Surgeons at AIIMS Delhi conducted the first-ever dual kidney transplant on a 51-year-old woman who was undergoing dialysis for almost five years. The donor was a 78-year-old woman who tragically suffered a severe head injury following a fall down the stairs and was declared brain dead. Later, her family consented to donate her organs.

Dual kidney transplantation (DKT) is a procedure where doctors transplant two kidneys into the recipient simultaneously that especially benefits individuals undergoing dialysis and suffering from kidney failure.

Kidneys from donors aged 60 and above are accepted for transplantation, which is termed ‘expanded criteria donor’ (ECD) kidneys. Essentially, an ECD includes donors aged 60 or older, or those over 50 with a history of high blood pressure, a creatinine level equal to or greater than 1.5, or those who have passed away as a result of stroke.

Dr Asuri Krishna, Additional Professor of Surgery at AIIMS, New Delhi, who performed the surgery, clarifies that although organs from brain-dead donors over 65 years old are not commonly accepted, his team opted to maximize the utilization of this donor considering the organ scarcity in India. The team decided to transplant both the kidneys into a single recipient citing the donor’s extreme age, where a single kidney would not suffice for a patient on dialysis.

Renal replacement therapy is generally performed in patients who are over 50 years old. Unfortunately, the paucity of organs entails an extended wait for both dialysis and kidney transplants. However, Dr Asuri, points out that dual kidney transplants help to utilize resources that would typically go unused in addition to addressing the pressing demand for organs in India. 

“By harnessing the potential of organs from elderly donors that might otherwise be rejected, this surgery serves as a great example of maximizing limited resources to bridge the gap between supply and demand in the organ donation system,” says Dr Asuri.

How was the surgery conducted?

The surgery involved placing two new kidneys in a heterotropic manner alongside the recipient’s kidneys, resulting in a total of four kidneys. Dr Asuri explained that the main challenge was positioning both kidneys on the patient’s right side given the advanced age of the donor, who was the second oldest organ donor at AIIMS, New Delhi. 

“We had to clamp the major artery and vein of the patient to join the first kidney and then place the second kidney below it.” he said.

Dr Asuri assured that the patient is doing well and is off hemodialysis with normal-functioning kidneys.

 (Input from various sources)

(Rehash/Dr. Vineesha V/MSM)