PESHAWAR: The Institute of Kidney Diseases (IKD), Peshawar, has successfully performed its first kidney transplant in a patient, who had donor-specific antibodies (DSA) against the intended kidney donor, marking an important development in the institute’s renal transplant programme.
According to the transplant team, led by Dr Samiur Rahman, the presence of these antibodies made the case more challenging than a routine kidney transplant because they could increase the risk of patient’s immune system rejecting the donated kidney.
“Before kidney transplant, patients undergo special blood tests to determine whether their immune system has antibodies against the donor. When these antibodies specifically target the intended donor, they are known as donor-specific antibodies, or DSA,” said Dr Sami.
He said that in some patients, the presence of significant DSA could make transplantation with an otherwise willing and suitable family donor difficult because of the increased risk of antibody-mediated rejection.
Institute likely to conduct swap donor procedure within few weeks
In this case, the patient underwent a planned treatment known as de-sensitisation, which was used to reduce or control the harmful antibody response before transplantation he said.
“Following the treatment, the patient underwent repeat immunological testing. Once the results showed that the risk had been reduced to a level considered acceptable by the transplant team, the kidney transplant was performed successfully,” said Dr Sami.
He said that the development could be particularly important for kidney-failure patients, who had a willing living donor but faced compatibility problems because of antibodies against that donor. In carefully selected cases, de-sensitisation might provide an additional route to transplantation rather than requiring the patient to continue dialysis while searching for another suitable donor, he added.
However, he said that DSA-positive transplantation was not the same as a routine compatible transplant. He added that such patients remained at higher immunological risk and required careful selection as well as close monitoring after surgery for kidney function, anti-rejection medicine levels and signs of antibody-mediated rejection.
“The successful procedure represents another step in the development of the IKD transplant programme towards handling more complex transplant cases,” said Dr Sami.
Other members of his team said that they wanted to build a comprehensive transplant service capable not only of increasing access to kidney transplantation but also of providing safe treatment options to those patients, who might previously have had limited possibilities because of difficult immunological compatibility.
They said that the patient was being closely monitored by the transplant team following the procedure.
The public sector IKD, an affiliated institute of Khyber Girls Medical College and Hayatabad Medical Complex, has been conducting renal transplants since long but of late it has started performing complicated medical procedures.
Two patients are being prepared for swap transplants as there is lack of organ donors.
The current team led by Dr Samiur Rahman has carried out 60 cases in the past few months. “We are trying our level best to start new procedures as well as scale up public awareness for organ donations,” said doctors.
They said that many times, patients with both damaged kidneys needed renal transplants and their tissues did not match with their legal donors. In such cases, they opted for swap donors where two or more incompatible donor-recipient pairs exchanged their donors to receive healthy, matching kidneys, they added.
“We have started workup on two patients and their donors and hopefully the first-ever swap donor procedure would be conducted within few weeks,” they said.
Published in Dawn, September 15th, 2026
