Massive kidneys weighing 7 Kgs and 5.8 Kgs removed from a 41-year-old at Global Hospital

Mumbai: Surgeons have cut kidneys weighing 7 kgs and 5.8 kgs out of a man with a life-threatening genetic disorder, Autosomal dominant polycystic kidney disease (ADPKD).Combining weight of both the kidneys, 12.8 kgs is one of the biggest ever removed in an operation in India. A team headed by Dr Pradeep Rao Director - Urology and Renal Transplant,Global Hospital, Mumbai and Dr Bharat Shah Director - Institute of Renal Sciences, Global Hospital, Mumbai successfully removed the kidneys and subsequently performed a Swap Kidney Transplantation giving a new lease of life to the patient. The 41-year-old patient's wife donated her kidney to another patient, Mr. Nitin from Amravati who was also waiting for a suitable kidney donor. Likewise, Nitin's wife donated a kidney to the 41-year-old.

Roman, a resident of Goa, suffered from kidney failure, and was on dialysis at the age of 41 owing to Autosomal dominant polycystic kidney disease (ADPKD). It is a genetic disorder characterized by the growth of numerous cysts in the kidneys reducing functioning kidney tissue. The patient's life was disrupted, and he wasn't able to do his daily activities with ease as he was breathless, couldn't walk and his hemoglobin was low. The patient was referred to Global Hospital, where the kidney transplant team found a suitable kidney donor through swap transplant registry maintained by the hospital.

Dr Pradeep Rao Director - Urology and Renal Transplant, Global Hospital, Mumbai, said, "Although at our hospital most kidneys are removed laparoscopically with Key Hole Surgery, Roman's kidneys were measuring almost a foot in length, so he was just not the candidate and required an open surgery. This way through a single incision, we could remove both the kidneys which weighed 12.8 kg in total.

Roman's kidneys weighing 7 Kgs and 5.8 Kgs were removed on 12 th November 2019. A normal kidney weighs about 150 gms and is 8-10cms in length. But the kidneys cut out from Roman were nearly 26cm and 21 cm.

According to Dr Bharat Shah, "A swap kidney transplant – also known as paired kidney donation is the interchange of kidney donor between two families. Roman from Goa and Nitin from Amravati were to get kidney transplantation due to renal failure.  The doctors found out that Roman and wife had incompatible blood group type and Nitin and his wife had incompatible tissue type. The doctors discussed the swap kidney transplantation with both the families and they immediately accepted. After getting the necessary approval the procedure was carried out on the patients. Both transplantations were performed simultaneously on 17th December 2019. Post-transplantation, both the patients are keeping good health and do their daily activities with ease."

Patient Roman said, "ADPKD runs in my family, and I have witnessed my mother suffering from it. 10 years back I was diagnosed to have ADPKD and was managed medically. About a year and a half back my condition started deteriorating and I was unable to do routine chores. My stomach started to swell and I gained more and more weight. I would become breathless after walking for a short while. I underwent a Nephrectomy before the transplant and after the surgery started feeling better, I lost almost 25 kgs after the first surgery. I thank doctors from Global Hospital and the family from Amravati who saved my life. I am well on the road to recovery now.

"Swap transplant can be a good option and help increase the donor pool  when there is blood group or tissue incompatibility. Global hospital is one of the leading centers in Mumbai performing swap kidney transplants. Currently, the number of patients suffering from kidney disease is rising at a rapid rate, and many of them require kidney transplantation. It is the need of the hour to spread awareness regarding paired kidney exchange or swap transplant when the blood group and tissue of recipient do not match.

"As leaders in multi organ transplantation, our clinical teams tirelessly work to meet the unique needs of each patient. In this case, the clinical teams discussed the possibility of swap transplants due to blood group and tissue incompatibility and also the need for open nephrectomy much before the transplant to alleviate him of pain and other symptoms. It has been our endeavor to offer innovative clinical solutions to complex medical problems in all specialties," concluded Dr Vivek Talaulikar, Chief Executive Officer, Global Hospital, Mumbai.