A combined kidney-pancreas transplant was performed on a 46-year-old woman by a team of surgeons at the Apollo Hospitals here. The patient’s sugar levels have returned to normal, but she continues to be under observation, doctors say.
The pancreas is the insulin-secreting organ in the body, regulating the blood sugar levels in humans. The impairment, or complete failure of this organ, results in diabetes, Type 2 or Type 1, and this compromise, over a long period, leads to kidney failure.
Anand Khakhar, senior consultant, liver transplant and hepato-biliary surgery, Apollo Hospitals, who led the team, said: “In this particular case, the patient, had been on the list for a long while, she was a diabetic on dialysis. Her diabetes was the burnt-out Type 2 variety, where there was no insulin at all. She is young, has a long life ahead and we thought we had to give a solution that will ensure a long life, free from the complication of diabetes and recurrence of kidney failure.”
Therefore, this was not an impromptu surgery. “We were considering a simultaneous transplant, and we had to wait for a donor of good quality and similar size,” Dr. Khakhar added. After months of waiting, a cadaveric donor emerged, who finally had a kidney and pancreas suitable to their requirements.Old pancreas not removed
The new kidney was placed on the left, and the pancreas, placed on the opposite side, on the right flank, at a slightly higher angle. It was connected to the artery and vein, and drains out into the intestine, Dr. Khakhar explained. This mimics the connections of a regular pancreas, and its functions too. The old pancreas has been left inside, as removing it might lead to unnecessary complications.
Just about 24 hours post surgery, the kidney is producing urine, and the pancreas, insulin, he added. “While everything is going as per plan, so far, I’d call this a success when the patient goes home and does not have any complications.”
“This is a revolution in transplant science in Tamil Nadu for sure. It is the first-ever pancreas transplant in the State for sure,” J. Amalorpavanathan, convener, Tamil Nadu Cadaver Transplant Committee, says. Online medical literature lists the country’s first successful simultaneous kidney-pancreas transplant (from a cadaver) in 2005, and then, a second, from a living donor at Narayana Hrudalaya in Bangalore, in 2008.