A young man, who had been battling Type 1 diabetes for the last 21 years and had little hope with end-stage kidney failure, needed both kidney and pancreas transplants to live. While his sister decided to donate a kidney, they had to wait for a brain-dead person to donate the pancreas. When they did get consent of the family of one such victim, doctors at PGI Chandigarh acted fast. They decided to go for a simultaneous pancreas and kidney transplant with pancreas retrieved from the deceased donor and the kidney from the patient’s sister. The young man is alive and doing well with his transplanted organs.
Says Prof H S Kohli, Head, Department of Nephrology, PGI, “It was a huge challenge preparing for cadaver and live transplant simultaneously. The team worked in tandem and the first such procedure was a success.”
Giving details of the procedure, Prof Ashish Sharma, Head, Department of Renal Transplant Surgery, says, “The patient was suffering from Type 1 diabetes for the last 21 years and it had affected his kidneys to such an extent that his condition led to end-stage kidney failure requiring hemodialysis for the last three years. While on dialysis, his condition continued to deteriorate last year, requiring repeated admissions to the PGI emergency for fluid/electrolyte disturbances, immediate dialysis or episodes of hypoglycemia or hyperglycemia despite being managed by doctors from the departments of endocrinology, nephrology and renal transplant surgery.”
While the patient’s sister was willing to donate her kidney, she could not donate her pancreas. As the waiting list for the pancreas was too long, the patient, along with the doctors, decided to proceed with a kidney transplant alone, which meant that the disease which caused the kidneys to fail would still be there. Meanwhile, Kundan Baitha, a 21-year-old from Bihar, suffered serious head injuries in an accident and was admitted to PGI in critical condition on January 23. He was declared brain dead by the certification committee. His father Narsingh Baitha consented to donate the organs and following the family’s consent, the heart, liver, kidneys, and pancreas were retrieved from the donor for transplantation.
The diabetic man’s family was given the option of a twin transplant — of an emergency living donor kidney transplant along with a deceased donor pancreas transplant — to which they agreed. The operation lasted for 12 hours and involved nearly 30 medical personnel from various departments. The combined transplant operation was successful without any complications. Currently, the patient is maintaining a good urine output with normal blood sugar.
“Pancreas transplant is the only modality known to cure diabetes in the current era. Currently, this option is limited to a very few hospitals in India. PGI, Chandigarh has become the leader in pancreas transplants in the country over the last few years,” adds Prof Sharma.
As per the current waiting list at PGI, 60 patients are awaiting pancreas and kidney transplants. While around a thousand deceased donations happen across India every year, the number of pancreas transplants across the country remains less than 10 to 20 per year. The reason for non-utilisation of the pancreas includes a lack of trained doctors in this field as well as organ allocation rules, which do not allow kidneys to be allocated along with the pancreas in most states. If the families of these patients, adds Prof Ashish, can come forward for kidney donation, then the pancreas can be utilised too as was done in this case.
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