Skilled team and technology makes transplants efficient at Manipal Hospitals

It is no longer a death sentence for patients with both kidneys and liver or kidneys and pancreas failure. A dual transplant is possible, and the patient can resume a near-normal life.

Bengaluru (Karnataka) [India] March 20 (ANI/PRNewswire): It is no longer a death sentence for patients with both kidneys and liver or kidneys and pancreas failure. A dual transplant is possible, and the patient can resume a near-normal life. This was conveyed by Manipal Hospital at a workshop in the city to mark World Kidney Day. "There is a need to create more awareness on the possibilities of transplant surgery", said Dr H Sudarshan Ballal, Chairman, Manipal Health Enterprises.

Three patients shared their experience at the event, highlighting the hospital's efficiency and competence in performing dual transplants that entail a multidisciplinary approach. Confidence in specialists, the hospital paved the way.

16-year-old girl, Tejaswini had acute Type I diabetes that made her insulin-dependent. Her pancreas cells were totally destroyed and the condition led to kidney failure in due course. High sugar levels due to Type I diabetes in children often lead to renal failure. "In this case, the child's quality of life was severely affected as being dependent on insulin injections hampered here schooling. She had to drop out of school", said Dr Ravichand C Siddachari, Consultant HPB, Organ Transplant, Liver Transplant Surgery, Manipal Hospital, Old Airport Road, who was part of the team that saw her through a dual transplant.

The specialists at Manipal Hospital decided on a dual transplant in Tejaswini's case. "We had to transplant both pancreas and kidney. Just the kidney transplant would have resulted in a renal failure again a few years down the line. The pancreas is discarded in a cadaver. We made use of it. This cured the girl of diabetes. The transplanted kidney and pancreas gave the girl a new lease on life", said Dr Goutham Kumar, Consultant, HPB - Organ Transplant, Liver Transplant Surgery. "This dual transplant surgery was a complex one that required a multidiscipline approach. The surgical procedure took over six hours to complete", explained Dr H Sudarshan Ballal, Chairman, Manipal Health Enterprises and Dr Vishwanath S, HOD & Consultant - Nephrology.

Tejaswini's mother, D Lakshmi, is a single parent and comes from the economically weaker section. The case is unique for the confidence she had in the specialists and hospital to entrust her daughter to their care. Tejaswini is no longer a diabetic. She has been off the insulin and leads a normal life. "She can now eat anything including foods with sugar content. Any child would like to indulge in them and she is no exception", said Dr Deepak Dubey, Consultant - Surgical Urology, Organ Transplant, Manipal Hospital, Old Airport Road.

She is now relaxed and looking forward to pursuing her education again. "I had to drop out of school because of my illness. Now I want to resume my studies. I plan to clear the school board exam and then start college", said a smiling Tejaswini.

Culture, language no barriers A farmer from Yemen, Mujahed Ziyad Moqbel Qaid Farea, first came to Manipal Hospital for a liver condition that required a transplant. After the procedure, at Yemen, he was diagnosed with a kidney ailment. Ziyad was advised to go back to India to consult specialists for his kidney ailment.

Having gone through a transplant at Manipal Hospital and familiar with the expertise here, he decided to come back and consult the specialists. He was advised kidney transplant after tests performed at the hospital. Ziyad did not know any local language and had no contacts here. This could have been a huge challenge for him. The hospital, however, helped him overcome all barriers with comprehensive care. "We had him received by our staff at the airport. A counsellor explained the formalities such as paperwork to him and made him comfortable. He was then taken to our guest house and then introduced to the specialists. They explained just what the surgical procedure involved, to him and proceeded with the tests and preparations", said Dr Siddachari who was a part of the team of specialists who treated Ziyad.

"Luckily for Ziyad, he had a brother whose kidney was a perfect match. It was almost like they were twins. It was possible for us to proceed with the surgery quickly", he added. A takeaway from this case is that foreigners needn't have any family or friends here to seek treatment.

"It made no difference to Ziyad that he belonged to a different culture and he did not know any language people here spoke. We had a translator, ensured all his needs including paperwork were attended to, and even prepared food as he was used to back home", said Dr Vishwanath. Also, Ziyad, being a farmer, could not afford a high cost. The hospital ensured the entire procedure was completed within his budget. "He went back happy and is leading a normal life. That is what matters", he added.

The 360-degree approach Manipal Hospital has for foreign nationals promoted it as a centre of global medical tourism. "I was treated well by all at the hospital", said Mujahed Ziyad Moqbel Qaid Farea.

Complex surgery made easy with skill With a history of kidney ailment, Babu Reddy's creatinine level was very high and was advised to undergo a kidney transplant. "It was also observed that his liver function was down to just 50 per cent. He was lucky to get a cadaver kidney and liver within two weeks of being advised on the dual transplant surgery", said Dr Sundar Sankaran, Consultant - Nephrology, Manipal Hospital, Old Airport Road.

"The surgery was challenging and it took 14 hours to complete both transplants. His creatinine level normalized. He is now leading a normal life and is more active", said Dr Goutham Kumar, Consultant, HPB - Organ Transplant, Liver Transplant Surgery, Manipal Hospital, Old Airport Road and Dr Siddachari. "I am feeling fine now. The doctors gave me a lot of courage and took good care of me. My dream now is to get my children married", said Reddy.

Competence to treat complex cases Surgeries such as transplants where the donor and recipient are ABO incompatible - no match - require a special procedure. There aren't many hospitals that perform such transplants. Another difficult procedure to bring about is the swap transplant.

Here, a couple where a spouse needs a kidney but the other's doesn't match is brought together with a similar case. Then, the couples swap kidneys. This is possible only when a hospital has a large patient pool. Manipal Hospital is at an advantage with a large number of people waiting for kidneys. This facilitates such a possibility with the higher number of possibilities the hospital has.

Manipal Hospital performs steroid-free transplants, especially in cases of children. Among the three drugs prescribed after a transplant, one is a steroid. Asteroid has harmful side effects and some patients react adversely to it. In children, it can stunt growth. The patient is placed under very close observation and managed without the use of steroids. The hospital is also one of the few facilities that perform transplant surgeries on HIV positive patients. In these cases, the risk of the body rejecting the organ is high. The HIV drugs interfere with those used in the case of transplant. These cases are managed here with the technology and skills of specialists.

Manipal Hospitals' firsts in Karnataka * Cadaver transplantation

* Laparoscopic donor nephrectomy (minimally invasive surgery) * Single-incision donor nephrectomy (umbilical)

* Trans vaginal donor nephrectomy * Robotic renal transplant

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