undergone transplants in India, little was chronicled. “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. (The patient’s name has been changed)
A Positive Development
THE ISSUE Mumbai reports first kidney transplant for an HIV-positive person. Until recently, HIV was considered an absolute contra-indication to transplant
WHY? There were concerns about the side-effects of immuno-suppressive drugs in HIV-positive patients
INCIDENTALLY HIV-associated nephropathy is the most common cause of kidney failure
THE NEW PROTOCOL Any HIV patient with renal disease can undergo a kidney transplant if his or her HIV infection is stable
PREVIOUS CASES IN THE COUNTRY 3 June 2008 | A 66-year-old Nigerian male got a kidney from his son-in-law at the Fortis Hospital, Noida 14 May 2008 | A 49-year-old hypertensive healthcare worker from Africa underwent live, related transplant at Sri Ramchandra Institute, Chennai (SOURCE: INDIAN JOURNAL OF NEPHROLOGY)