Kochi, Kerala (ISJ): Kochi-based Amrita Institute of Medical Sciences, Kochi has done the first combined pancreas-kidney transplant of the state last week, the third successful in the country. This highly complex surgery was done in a 35 year old civil engineer ? S.Syed Yunus Shahir, hailing from Palakkad, and the donor, a brain-dead 38-year old patient in Kochi.
Shahir had Type 1 Diabetes for the past 16 years and developed diabetes-related complications like retinopathy, diabetic nephropathy and end-stage kidney failure over the past two years. Despite using an insulin pump he had erratic control of the blood sugar, affecting his routine life. However, after the surgery, his blood sugars are normal on a normal diet and his diabetes has been cured without the need for insulin administration. The kidney function has also normalized.
Type 1 Diabetes mellitus -- otherwise called Insulin Dependent Diabetes Mellitus (IDDM) or Juvenile Diabetes Mellitus, is a relatively rare health disorder primarily affecting young people as a result of destruction of insulin producing Beta cells present in pancreas. The subsequent lack of insulin leads to increased blood and urine sugar which in turn result in damage to multiple organs like kidney, heart, nervous system, blood vessels, eyes and gut.
?This combined procedure of transplanting both the Kidney and Pancreas in a single surgical operation is particularly effective for patients who have Type 1 Diabetes and chronic kidney failure. If the kidney alone is transplanted and the diabetes is poorly controlled, then even the transplanted kidney will slowly be affected by the high blood sugar levels,? said Dr. Ramachandra, the lead surgeon. ?The advantage of this combined transplantation is improvement in quality of life and freedom from diabetes- related complications and dialysis. This also avoids frequent blood sugar testing and occurrence of life threatening low blood sugars as a result of insulin overdose.?
Simultaneous kidney-pancreas transplants aren't new in medical literature. The first transplant was done in 1966 in the US and hundreds of transplants have been done since then in Western and Far East centers. However this is a rare surgery in India due to scarcity of donor organs.
This technically complex surgery was done by a multi-disciplinary team involving Transplant Surgery, Nephrology, Urology, Endocrinology and Anesthesia and Critical care. Solid organ transplant unit of AIMS has been active in the field of both live and deceased donor liver transplantation. So far, more than 350 liver transplants have been performed at AIMS since 2004, including India?s first pediatric liver transplant.
-By NB Nair
Source: Amrita Institute of Medical Sciences, Kochi
Image courtesy: AIMS