Pancreas and kidney transplant performed together

Apollo Hospitals, Asia’s largest and most trusted multi-specialty chain of hospitals has given a new lease of life to a 38 year-old man by performing a Simultaneous cadaveric Pancreas and live-donor kidney transplant. While, most simultaneous Pancreas-Kidney transplants are performed from organs harvested from the same cadaveric donor, this case highlights the need to adapt to other strategies to help patients when the allocation rules for the kidney do not favour diabetics on dialysis.

Apollo Hospitals in Chennai are the leaders in undertaking Simultaneous Pancreas-Kidney (SPK) transplantation in India. Patients with diabetes and renal failure requiring dialysis receive organs (pancreas and kidney) from the same cadaveric donor and are transplanted simultaneously. Currently, there are a substantial number of patients waiting for this dual transplant that not only helps them come off dialysis but, more importantly, cures their diabetes that was the root cause of the kidney failure.

Hitesh, a 38-year old patient from New Delhi, was on such a waitlist for a simultaneous Pancreas Kidney transplant (SPK) for over 8 eight months. International data suggests that diabetic patients on dialysis are prone to cardiac complications and have a median survival of 8 years if they do not get a transplant in time. In addition there is a 8-12% chance of death every year on the waiting list.

The rules of allocation of the kidney in India does not recognise this fact and such patients who need these dual transplants may have to wait along with other patients who are on the list for a kidney transplant alone (due to reasons other than diabetes). Furthermore, a pancreas graft (that can potentially cure diabetes) may not be utilised because the kidneys from the same donor have been allocated to other patients who are not diabetic.

Considering the situation, the team of doctors at Apollo’s Institute of Transplantation, adopted a different strategy in order to shorten the time a patient waits on the list for dual organs. This being a temporary measure till the allocation system prioritises the requirement of such patients.

A simultaneous cadaveric Pancreas and live-donor kidney transplant (SCPLK), a ‘first of its kind’ in Asia was opted to save Hitesh. The pancreas was harvested from a suitable cadaveric donor from Vellore and simultaneously, the kidney was donated by Hitesh’s wife Supriya. The kidney from the same cadaver donor from Vellore was allocated to another patient at Apollo.

Elaborating the case, Dr. Anil Vaidya, Multi Visceral Transplant Surgeon at Apollo Hospitals, said “Apollo started their SPK program in 2015 and are by far the busiest transplant centre for this type of operation in India. There are a substantial number of patients waiting for this dual transplant that not only helps