First case of ABO-incompatible kidney transplantation carried out in Hainan. 

On the morning of January 4, the temperature rose and the city was warm. In the transplantation ward of the Second Affiliated Hospital of Hainan Medical University , after 26 days of admission, the 25-year-old boy Xiao Cheng (pseudonym) took off his sick suit and put on a new spirit. "This time I walked out of the hospital and finally waved goodbye to the disease that has been plagued for four years, uremia."

"Thank you for my mother, gave me a second life. Thanks to the experts, doctors and nurses of the Second Hospital ofHNMU, I was reborn." Xiao Cheng was grateful. On December 18, 2018, the Second Hospital of HNMU successfully completed the first ABO- incompatible  kidney transplantation. President Wang Yi led the organ transplantation team help the 49-year-old mother to take her own left kidney  donated to his son Xiao Cheng.

The disease is raging and almost "ruined" a family.

Back in time to 2014, when Xiao Cheng was still in college, he was diagnosed with uremia.

"I can't believe that my son is young, how can he get this disease?" Mrs. Cheng took him to a number of hospitals. The doctor's diagnosis is basically the same, if you do not change the kidney, dialysis is the only treatment.

After 4 years of illness, the health condition of Xiao Cheng went from bad to worse. He started 5 times of dialysis in the first two weeks, and  needed to do 3 times of dialysis every week for the recent half year. Due to the general economic situation of the family, Mrs. Cheng had to choose the kidney transplantation in the province. However, she has not waited for a suitable kidney source.

By chance, Mrs. Cheng  heard  that the related donor were relatively safe to transplant and could save the cost. However, the results of the examination shredded her hope again: Mrs. Cheng  is AB blood, while the Xiao Cheng is B blood, the mother and child blood types are incompatible.

Seeing that  Xiao Cheng is getting thinner, the family is almost in a desperate situation...

People with a little medical knowledge know that even if a normal blood transfusion, the first thing that must be guaranteed is that the blood donor and the recipient's ABO blood type match, otherwise it will lead to severe hemolysis and rejection. Dr. Li Desheng from the Organ transplantation department said that hemolysis reaction generally refers to the destruction of erythrocyte membrane, or the occurrence of most small pores, or the reaction of hemoglobin from red blood cells due to extreme stretching, which can cause shock, acute renal failure and even death.

Li Desheng told reporters that ABO blood group antigen is the strongest antigen leading to rejection. If there is no special treatment for incompatible kidney transplantation, hyperacute rejection will occur, resulting in irreversible damage in the transplanted kidney within a few minutes, eventually leading to transplanted kidney failure. Traditionally, ABO-incompatibility is an absolute contraindication to kidney transplantation. There is no precedent in Hainan for organ transplantation across blood-type disorders.

The team of experts broke the blood type disorder, and the mother donate the kidney to save the child. 

At this time, Wang Yi, the top expert in the domestic transplant discipline, also president of the  hospital was concerned about the situation of Xiao Cheng and proposed a solution for the transplant of related,“Even if the blood type is different, the kidney can be carried out as long as the relevant indicators reach the standard."

President Wang Yi’s words were like a life-saving straw, Mrs. Cheng told reporters that she did not consider her kidney at all. The only thing she wanted to do was to save her son.

"With the help of plasma exchange and other therapies, ABO incompatibility will no longer be a contraindication for kidney transplant surgery. According to the current conditions, our hospital of  is fully capable of overcoming blood group disorders and achieving the same survival rate as ABO blood group compatible patients. According to President Wang Yi, effective elimination of blood group antibodies in the recipient before surgery and prevention of post-operative blood group antibody rebound leading to hyperacute humoral rejection of the transplanted kidney is the key to successful ABO incompatible living kidney transplantation.

On December 18, 2018, the mother and son were both promoted to the operating room. President Wang Yi led the organ transplant team of the  hospital to complete the kidney cutting and kidney transplantation. The successful implementation of this operation also marked the success of the first ABO blood group incompatible kidney transplantation in Hainan.

On December 29, 2018, after the examination, Mrs. Cheng was successfully discharged from the hospital. On January 4, after examination, the renal function of Xiao Cheng had returned to normal level, and the physical indicators were good, reaching the discharge standard.

Good news for patient's in Hainan, we can also undergo blood group incompatible transplantation without going out of the island

Kidney transplantation is the most effective treatment for end-stage renal disease, but the shortage of donor kidney has always been the biggest bottleneck for kidney transplantation. The living donor kidney has greatly relieved the tight supply of kidney, but because of the ABO incompatibility, many end-stage renal disease patients with relatives donating kidneys have lost the opportunity to obtain a transplantation. According to foreign statistics, about 30% of potential donors are incompatible with recipient ABO blood type, that is, donor blood type and recipient blood type do not meet the principle of blood transfusion.

President Wang Yi  told reporters that organ shortage has always been a problem that the whole world facing, and the contradiction between supply and demand in China is more prominent. The living relatives of the “self-help in the family” kidney transplant is still the preferred method for many patients with end-stage renal disease.

President Wang Yi said that if the ABO-incompatible kidney transplantation operation is carried out and promoted, the current situation of a serious shortage of kidney donors in China means that one third of the kidney donors can be increased, so that more uremic patients can get a kidney transplantation opportunity. The success of the first ABO-incompatible kidney transplantation in the Second Affiliated Hospital of HNMU marked the complete breakthrough of blood transfusion in kidney transplantation in Hainan Province, and laid a good foundation  of various types of blood group incompatible transplantation in the Department of Organ Transplantation of the hospital.  

At present, the Second Affliated Hospital of HNMU has carried out kidney transplantation, liver transplantation, and pancreas-kidney transplantation. It will gradually carry out physical organ transplantation such as heart and lungs, which will truly realize “transplantation in islands”,  benefits people in Hainan Province.