34-Year-Old Woman was saved by First-In-The-World Medical Interventions In Kidney Transplant

Dr. Madan Bahadur, Director, Department of Nephrology and Kidney Transplantation, has published a first-in-the-world medical research that found life-threatening antiviral side effects in patients with a genetic defect that is frequent among Indian transplant patients. This research was carried out at Jaslok Hospital and Research Centre, which is the pioneer of kidney and liver transplantation in western India.

Following a kidney transplant, valganciclovir is commonly administered to prevent viral infection. Patients with NUDT15 enzyme deficiency have severely low blood counts after using valganciclovir, according to Dr Ashay Shingare, Consultant Nephrologist at Jaslok Hospital, making them exposed to life-threatening infections.

In one recent kidney transplant recipient, a genetic test revealed NUDT15 deficiency, and after quitting valganciclovir, his blood numbers improved, and the infection went away.

First Case Of To Find The Link Between Valganciclovir And Genetic Variation

The prominent transplant journal Transplant Infectious Disease has published the first case report of a link between valganciclovir and genetic variation. In the instance of Mahima Ralli, 34, who was hospitalised to the ICU in January 2022 with a urinary tract infection following a kidney transplant, this genetic association report saved her life.

Mahima was diagnosed with the renal illness in 2002 and began hemodialysis in 2004. She was taken to Jaslok Hospital’s ICU after experiencing a dramatic rise in her blood pressure that was uncontrollable despite seven blood pressure medications and the removal of both of her damaged kidneys. She was given a combination of sodium nitroprusside and sildenafil for blood pressure control, which was a new, first-in-the-world intervention that saved her life.

Patients Got A Kidney Transplant A Second Time

Later that year, in 2004, she received a living donor kidney transplant from her mother, which has been functioning successfully for more than 16 years. Her kidney function deteriorated as a result of urinary bladder difficulties, and she was forced to return on dialysis in 2021. Mahima’s maternal aunt gave her kidney to her for a second kidney transplant at Jaslok Hospital in November 2021.

A new urinary bladder was surgically built prior to the donation. Because the blood types of the donor and recipient did not match, she underwent plasmapheresis operations. She got an extremely low blood count two months after the transplant, which led to a bacterial infection that necessitated ICU care.

Mahima also has a deficit of the enzyme NUDT15, according to genotyping research. She improved after the antiviral was stopped, and she was discharged from the hospital. It’s a miracle that this young child lived to see another day at Jaslok Hospital, where she received unique, first-in-the-world medical treatment.