India's first 'saviour sibling' cures brother of fatal illness

Kavya Solanki at the age of 18 months old, saved her seven year old thalassaemic brother Abhijit. Her bone marrow was extracted and transplanted into Abhijit, making her the first 'saviour sibling' in India.

Abhijit suffered from thalassaemia major, a disorder where his haemoglobin count was dangerously low and he required frequent blood transfusions.

"Every 20-22 days, he needed 350ml to 400ml blood. By the age of six, he'd had 80 transfusions," his father Sahdevsinh Solanki told BBC on the phone from their home in Ahmedabad, the largest city in the western state of Gujarat.

"Abhijit was born after my first daughter. We were a happy family. He was 10 months old when we learnt that he was thalassaemic. We were devastated. He was weak, his immune system was compromised and he often became ill.

In 2017, the father came across an article on "saviour siblings" - a baby created for the purpose of donating organs, cells or bone marrow to an older sibling. He approached Dr Manish Banker, one of India's best-known fertility specialists, and persuaded him to prepare a thalassaemia-free foetus for Abhijit's treatment.

Mr Solanki says they opted for a saviour sibling because they ran out of choice. One hospital told him that they had found a bone marrow tissue match in the US. But the cost was prohibitive - between 5m rupees ($68,000; £52,000) and 10m rupees - and since it was an unrelated donor, he was told the success rate would be 20-30%.

The technology used for Kavya's birth is called pre-implantation genetic diagnosis - it allows embryos to be screened for disease-causing genes and has been used in India for a few years now, but it's the first time it's been used to create a saviour sibling.

Dr Banker says it took him more than six months to create the embryo, screen it and match it with Abhijit's. Once they had the perfect match, the foetus was planted in the mother's womb.

"After Kavya's birth, we had to wait another 16 to 18 months so that her weight could increase to 10-12kg. The bone marrow transplant was done in March. Then we waited for a few months to see whether the recipient had accepted the transplant before announcing it."

"It's been seven months since the transplant and Abhijit has not needed another transfusion," Mr Solanki told the BBC. "We had his blood sample tested recently, his haemoglobin count is over 11 now. The doctors say he's cured."

Dr Deepa Trivedi, who carried out the transplant, told BBC Gujarati's Arjun Parmar that after the procedure, Kavya's haemoglobin levels had dipped and there was localised pain for a few days from where the bone marrow was taken, but she's now fully healed.

"Both Kavya and Abhijit are now completely healthy," she said.