Complex and Simultaneous kidney-pancreas transplantation performed at Sahyadri hospital Pune. It is probably Asia’s first such critical and complex process. Sahyadri Hospitals recently conducted an extremely complex and critical simultaneous kidney-pancreas transplantation at Sahyadri Super Specialty Hospital Deccan. Before this four kidney & pancreas transplants were conducted at Sahyadri Speciality Hospital Deccan Gymkhana. For the first time in Western India, a single centre has performed five complex simultaneous kidney & pancreas transplant.
Elaborating on the successful transplant, Dr Bipin Vibhute Liver and multivisceral Transplant Surgeon said our last case of simultaneous Kidney and pancreas was unique & were transplanted to a 52-year-old Mr Kunal Pandit from Mumbai who was suffering from renal failure since 7 yrs. and severe diabetes since 25 yrs which had damaged his kidney, had weakness of both lower limbs due diabetes. He had to depend on two dialyses a week and heavy doses of insulin. He was completely dependent on his retired father & wife.
Prof Dr Anil Vaidya Mutlivisceral transplant Surgeon added that Mr Kunal pandit’s diabetes complications were not limited to his kidney but also his heart function was also weak but good enough or fit for transplantation. When we started his surgery he had lot of fat on his belly and his main blood vessels which usually carries oxygenated blood from heart to abdomen & Lower limb were completely calcified (calcium deposition in the blood vessels due diabetes & hypertension) and there was no place on that blood vessel to suture or to give blood supply to new pancreas & kidney. Hence for a moment we thought we are not going to transplant him but after lot of discussion we decide to explore more option because this was his best ever chance and without it he wouldn’t have survived for long time. Hence we dissected lower limb blood vessel to find out whether we can get sufficient blood supply & fortunately we got 1 cm patch from where we got cadaveric conduit ( blood vessel) from which we could give blood supply to both new pancreas and kidney and was transplanted one above the other otherwise both organs would have been transplanted at different locations. Transplant went on well and post op period was uneventful & discharged from the hospital 7th day after transplantation.
In addition, what made this transplant a complex one is that the blood supply to the pancreas and kidney had to be derived from a single unconventional source because the conventional vessels were rigid with calcium deposits, making it impossible to use without risking the blood supply to the lower limb.
Innovative approaches to complex pancreas transplantation should be attempted by a mature team with years of experience behind them. These cases should not be done by a young inexperienced team.
Dr Dinesh Babu senior anaesthetist said He never required dialysis since transplantation though he was on very small doses of insulin immediately after surgery but now he is off insulin or for that matter any diabetes medicines. We claim this type of surgery to give new lease of life to end stage kidney transplant recipient & innovation is worlds first reported case. the patient is doing well after the transplant and is completely relieved of his insulin intake and dialysis. We are constantly monitoring his progress.”
Diabetes is one of the most common problems in India and can affect various organs. Replacing kidney and pancreas is one of the most useful solution, however, pancreas transplant are still rare in India. Simultaneous Kidney-Pancreas transplant is an operation to replace kidney and pancreas at the same time in a patient who has kidney failure and also suffers from diabetes, needing very high insulin dose to control sugars.
This surgery eliminates problems by optimally controlling sugar levels and by protecting the transplanted kidney from the adverse effects of diabetes. Additionally, it will also help reverse the effects of diabetes on other systems including peripheral neuropathy thus, protecting the limbs.
Esthetic and happy , Kunal Pandit said that those who suffer from heavy diabetes will relate to what I must have gone through . Life was a challenge because of the chronic illness i was suffering and not only me but my entire family was extremely disturbed . Thanks to the doctors and the transplant team , i got a new life which I will cherish every moment . Transplant is no less than a miracle and for me this life without the tensions of insulin and dialysis is no less than a dream come true . My goal now will be to spread the nobel cause of Organ Donation which changes lives of so many patients like me and gives enormous happiness to their families .
Dr Ketan Apte, Unit Head Sahyadri Hospitals said that I would like to congratulate the entire team of doctors and staff for their path breaking work . This success again highlights our mission “All About Possibilities” where doctors and staff try to push their boundaries to create new possibilities for our patients and bring happiness to their families even in the most difficult of situations .
The complex transplant surgeries were performed with the help of various speciality doctors including multi-organ transplant surgeons – Dr. Bipin Vibhute, Dr. Anil Vaidya, Dr. Dinesh Zirpe, Dr. senthil kumar, & Dr. Abhijeet Mane, transplant Anaesthetists – Dr. Dinesh Babu,Dr Manish Phatak , Dr Nivas Nephrologist – Dr. Sachin Patil coordinators – Mr. Arun Ashokan, Mr Aman & Mr. Rahul Tambe and Medical Social Worker Ms. Sharmila Padhye were also part of this team.