Two donors, two recipients: Tech-driven kidney swap enables transplants, resolving blood group mismatch
Bengaluru, 16th October 2026: Aster CMI Hospital has successfully carried out India’s first reported pediatric ABO (A, B, AB and O blood group)-incompatible kidney transplant by enabling a two-way kidney donor swap and paired exchange between two families. As a result, a 15-year-old boy and a 21-year-old adult male, whose family donors had incompatible blood groups, underwent life-saving kidney transplants.
Aster CMI Hospital, Bengaluru carried out the complex procedure, reportedly the first such involving a child, using Alliance for Paired Donation (APKD) software to identify successful donor-recipient combinations.
Both young patients had relatives willing to donate a kidney, but neither donor could safely give directly because of blood-group mismatch. Aster used a kidney swap supported by matching software, so the two donors exchanged recipients, enabling both patients to receive a more compatible kidney. Kidney-paired donation (KPD) is specifically designed to overcome ABO blood-group and human leukocyte antigen (HLA) incompatibility in living donation. In this case, the teenager received a kidney from the 21-year-old’s family donor and vice versa.
By using matching technology, Aster could assess multiple donor-recipient pairs simultaneously to identify the best compatible combinations for potential exchange. This method brings down the possibility of re-transplants for each patient and reduces the chances of infection afterwards. Crucially, this enables a safer return to normal life for both patients, post-transplant. Aster estimates this also cuts costs by 40% compared to conventional methods.
Months of planning
The kidney swap posed significant logistical challenges and required months of planning and coordination. The procedure involves four OTs (Operation theaters) functioning simultaneously with four anesthetists and four transplant surgical teams, supported by infectious disease teams.
Dr. Arun Kumar N, Senior Consultant – Nephrology & Renal Transplant, Aster CMI Hospital, said: “It is time India shifts from the conventional transplant method to ABO-incompatible kidney transplants to ensure the best possible outcomes from the first attempt. This is a precision and target-driven transplant assuring 99% adaptability. This gives a better perspective on survival, longer graph survival and does away with repeated transplants. The software helped us identify appropriate matches, while the coordinated efforts of our multidisciplinary teams enabled us to successfully conduct simultaneous procedures.”
Dr. Avinash T S, Lead Consultant – Urology, Aster CMI Hospital, said: “Both patients had willing family donors, but direct transplant was not possible because of blood group incompatibility. Kidney-paired donation provided the pathway by allowing the donors to exchange recipients. The success of such a procedure depends on identifying compatible matches and meticulous planning, simultaneous surgical coordination, not to mention close collaboration across multiple specialties.”
Sudhindra G Bhat, Chief Operating Officer, Aster DM Quality Care, said: “This achievement reflects our commitment to making advanced healthcare solutions accessible to patients who need them. For families facing challenges in finding a suitable kidney donor, paired donation can create new possibilities when a direct transplant is not feasible. It reinforces our focus on building healthcare capabilities that address complex patient needs and improve access to life-saving treatment.”
Dr. Prashant N, Regional Chief Executive Officer, Aster DM Quality Care, said: “The successful completion of this complex transplant highlights the growing role of technology in enabling more precise donor-recipient matching. Kidney-paired donation has the potential to expand the living-donor pool by connecting compatible pairs who might otherwise be unable to proceed with transplantation. Strengthening such capabilities will be important in advancing transplant care and exploring new pathways for patients with donor incompatibility.”