Business Wire India
The team of doctors at BGS Gleneagles Global Hospitals completed a complex case of transplantation of a transplanted kidney on June 14, 2018. This occurs when a donated kidney is later transplanted to another recipient from a recipient of kidney transplant. This procedure is extremely rare with only around 8 such cases reported globally. In this case, it is of interest to note that the first and second recipients were in their 60’s, having received the organ from a donor who is also a senior citizen.
Mr. Ramkumar (name changed), was a middle-aged government servant who had been suffering from diabetes for many years. He was also hypertensive. In 2006, he was diagnosed with chronic kidney disease. He was on medical management until 2010. He was initiated on haemodialysis while placed on the transplant list. At the time, his elder brother, aged 62, came forward to donate one of his kidneys. On evaluation, it was seen that there was a 100 percent genetic match in the kidneys. This meant that the donated kidney would function very well in the brother and that he would require minimal immunosuppression.
Therefore, the kidney transplant surgery was planned and executed in 2010 at BGS Gleneagles Global Hospitals. Ramkumar was 58 years at the time. The surgery went off well with no complications. Ramkumar made a complete recovery and did not require dialysis any more. He was very regular in his follow up and took all necessary precautions to maintain normal kidney functions. Four years following his surgery, Ramkumar retired from his government job. He moved on to a more relaxed daily routine that included a morning and evening walk along with his friends in the locality. After his walk he would head back home on his two-wheeler.
On June 10, 2018, as he was heading home on his scooter, he suffered a bad fall. Nevertheless, he drove back home by himself. At home, he experienced a sharp headache and was immediately rushed to a nearby hospital where he had a cardiac arrest. It was then that he was shifted to BGS Gleneagles Global Hospitals. On evaluation, it was determined that he had suffered from an intracerebral haemorrhage and hence was swiftly taken into emergency surgery. Unfortunately, his condition continued to deteriorate over the next two days and he was declared brain dead.
The family though shattered with the news, wanted to share the gift of life through transplantation, just as Ramkumar had been lucky to receive an organ 8.5 years ago. They came forward and suggested organ donation. As Ramkumar was himself a recipient of kidney transplant, the possibility of donating his kidney was unlikely.
This is because, in most cases, the kidney after 10 years of transplantation is likely to have some dysfunction and in addition, surgery to retrieve a transplanted kidney is clinically more difficult. Surprisingly, in this case, the transplanted kidney showcased very normal functioning. Mr Ramkumar’s elder brother was 62 at the time of donation. This meant the age of the kidney was already around 71 years. Any donor after 60 years is considered to be an ’extended criteria donor’, which meant that transplanting such a kidney may have less than optimal function.
Keeping in mind, the surprisingly healthy condition of the transplanted kidney and the risks associated with using a kidney from an extended criteria donor, it was decided that if at all the kidney was offered for another transplant, it would have to be offered to an individual who is over 65 years and has been on the cadaver waiting list for a long time. After assessing all these conditions, the kidney was offered to Mr. Avinash (name changed), a 68-year-old individual who had been diagnosed with end stage renal disease in 2015. In addition, his liver was also transplanted to another recipient.
(Chief Transplant Surgeon) and his team of surgeons at BGS Gleneagles Global Hospitals had a challenging surgery retrieving the transplanted kidney, but in the end, they managed the procedure smoothly and successfully transplanted the kidney to the new recipient. Mr. Avinash had an uneventful postoperative period and made a full recovery. He was discharged after 8 days. The kidney has been functioning very effectively and has shown effectiveness similar to that of a kidney from a young donor.
Dr. Anil Kumar BT, Senior Consultant and Transplant Physician, BGS Gleneagles Global Hospitals, Bengaluru
shared his thoughts on this unique case, “Recently, I had the chance to meet the original donor. I expressed how this unique situation benefitted not only his brother but a complete stranger many years later. Naturally, he was grieving about the loss of his younger brother, but he was happy to learn that he was able to save two lives through this act of donation. This case was set in extremely rare circumstances. Medical literature states that there has been only eight such reported cases.”
Ms. Shailaja Suresh, CEO, Gleneagles Global Hospitals, Bengaluru
added,” At BGS Gleneagles Global Hospitals, kidney care is one of our leading practices. Our team of highly skilled doctors leading the nephrology and urology departments are experienced in handling complex cases and therefore better prepared to take on challenging cases such as these.”