Both kidneys on right side- a challenging auto-Kidney transplant performed at Ganga Ram Hospital

Last month Department of Urology & Kidney Transplant, Sir Ganga Ram Hospital, received 29 year old patient Abhay (name changed) from Punjab. He had a history of stone in left ureter (pipe connecting kidney and urinary bladder). Local Doctor from Punjab tried to remove the stone but during the process 25-26cm of left ureter also came out along with stone.

According to Dr. Vipin Tyagi, Senior Consultant, Department of Urology & Kidney Transplant, Sir Ganga Ram Hospital, "In a normal patient there is one kidney on left and one on the right side and two ureters connecting these kidneys to the bladder. But in this case we were surprised to see the left kidney lying alone without any connection with the bladder."

According to Dr. Sudhir Chadha, Co-Chairperson, Department of Urology, Sir Ganga Ram Hospital, "Seeing the complexity of the case this was going to be a challenging surgery. The options before us were either to remove the kidney or re-make the missing connection between kidney and bladder by using intestine or perform kidney auto transplant."

Dr. Vipin Tyagi who operated on the patient further added, "Since the patient was young and the intestine is not the ideal substitute for the ureter reconstruction. We decided to perform 'Auto-Kidney Transplant' which means in this patient taking the normal kidney out from left side and bring it as closed to the bladder on the right side and connecting it with blood vessels going from the abdomen to the right leg (External Iliac Vessels). Now both the kidneys were on the right side."

Dr. Vipin Tyagi said, "Now, that kidney was close to the bladder but with the gap of 4-5cms. Now we had to bridge this gap. For this we decided to reconstruct a tube of 4-5 cms using the wall of urinary bladder. As soon as this reconstructed tube was connected to bladder, the blood flow to this kidney restarted and immediately urine started coming out through this tube."

The patient recovered well and recently been discharged with both the functioning kidneys on one side of the body (right side).

According to Dr. Harsha Jauhari, Chairperson, Department of Kidney Transplant, Sir Ganga Ram Hospital, "There are three kinds of organ transplants: Auto-Transplant, Allotransplant and Xeno Transplant. Auto-Transplant means transplanting one organ from one place to another in the same human being. Allo-Transplant means transplanting organs from one individual to another and Xeno Transplant means transplanting organ from non-human source into human being."

 Reference:Department of Urology & Kidney Transplant,Auto-Kidney Transplant, Xenotransplant, Allotransplant,kidneys,External Iliac Vessels. Aw