In a rare case, Sandeep Bhatnagar, 51, the principal of a school in Chhattisgarh, and 37-year-old Telangana businessman CG Hanumanthu have successfully undergone an interstate kidney swap from each other’s wives which cross-matched, according to a report in the Times of India.

The kidney transplants in the two patients took place at two hospitals in Hyderabad. Four surgeries were carried out on the couples at the same time in  Virinchi hospital and KIMS hospital in Hyderabad..

Bhatnagar and Hanumanthu from Mehbbnagar had been waiting for a suitable match but couldn’t find one in their families. Eventually, Sandeep’s wife Indu Bhatnagar, 40, donated a kidney to Hanumanthu and Varalaxmi, 37, wife of Hanumanthu donated a kidney to Sandeep.

Doctors say that this procedure has opened up the possibility of carrying out more kidney transplants as matching donors are not always available within the same family. This cross-exchange of kidneys between families provides a new opening in such cases.

However, the Times of India report also states that complex legal paperwork is required to carry out the process and it took almost eight months in this case.

“There are many legalities involved and several trips had to be made. To cut out any chance of withdrawal of consent by one couple after one of the surgeries, all the four had to undergo surgeries at the exact time and date (December 9),” Dr KS Nayak, chief nephrologist at Virinchi hospital, told the Times of India.