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Mumbai: On 2nd March 2020, just days before the first Covid cases in Maharashtra were detected, the Nair hospital in Mumbai was gearing up for the kidney transplant of 41-year-old Sudhir Mishra, who describes himself as self-employed.
What made this transplant significant was that the donor was his wife, 31-year-old Roma Mishra, whose blood group did not match his, making it the first of its kind in a BMC hospital. Now close to 8 months later, the doctors have declared the operation a success as Mishra's body has fully accepted the donor kidney.
"Going against blood type is always a complicated procedure. We used to be always hesitant doing this in a civic hospital as there are many ancillary procedures involved, which majority of our patients who are poor cannot afford or sustain. Preparing the patients' bodies for this procedure is very crucial. So initially when the procedure began I was jittery but when we saw that the kidney was pink and turgid on engraftment, we were relieved as this was half the battle won," says Dr. Kalpana Mehta, head of the Nephrology department at Nair.  
Sudhir Mishra's mother had initially volunteered to donate her kidney but her organs did not fulfill the required conditions. Roma had then volunteered but her parents were not really keen on it. "Once we gave our consent as a couple, the doctors wanted to be absolutely sure, so they asked us to bring both our fathers to meet them. Her father lives abroad, he came down to speak to them," says Mishra. His wife says for her it was about love, a sense of duty too, "I did not want to look back in regret thinking what if I had tried this or that. I wanted to be sure, we had given it our best shot. I was prepared to work hard the rest of my life if it was needed, knowing he was safe would have made that also bearable," she says.
Roma Mishra had to convince her parents who were initially worried not just about her health but also the future of their two granddaughters aged 11 and 6. Roma says she had trained her elder daughter to take care of the younger one as the couple made rounds of hospitals.
Mishra, of course, had the option of going in for a cadaver transplant, but the wait time for that is 6-7 years in Mumbai. "I did not see myself living with regular dialysis, I have to save for my daughters also. I explained my situation to Dr. Salman who consulted his seniors and my case was referred to Dr. Mehta. I told the doctors there was a risk either way, so I was willing to undergo the procedure," he says.
Dr. Mehta adds, "At a private hospital this procedure costs 10-14 lakhs. We had to perform 15 rounds of plasma for antibodies as his blood group was different. Sudhir Mishra needed help soon as he did not want to live on dialysis and he also had expressed inability to afford private care."   
The doctors at Nair had prepared Mishra and his wife for the procedure for one and a half months before the operation on 2nd March. A few days after the operation, Mumbai recorded its first Covid cases, bringing with it a further challenge for the doctors. "We kept him at the hospital for a longer time than usual as there was a risk of infection," Dr. Mehta confirmed.
While dietary restrictions continue and life will no longer be exactly the same for Mishra, he is optimistic about his future, "I am perfectly fine now and we will always be grateful to these doctors." "I used to initially worry about it being a government hospital but we were well taken care of," adds his wife.
BMC's director of medical education, Dr. Ramesh Bharmal, called it a "monumental" achievement for the civic-run establishment.