Introduction
In a groundbreaking medical achievement, a seven-year-old boy from West Bengal underwent India’s first successful rare kidney autotransplant surgery at AIIMS Delhi. This intricate procedure, performed on June 29, marks only the third instance of such a surgery worldwide. The successful operation not only resolved the boy’s severe health issues but also set a new benchmark in pediatric renal surgery.
The Medical Challenge
The boy was diagnosed with resistant renovascular hypertension caused by an aneurysm blocking the blood supply to his right kidney. This condition led to dangerously high blood pressure readings of 150/110 and recurrent episodes of blood in his urine over three and a half years. Prolonged exposure to such high blood pressure can damage vital organs, including the brain, heart, and kidneys, necessitating urgent medical intervention.
The Surgical Solution
Dr. Manjunath Maruti Pol, an additional professor of surgery and renal transplant surgeon, and Dr. Pradeep, a professor of CTVS cardiac surgery at AIIMS, led the team that performed the surgery. Due to the aneurysm’s location near the renal hilum and its fusiform shape, stenting was not a viable option. Therefore, the team decided to proceed with a kidney autotransplant surgery.
The eight-hour procedure involved removing the boy’s right kidney and transplanting it to a different area of his body. The surgery was complex due to the anatomical challenges, including the presence of the vena cava and small, delicate veins prone to rupture. Despite these difficulties, the surgery was a success.
Post-Surgery Success
The patient was discharged just seven days after the surgery. Follow-up tests revealed that his transplanted kidney was functioning normally, matching the performance of his other kidney. Remarkably, Pranil no longer requires medication to control his hypertension, a significant improvement from the daily medication regimen he had been on for the past year.
Significance of the Surgery
Dr. Pol explained the goal of the autotransplantation procedure: to restore renal anatomy, treat renovascular hypertension, preserve normal renal mass, and eliminate the risk of aneurysm rupture. The success of this surgery highlights the advanced capabilities of AIIMS Delhi in handling complex pediatric renal cases.
Historical Context
The first kidney autotransplantation was attempted in 2014 in Korea on a 13-year-old patient, but it was unsuccessful, necessitating the removal of the kidney shortly after the operation. The second case occurred in 2021 in London, where a four-year-old girl underwent surgery for a left renal artery aneurysm as a preventive measure. This case is the third in the world and the first successful right kidney aneurysmectomy and autotransplantation.
Personal Impact
The patient’s father expressed his relief and gratitude for the successful surgery. Diagnosed last year, the boy’s condition was a significant concern for the family. Now, after the operation, he is doing well and leading a normal life without the need for hypertension medication.
Conclusion
This successful kidney autotransplant surgery at AIIMS Delhi represents a significant milestone in medical science, particularly in pediatric renal surgery. It demonstrates the potential of advanced surgical techniques to transform lives and paves the way for similar procedures in the future. The medical team’s expertise and dedication have given Pranil a new lease on life, offering hope to many others facing similar challenges.
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