Chennai: A man who suffers from severe hypertension, had his third kidney transplant at the Madras Medical Mission and now has five kidneys within his body.
Due to the limited area within his abdominal cavity for the physicians to work on, the unconventional transplant technique evolved into a tremendous effort.
After two failed kidney transplant surgeries, Dr. S Saravanan took on the third kidney transplant attempt. Hypertension caused both operations to fail.
The team had to be extra cautious since the patient had recently undergone triple bypass surgery after being diagnosed with coronary artery disease.
The donor kidney is generally retained adjacent to the native kidney throughout a transplant and the renal artery, renal vein and ureter are all connected to the external celiac artery, vein and bladder, respectively.
However, due to a shortage of space for the replacement kidney, the physicians’ team encountered many obstacles. Another difficulty was the patient’s tendency to generate too many antibodies as a result of prior procedures, as well as a shortage of blood arteries to link to the new kidney.
Unlike the conventional procedure, the team placed the kidney high in the abdominal cavity, close to the intestine.
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‘The transperineal approach (through the gut), a surgery rarely performed even globally, was what saved the day for my patient. This is such an uncommon surgery that I am yet to see a paper published in India on this,’ said Dr. Saravanan who completed the surgery on August 10.
The rationale for not removing the old kidney to make room for the new one, according to the physicians, is that the patient might bleed heavily and require a blood transfusion, which could lead to antibodies and rejection of the new kidney.
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