Vadodara: A 62-year-old Vadodara resident who had already undergone a liver transplant and spent nearly four years on dialysis after his kidneys failed has successfully undergone a highly complex kidney transplant, overcoming multiple medical hurdles that kept doctors on edge even after the surgery.The patient developed end-stage liver disease due to cirrhosis and underwent a liver transplant in 2019, with his daughter donating a portion of her liver. However, his kidney function deteriorated over the next few years and he became dialysis-dependent in 2022.His condition was further complicated by diabetes, lifelong immunosuppressive medication and repeated failure of dialysis access, forcing doctors to use an artificial vascular graft after conventional options were exhausted.With no suitable living donor available, he was placed on the waiting list for a deceased donor’s kidney. Eventually, a kidney from a 63-year-old road accident victim became available. During surgery, severe bleeding and vascular leakage forced surgeons to temporarily remove the transplanted kidney, repair it under cold preservation and reimplant it before restoring blood flow.The challenges continued after surgery as the transplanted kidney did not function immediately, requiring the patient to remain on dialysis for nearly a week. Repeated biopsies ruled out rejection and showed the kidney had suffered temporary blood deprivation-related injury, a condition that can recover over time. Dialysis after the transplant was also difficult as blood thinners could not be safely administered, necessitating repeated blood transfusions.Signs of recovery emerged on the eighth day when the patient began producing urine. By discharge two weeks later, his urine output had crossed 700 ml a day, indicating improved kidney function. He required only two more dialysis sessions before the transplanted kidney began functioning normally. Doctors said his urine output has now increased to around 2.7 litres a day, while creatinine levels indicate healthy graft function.“The transplant was performed by a multidisciplinary team led by Dr Kamlesh Parikh, director of renal sciences. The case was particularly challenging because of the patient’s previous liver transplant, prolonged dialysis history, diabetes and the need to carefully balance immunosuppressive therapy to protect both transplanted organs,” said Dr Prasad Muglikar, group medical director at Sterling Hospitals.
