A man suffering from severe hypertension underwent a third renal transplant at the Madras Medical Mission and has now ended up with five kidneys inside his body.
The unconventional transplant approach turned into a huge task as there was not much space within his body cavity for the doctors to work on.
Dr S Saravanan took on the task of the third kidney transplant attempt after the patient had already undergone two failed transplant procedures. Both the surgeries had failed due to hypertension.
The team also had to be careful as the patient had recently undergone triple bypass surgery after being diagnosed with coronary artery disease.
During a transplant, the donor kidney is usually kept next to the native kidney and the renal artery is attached to the external celiac artery, renal vein to the external celiac vein and the ureter to the bladder.
However, the team of doctors faced several challenges due to lack of space for the new kidney. Another issue was the lack of blood vessels to attach to the new kidney and also the problem of the patient’s tendency to develop too many antibodies due to previous surgeries.
Hence, unlike the conventional procedure, the team placed the kidney high in the abdominal cavity, close to the intestine.
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 doctors said that the reason for not removing the old kidney to make space for the new one is because the patient could profusely bleed and may have required blood transfusion, which could lead to antibodies and rejection of the new kidney.
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