A case of simultaneous transplantation from a live donor saw a kidney and a residual portion of the pancreas being donated by a father to his ailing daughter.
Neeraja of Bellary, 27, a diabetic, suffered kidney failure and was suggested a simultaneous pancreas and kidney transplantation. Her 63 year old father Ramadoddi Kullayappa, donated one of his kidneys and a part of his pancreas to her. The rare multiple surgery claimed to be the first of its kind in the country was conducted by doctors at Bangalore’s Narayana Hrudayalaya Hospital by a team of eight specialists including transplant surgeon Dr Shanthanu Bhattacharya, and hospital director Dr Ashley D'Cruz.
Dr Ashley said, “The father donated half of his pancreas and one kidney to his 26-year-old daughter, who is diabetic. The patient can henceforth reduce the dosage of insulin, post operation,” he said.
The procedure is called a Simultaneous Pancreas and Kidney (SPK) transplant from the live donor.
Dr Ishthiaque Ahmed, a nephrologist said, "She came to us for kidney transplantation last November, but seeing her condition we suggested pancreas transplation too. Her mother is diabetic and the husband's blood group didn't match. Her father was found to be the ideal donor. He had deep vein thrombosis, for which he was treated before the transplantation. Within eight hours, first the kidney and then pancreas were transplanted."
Insulin-dependent diabetics, who develop renal failure requiring dialysis, have a short lifespan, with less than 20 % of such patients surviving more than five years. The only solution is a successful renal transplant which almost doubles their longevity. However renal allograft is not free of its share of problems and inevitably suffers the consequence of hyperglycemia and patients develop recurrent diabetic nephropathy.
An SPK transplant by creating a euglycemic state significantly prolongs the survival of both the patient and the graft. According to the doctor a pancreas transplant can be performed in insulin-dependent diabetic patients who have already received a renal allograft and have stable renal function or who have no renal failure.
Urologist Dr Hasit Mehta said, "By encouraging cadaver donors, the risk on live donors can be reduced. Pancreas transplantation is usually done only from cadaver donors. The simultaneous operation addressed both the complication as well as the cause."
Although the operation cost Rs 10 lakh, the patient’s family bore Rs 4 lakh while the Hrudayalaya subsidized the remaining amount. Doctors said the success of this procedure is encouraging for diabetics who suffer kidney failure.
