kidney swap

Swap Transplants & How They Save Lives

Kidney failure is a major healthcare problem, and transplanting a new kidney is sometimes the only medical solution. Less than 10% patients with kidney failure undergo a kidney transplant with a family donor and 1% do so with a kidney from a deceased donor (someone who has died and their organs have been donated). The rest of the patients with kidney failure remain on dialysis because they do not find a deceased donor, don’t have a family donor, or the family donor that they do have is incompatible.

The deceased donation and transplantation program in our city and our country is yet to come of age and become a powerful organ resource for these patients. It is now 15 years since the inception of this program in Mumbai, and yet organs from deceased donors still form less than 10% of all transplants performed here. In the west, this forms 90% of the transplants.

Several practical hurdles cause this shortage of transplantable organs. While every attempt is being made to correct this situation, there is a need to explore other avenues to minimise this shortfall. Therein lays the role for a mathematical match-making approach as an additional avenue for a solution to this problem.

If you’ve been advised a kidney transplant by your nephrologist and are not able to go ahead because your prospective kidney donor has a blood group that does not match, then a swap transplant could be the solution for you.

ASTRA (Apex Swap Transplant Registry)

In January 2011 the Apex Swap Transplant Registry (ASTRA) was launched by the Apex Kidney Foundation. Since its inception 250 donor-recipient pairs have registered for a swap transplant.

40 kidney transplants have been completed successfully, with 10 kidney transplants in process. ASTRA leverages the principle of a database and mathematical modelling to find a solution for the problem of organ shortage. It is based on the principle of paired exchange or ‘swap’.

Kidney exchange or ‘swap’ is a simple barter system. It is a ’give and take’ deal between two pairs of people, each pair consisting of a giver and a taker, where each pair benefits by receiving a suitably matched organ. In this simple barter framework, it is possible to maximise returns exponentially when the pool is large and complex algorithms for exchange are built into it. A swap pair consists of a recipient (patient) and a donor (a family member). These pairs are such that they cannot ordinarily donate an organ to each other. This could happen because of blood group incompatibility or a tissue incompatibility. Such pairs register within the ASTRA database. ASTRA then runs an application based on a mathematical model and searches across the database for compatible pairs. It then generates simple binary donor recipient pairs or complex chain like the current domino.

What Exactly Happens During A Swap Transplant?

A Swap transplant involves an exchange of organs between two families, who cannot donate the organ to their own family member because of blood group mismatch. This is in a sense ‘paired exchange’.

This would minimize this shortfall of organs and increase transplant numbers legally. In this method there is a mechanism for organ sharing between two unrelated donor-recipient pairs.

Sheikh Family Shah Family

swap transplant kidney

By doing a swap, two patients with kidney failure who in normal circumstances cannot undergo a transplant because of blood group mismatch within that family, can now go ahead with kidney transplantation.

Once there is a match, your nephrologist will be informed and your surgery will be done by your transplant team at the hospital of your choice. ASTRA will only generate compatible pairs, hand them over to the respective nephrologists and not do anything beyond this.

Swap Transplants Are Important For Certain Patients

Patients with kidney failure who have a family donor, but the blood groups are incompatible.

Patients with kidney failure who have a blood group compatible donor, but their lymphocyte cross-match is positive.

Patients with kidney failure who have a suitable donor within the family, but such a donor has tested positive for Hepatitis B or C. Such patients may enter the ASTRA to find a possible virus positive recipient so that the respective transplants can go through. Such pairs will have to however undergo mandatory liver tests to assess their liver function status as well as their suitability to give and receive a kidney.

Patients who have an elderly donor or a marginal donor with a compatible group can also register to get a donor who is better. For example – Mr Patel was on dialysis. His blood group is B. His father was a prospective donor. His blood group is O. He could have directly donated to his son, Mr Patel. But they registered for a swap transplant and get a relative young man to donate. While Mr Patel’s dad donated to someone else. This is possible if your marginal related donor’s blood group is O. Please consult your nephrologist or call us for explanation if you’re confused about the issue.

ASTRA’s Achievements

ASTRA is now 3 yrs old. Within this short period, 250 donor-recipient (D-R) units have registered within ASTRA across India and internationally. Altogether 65 transplantable pairs were matched; 40 swap transplants have been done; 10 of the others are in the process of completing formalities to undergo the transplant. There has also been an international swap generated from this database.

After two years of hard work and on the second attempt, India witnessed its first domino swap kidney transplant surgery in June 2013, made possible by ASTRA. The first attempt fell through when the chain (where only one patient-donor pairs was common), was disrupted by the death of one patient thanks to delays in getting permissions which did not come through on time. It took us 8 months to rebuild the chain. The Maharashtra government was very cooperative and five transplants were performed simultaneously. All the transplants were successful and the effort was huge. It involved the booking of 10 theatres in three hospitals and 40 senior doctors working together.

One of the patients was a roadside barber, they were of different strata and religions, and we are hopeful that the success of this will lead to many more domino kidney transplants in the future.

The exact role of ASTRA

You must understand that ASTRA is only a match-making agency. Once a patient is referred to the ASTRA, he would be registered and as soon as a possible swap match is generated by the database, this information would be conveyed to the two primary Nephrologists of the two patients. Further workup, assessment, legal formalities, organisation of the logistics of the transplant as well as the procedure of transplant would be the prerogative of these two nephrologists, in mutual consultation.

The ASTRA does not participate in the actual transplant surgery and is not liable for any of the events following the generation of the match.

What does ASTRA gain?

We gain nothing. It is a humanitarian effort. The charges to register are a nominal Rs. 200. There are no hidden costs. The more the people who register, the faster a match may happen.
The idea is to increase the number of living donor transplants successfully and legally. Our reward is the smile on the faces of those who have been given a new chance at life through ASTRA.

The author can be reached at drganeshakc@gmail.com or at 09029938711

Dr. Ganesh Sanap

Dr.Ganesh Sanap is the ASTRA Coordinator and Head Clinical Operations, Apex Kidney Care Pvt.Ltd. He is a general physician by profession and has been working in nephrology and hemodialysis dialysis for the last six years. He has been working with the ASTRA registry since it was initiated in 2010 by the Apex Kidney Foundation.

73 Comments

  1. Sonam Sinha · April 20, 2015 Reply

    Good to know. If I hadn’t read this article I’d have never known this existed. Shouldn’t the government be doing something to popularize it.

  2. jatin kothari · April 21, 2015 Reply

    great work done by dr ganesh sanap,dr vish billa and entire team -ASTRA

  3. Dr.ranjeeta Bhalavi · April 21, 2015 Reply

    Nice article, swap donations are allowed in 2014 Act & rules of THO Act. govt. is taking new steps to fulfill the demand and supply gap of Organs. but till some states have not adopted new act & rules yet. 🙁

  4. Yashika Khurana · April 22, 2015 Reply

    Dear Sir,
    Its nice to hear and I require for my hubby leaver transplant for tht b+ blood grp…pls explain if you help me out. Me from ludhiana, punjab.
    Kindly give me your contact no.Mine I 9646786781

  5. Prajesh Taneja · April 23, 2015 Reply

    Respected sir,
    Really very nice article, you are doing a very good job towards humanity.
    We are also doing on diseased organ donation at Jaipur and our organisation is MFJCF and it is a NGO.It is first time in Rajasthan and you will glad to know that three case of brain death organ donation are done just in last two months and by this life of seven person is saved.
    You work is very good and i will certainly put this idea to my team also.
    Prajesh Taneja, Jaipur
    09001199198

  6. Esther Githinji · June 11, 2015 Reply

    Dear Sir,
    Good work keep it up. Having received a kidney from an Indian through the swap arrangement was a miracle to me and my family because for almost two years we had no hope but thanks to swap transplant I received a kidney, as the first international swap transplant patient. Thank God. Keep up the work and create more awareness.
    Esther Githinji Kenya.

  7. ann githinji · June 11, 2015 Reply

    Am glad it was performed on us glad for learning of its existence. Wish more patients and donors would do same to save more lives.

  8. Dr Shital Lengade · October 25, 2015 Reply

    nice work initiated by ASTRA. hope it reaches out to maximum nephrologists and kidney failure patients. Is their a provision for online registeration for swap transplant matching? if yes, it would simplify the process and more people would probably get registered, leading to more matching pairs. Kindly let me know.

  9. mukesh Hingwe · November 12, 2015 Reply

    Hi Sir,
    Glad to know about kidney swap transplant…,my sister is suffering with kidney failure,she is kidney recepient with blood group with O positive while her husband (my Jijaji) is with A group.If any hope for swap transplant please let us know…
    Mukesh..9552510468

  10. anoop · December 22, 2015 Reply

    my nephew suffering from kidney failure his blood group is O positive. we have a donor of B blood group. anybody want to paired transplant (Swap) pl contact :+919098192373

  11. abhi · January 2, 2016 Reply

    I am 21 years old and before two years i was observed kidney dysfunction, now i need O + kidney. if any person interested to paired/exchange transplant pl contact me on 09179354166

  12. Pushpa Raghani · January 19, 2016 Reply

    Hello,
    My brother has had kidney failure and we want to register for Astra. How should we go about it?
    Thanks.

  13. Kajal Pahwa · February 1, 2016 Reply

    M looking for a person who can give kidney for A+ blood group and can get from B+ blood group.

    • Manoj · February 10, 2016 Reply

      Hi kajal,

      My father who is a+ve is willing to donate his kidney who is b+ve.

      Please contact ASAP.
      9971930997

    • Manoj · February 10, 2016 Reply

      Hi kajal,

      My father who is a+ve is willing to donate his kidney to my mother who is b+ve.

      Please contact ASAP.
      9971930997

  14. SHRUTI SEN PATEL · February 8, 2016 Reply

    my brother is suffering kidney failure his blood group is O+.HIS WIFE HAS DONOR A GROUP AGE 30 .PLEASE CONTACT 09431418016

  15. sahil thapar · February 20, 2016 Reply

    My uncle is suffering from kidney problem, we are looking for swap(exchange) kidney transplant.

    Patient Age : 40 yrs
    Blood Group :A+

    Donor(wife) Age:36 years
    Blood Group: B+

    Contact me at 09501030433

  16. m ramesh kumar · February 23, 2016 Reply

    Its wonderful initiative by Dr Ganesh sir. I am a patient of O positive aged 50 years, under treatment at apollo hospita hyderabad Dr Sanjay Maitra Nephrologist, looking forward for a donor under swap initiative. My wife is A positive aged 45 years . How to initiate process ? Please guide. My phone : 9959299557, hyderabad

  17. karun · March 14, 2016 Reply

    Hi we want swap transplant.we need A+ and we have B+ kidney..
    Contact on 9796005748

  18. biraja swain · March 31, 2016 Reply

    Hi Doctor,

    I am a CKD patient on dialysis for last 3 years. My blood group is O+ve and my wife is B+ve. We would like to enroll for the kidney swap program.

    Please let us know how to connect with a swap donor.

    regards,

  19. Vishal Goyal · April 2, 2016 Reply

    A new swap registry has been started by Recoup Medicare Private limited i.e. http://www.kidneyswapper.com

    It is a advanced portal for swapping.

  20. kopal tandon · May 10, 2016 Reply

    HI,

    my father is O+ve on dialysis 58 years old. my mother wish to donate but is AB+ve and hence incompatible. i am looking for swap so that she can donate to AB+ve and someone donate to my father. if someone is O+ve and is donating to his or her family member who has AB+ve kindly contact me, so that two patients will be transplanted. God will bless you.

    Thank you

  21. sivajothi · June 1, 2016 Reply

    Hi,
    I am looking for A+ donor for swapping with B+.

    Patient Age : 29 yrs
    Blood Group :A+

    Donor(mother) Age:49 years
    Blood Group: B+

    Please contact me @9738883745

  22. niraj kumar · June 4, 2016 Reply

    M looking for a person who can give kidney for A+ blood group and can get from B+ blood group.

  23. niraj kumar · June 4, 2016 Reply

    M looking for a person who can give kidney for A+ blood group and can get from B+ blood group.

    M-9724089093

  24. niraj kumar · June 4, 2016 Reply

    Hi we want swap transplant. we need B+ and we have A+ kidney..
    Contact on M-9724089093

  25. V N mishra · June 24, 2016 Reply

    I am looking for a person who can give kidney for B pos blood group (age group approx 30-40yrs) and can receive kidney of A pos blood group.
    my treatment is going on in cmc vellore. If interested contact me-9835342938,9931740259.

  26. Ashok · June 27, 2016 Reply

    I am looking for my brother A+ blood group kidney in exchange with B+ blood group kidney.
    My contact number is 09844857969.

  27. yubraj singh · July 23, 2016 Reply

    Hi, I am looking for a person who can give his/her kidney for B+ blood group in exchange with A+ blood group kidney (my mother). It will be good if donor is from Delhi/gurgaon as our medication is going on in Fortis hospital gurgaon. Thanks, Yubraj

    • MUKESH KUMAR · November 9, 2016 Reply

      I am Mukesh (donar) M 52 (B+) my DTPA GFR IS 104 I AM STRONG BUILT PERSON I REQUIRED A+ MY ALL TEST OK FROM AIIMS AND GANGA RAM HOSPITAL DELHI I CAN DO TRANSPLANT ANY TIME MY ALL FORMALTIES COMPLETE PL. CALL ME IF YOU INTRESTED

      REGARDS :MUKESH KUMAR
      9810396566

    • MUKESH KUMAR · November 9, 2016 Reply

      am Mukesh (donar) M 52 (B+) my DTPA GFR IS 104 I AM STRONG BUILT PERSON I REQUIRED A+ MY ALL TEST OK FROM AIIMS AND GANGA RAM HOSPITAL DELHI I CAN DO TRANSPLANT ANY TIME MY ALL FORMALTIES COMPLETE PL. CALL ME IF YOU INTRESTED

      REGARDS :MUKESH KUMAR
      9810396566

  28. MUKESH KUMAR · August 3, 2016 Reply

    Dear Mishra

    I am Mukesh (donar) M 52 (B+) my DTPA GFR IS 104 I AM STRONG BUILT PERSON I REQUIRED A+ MY ALL TEST OK FROM AIIMS AND GANGA RAM HOSPITAL DELHI I CAN DO TRANSPLANT ANY TIME MY ALL FORMALTIES COMPLETE PL. CALL ME IF YOU INTRESTED

    REGARDS :MUKESH KUMAR
    9810396566

  29. Amit Srivastava (9999191257) · September 6, 2016 Reply

    Hello, My father require B+ve kidney and my mother has A+ve to donate in Gurgaon, Haryana. if you have any scope please let me know.

    Regards
    Amit
    9999191257

  30. Vishal Saxena · October 5, 2016 Reply

    Hi,

    I am Vishal Saxena from Noida (Delhi (NCR region). We have an urgent need of Kidney donar of O+ blood group, in exchange of A+ blood group donar.

    Any quick answere shall be appreciated. If in case this is suitable please contact me on +91 – 9953757807. If not reachable, please call on +91-9953758303.

    Regards, Vishal Saxena

  31. MUKESH KUMAR · November 3, 2016 Reply

    I am Mukesh (donar) M 52 (B+) my DTPA GFR IS 104 I AM STRONG BUILT PERSON I REQUIRED A+ MY ALL TEST OK FROM PSRI AND GANGA RAM HOSPITAL DELHI I CAN DO TRANSPLANT ANY TIME MY ALL FORMALTIES COMPLETE PL. CALL ME IF YOU INTRESTED

    REGARDS :MUKESH KUMAR
    9810396566

  32. niraj kumar · November 7, 2016 Reply

    Hi we want swap transplant. we need B+ and we have A+ kidney..
    Contact on M-9724089093

  33. PRAVEEN ROY · December 4, 2016 Reply

    In this swapping service do you match only for blood group or go beyond that in matching of HLA as well ?

  34. vikash kumar · December 15, 2016 Reply

    Hi ,
    I need O group kidney in exchange of B group.My treatment is carrying on Apollo Indraprastha , delhi.
    Call me at +91-8130713054.

    Vikash

  35. vikash kumar · December 15, 2016 Reply

    Hi we want swap transplant. we need O+ and we have B and AB kidney..
    Contact on M-08130713054

  36. Shubham tripathi · December 17, 2016 Reply

    Hlw I have a doner of AB- blood group and I need B blood group kidney pls contact me its urgent 9158824829

  37. Dr. Ganesh Sanap
    ganesh sanap · December 19, 2016 Reply

    please contact on 9029938711
    dr.Ganesh

  38. MUKESH KUMAR · January 2, 2017 Reply

    HAPPY NEW YEAR 2017

  39. MUKESH KUMAR · January 2, 2017 Reply

    HAPPY NEW YEAR 2017 TO ALL GOD BLESS ALL

  40. Kusum · January 22, 2017 Reply

    My brother needs immediate liver transplant. I am ready to donate. My blood group is B and my brothers is O+. Can someone please help us. We are in New Delhi. My email address is kusumps@hotmail.com

  41. Peer Mohamed · March 7, 2017 Reply

    i am mohamed (Donor) M30(B+) I Required O+ for my brother kidney Transplant need urgent

    Regards
    Peer Mohamed
    7418731819

  42. Peer Mohamed · March 7, 2017 Reply

    Hello,
    My brother has had kidney failure and we want to register for Astra. How should we go about it?
    Thanks.

  43. Sumit yadav · April 7, 2017 Reply

    Hello sir, you and your team doing a great job for humanity. My father is a ckd patient and currently on dalysis since 1 year and he is bload grouo B+, and i have a doner of A+. I want to know that what is the procedure to transplantation of mismatche kidney. Pls revert me aa soon as possible you can contact me on this number 8527427067. pls revert me on same i’m waiting for your reply.
    Thanks in advance.

  44. S Jaiswal · April 25, 2017 Reply

    Hello,
    My brother in law is a CKD patient is in need of renal transplant. His blood group is O+ve but his wife who wants to donate her kidney has A+ve blood group. We would like to go for renal swapping. Could someone help in this matter. My contact number is 9890906852. Plz reply.

  45. Angad · May 18, 2017 Reply

    Hi I m Angad from Delhi I need kidney for my father b group A+ve my mother is b+ve his treatment in Delhi Apollo
    All test is completed urgent require

  46. Anirudha Roy · June 7, 2017 Reply

    My brother needs immediate kidney transplantation. His blood group is A negative. My mother ( age 50 AB positive) and father (59 O negetive) want to donate kidney. M- 9093516946

  47. Rekha BP · June 25, 2017 Reply

    I am 45 years old. My blood group B+ and we have A + donor / AB donor. If anybody has B+ group kidney Pl. contact us.

    Thanks.

    Rekha
    9686455324

  48. Surinder kumar · June 28, 2017 Reply

    My wife is sudffering from CKD her blood group is O+,iam ready to donate my kidney of B= group in swap case .it is urgent,contact me.

  49. Avishek Kumar · July 1, 2017 Reply

    Hi,

    I am Avishek Kumar from Patna. I have an urgent need of Kidney donar of O+ blood group, in exchange of A+ blood group donar.My treatment is carrying on Escort Fortis, Okhla ,New Delhi.

    Any quick answere shall be appreciated. If any person is interested,please contact me on +91 – 9835850907. If not reachable, please call on +91-7004178802.

    Regards, Avishek Kumar

  50. surab · July 9, 2017 Reply

    Hi sir meri mom ki kidny mere papa se match nai Ho rahi mere papa ka blood group o+ h n mom ka o-
    Unka treatment fortis,okhla,new Delhi m chal raha h
    Pls help me 09358404360

  51. Waseem khan · July 10, 2017 Reply

    I need o+ donor urgently i have Donor AB+ and A+ if anyone have o+ donor and need AB+ or A+ please contact 8708988443,
    9911442206

  52. rohit gupta · July 20, 2017 Reply

    We would like to go for renal swapping. Could someone help in this matter. My contact number is 7869915081. Plz reply.

  53. rohit gupta · July 20, 2017 Reply

    Hi Sir,

    my brother is suffering with kidney failure, he is kidney recepient with blood group with O positive while me (Younger Brother) and her wife (my Bhabhi ji) both are with A+ group. If any hope for swap kidney i swap A+ with exchange of o+
    We would like to go for renal swapping. Could someone help in this matter. My contact number is 7869915081. Plz reply.

  54. Neha Kansal · July 21, 2017 Reply

    My hubee suffering from kidney failure his blood group is B+and his 29 year old and I m donar my blood group A+ I m 22 year old so plz anybody want to paired transplant. (Swipe) contact no-8923384934

  55. Praveen · August 8, 2017 Reply

    We have ab+ blood group kidney donor and we need a+ blood group kidney. Plz contact me its urgent-
    9899248892

  56. Badri Yadav · August 11, 2017 Reply

    Hi I am O+ (recipient )my wife is AB+ (donor) Contact no.9323563315

  57. MUKESH KUMAR · August 31, 2017 Reply

    GOOD MORNING EVERYONE BY THE GRACE OF GOD MY WIFE TRANSPLANT HAD DONE IN IKDRC AHMEDABAD on 16/07/2017 AND SHE IS RECOVERING THIS HOSPITAL IS ASIA NO.1 HOSPITAL THEY HAD DONE AROUND 5200 KIDNEY TRANSPLANT I HAD REGISTERED MY WIFE NAME FOR SWAP TRANSPLANT IN ALL DELHI HOSPITALS BUT NO BODY FIND SUITABLE SWAP FOR ME BUT IKDRC
    DR. FIND FOR ME SWAP MATCH WITHIN MONTH THAT S MY PERSONAL SUGGESTION TO EVERYBODY THOSE IN SEARCH FOR SWAP MATCH PL. CONTACT DR. VIVEK KUTE IN IKDRC YOU WILL GET YOUR SWAP MATCH WITHIN MONTH HOPE ALL GET WELL SOON BEST REGARDS :MUKESH KUMAR

  58. rohit gupta · September 3, 2017 Reply

    Dear Mukesh ji
    can you please tell me how to contact DR. VIVEK KUTE because i am living in utter pradesh.

    any infromation kindly share me

  59. deepa bhurangi · September 5, 2017 Reply

    How do I register in ASTRA, my husband needs B+ve and I am A+ve .I am ready for transplant have been searching for B+ve donar . I stay near Delhi,

  60. Santosh Vishwakarma · September 12, 2017 Reply

    Great information to provide , just to gain humanity .live long Dr Ganesh and thanks to Dr Viswanath billa.

  61. BHUSHAN A SONAWALE · October 15, 2017 Reply

    Our daughter requires O + positive kidney…. We have B and Ab+ donor for swap to get O positive kidney donor…kindly let us know on the same…

  62. P.Asirappadu · October 18, 2017 Reply

    Sir ,

    I am O+ve kidney patient, And my brother is A +Ve ,So I would like to give my brothers kidney to any A +Ve fellow in swap of O+ve kidney for me in hyderabd, Telangana

    • Kumar Abhishek · November 3, 2017 Reply

      Hi Need B+ Kidney. We are having A+ kidney. If any one wants for swapping . Please call me 9109949113. Location(Indore)

  63. Kumar Abhishek · November 3, 2017 Reply

    Hi Need B+ Kidney. We are having A+ kidney. If any one wants for swapping . Please call me 9109949113. Location(Indore)

  64. TANISHA BORA · February 2, 2018 Reply

    Hi need B+ kidney. we are having A+ kidney.if anyone wants for swapping.Please call-8057070081
    Location (New Delhi)

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