Delhi Scientist Receives Third Kidney Transplant in Rare Medical Feat
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In a remarkable feat of modern medicine, Devendra Barlewar, a 47-year-old scientist residing in Delhi, has successfully undergone a third kidney transplant.The intricate procedure,executed at Amrita Hospital in Faridabad,provides renewed optimism after years of battling chronic kidney disease and enduring the challenges of two prior transplant failures. This unusual case underscores the significant progress in transplant surgery and the unwavering commitment of healthcare professionals.The National Organ and Tissue Transplant Organisation (NOTTO) played a crucial role in facilitating this life-saving operation.
Barlewar’s medical journey began in 2008 when he received a diagnosis of hypertension, which subsequently led to chronic kidney disease (CKD). This condition necessitated frequent dialysis treatments,significantly impacting his professional life,physical well-being,and dietary habits. He initially underwent kidney transplants in 2010 and 2012; however,both transplants ultimately proved unsuccessful. The failure of his second transplanted kidney accelerated after he contracted COVID-19 in 2022, making a third transplant a critical necessity for his survival and improved quality of life.
The Road to a Third Transplant
Despite the numerous challenges and previous setbacks, medical professionals persistent that another kidney transplant represented Barlewar’s most viable long-term treatment option. He officially registered for a donor transplant at Amrita Hospital in 2023, patiently awaiting a suitable match. On Jan.7, 2025, a potential opportunity arose when a kidney became available from a 50-year-old farmer who had been declared brain dead. The National Organ and Tissue Transplant organisation (NOTTO) promptly prioritized Barlewar, leaving the medical team wiht only a few critical hours to adequately prepare him for the complex surgical procedure.
Dr. Anil Sharma,Senior Consultant,Urology at Amrita Hospital,Faridabad,emphasized the urgency and coordination required in such situations: “Given the urgency,the National Organ and Tissue Transplant Organisation (NOTTO) prioritized him,and the medical team had only a few hours to optimize him for surgery.”
Medical Challenges and Surgical Expertise
Performing a third kidney transplant is an exceptionally rare occurrence in the field of medicine, primarily due to several significant factors. These include the inherent difficulty in locating a matching donor, effectively managing the heightened risk of organ rejection by the recipient’s immune system, and the considerable physical challenges associated with accommodating a new kidney within a body that already houses the remnants of previous transplants. In Barlewar’s specific case,the team of doctors had to meticulously navigate the complexities of his pre-existing medical conditions and the lasting effects of his previous surgical interventions.
Dr. Ahmed Kamaal, Senior Consultant Urology, Amrita Hospital Faridabad, highlighted the unique difficulties presented by this particular case: “Third transplants are rare due to donor paucity and recipient fitness concerns, and Mr Devender’s case presented additional complexities. His thin build and existing incisional hernia limited abdominal space, with two native and two non-functioning transplanted kidneys, complicating the placement of a fifth kidney.”
He further elaborated on the technical aspects of the surgery, noting that the surgical team had to carefully connect the new kidney to the largest available blood vessels within the abdomen while simultaneously managing Barlewar’s heightened immune response to minimize the potential risk of organ rejection.
Why Retain Non-Functioning Kidneys?
A frequently asked question in the context of kidney transplants revolves around the rationale for not removing the non-functioning kidneys during the transplant procedure. Dr. Nishchay Bhanuprakash, MD, DM Nephrology & Kidney Transplant, consultant at KAUVERY hospital, Marathahalli, Bangalore, provided clarification on this common practise, explaining that it is standard medical protocol to leave the recipient’s original, non-functioning kidneys in place. “The new kidney is typically placed in the lower abdomen (iliac fossa) to avoid complications. Removing the native kidneys could lead to bleeding, infection, and needless surgical risks,”
he explained, emphasizing the potential dangers associated with their removal.
Dr. Bhanuprakash further elaborated that removing the native kidneys, which are often shrunken and scarred due to chronic disease, offers minimal clinical benefit to the patient while simultaneously increasing the potential for surgical complications. “By keeping them in place, we minimise risks and focus on ensuring the new kidney functions optimally.”
this approach prioritizes the patient’s safety and the successful integration of the new organ.
long-Term Outlook
Following the successful completion of the transplant surgery, Barlewar’s long-term health prospects appear promising, offering a renewed sense of hope for his future. Doctors Sharma and Kamaal have reported that he has exhibited encouraging signs indicative of a favorable long-term prognosis, particularly given his positive progress observed during the immediate and early postoperative period. Though, they emphasized that ongoing monitoring and proactive management of his health will be crucial to ensuring the continued success of the transplant and his overall well-being.
Both Dr. Sharma and Dr. Kamaal underscored the critical importance of continued medical care and patient adherence to prescribed treatments: “He will have to monitor his health closely to keep his hypertension under control. Also, he needs to take immunosuppressant drugs as prescribed while being in close follow-up. He will have some dietary restrictions but very few as compared to being on dialysis.”
Barlewar will be required to diligently monitor his health, effectively manage his hypertension through medication and lifestyle adjustments, and adhere to a strict regimen of immunosuppressant drugs to prevent the perhaps devastating complication of organ rejection. While some dietary restrictions will be necessary to support his kidney function and overall health, these limitations are expected to be significantly less stringent than those he faced while undergoing regular dialysis treatments.
Conclusion
Devendra Barlewar’s successful third kidney transplant stands as a remarkable triumph of medical science and a powerful testament to the extraordinary resilience of the human spirit in the face of adversity. The collaborative efforts of the dedicated medical team at Amrita Hospital, coupled with the timely availability of a donor kidney facilitated through the National Organ and Tissue Transplant Organisation (NOTTO), have collectively provided Barlewar with a renewed lease on life and the opportunity to pursue a healthier, more fulfilling future. His inspiring journey serves as a poignant reminder of the profound importance of organ donation and the transformative potential of advanced medical procedures to dramatically improve and extend human lives.
Third Kidney Transplant: A Medical Marvel or a Risky Procedure?
“A third kidney transplant is exceptionally rare, pushing the boundaries of what we consider possible in transplant surgery.” – Dr. Eleanor Vance, leading Nephrologist and Transplant Surgeon.
World-Today-News.com (WTN): Dr. Vance, thank you for joining us. Devendra Barlewar’s successful third kidney transplant has captivated the world. Can you explain why such a procedure is so extraordinary?
Dr. Vance: It’s extraordinary because of the multiple challenges involved. A successful kidney transplant, even the first, isn’t simple; it’s a complex surgical procedure requiring a suitable donor match with minimal risk of rejection by the recipient’s immune system. Each subsequent transplant carries exponentially increased risks due to several factors. Firstly, finding a compatible donor becomes increasingly tough each time. Secondly, the recipient’s body has an increasing likelihood of escalating immune responses to foreign tissues, leading to organ rejection (even with immunosuppressants). Thirdly, the body’s anatomy may be severely impacted by previous surgeries—as in Mr. Barlewar’s case, where pre-existing conditions and scar tissue had to be carefully navigated. These combined factors make a third transplant a high-stakes endeavor.
WTN: The article discusses leaving prior non-functioning kidneys in place rather than removing them. Why is this the standard procedure?
Dr. Vance: That’s a crucial aspect often misunderstood. Removing the recipient’s original, non-functioning kidneys introduces significant surgical complications, such as increased risk of bleeding, infection, and potential for additional trauma. The benefits of removal are minimal, as the damaged kidneys at this stage provide no functional improvement; removing them greatly increases the risks and doesn’t improve patient outcomes. The new kidney is typically placed in a low-risk area of the abdomen (the iliac fossa), facilitating optimal function. This approach prioritizes the success of the new kidney over the surgical removal of deceased tissue.
WTN: The article highlights the role of the National Organ and Tissue transplant Organisation (NOTTO). How critical is this organisation’s role in facilitating such complex transplants?
Dr. Vance: Organizations like NOTTO are absolutely vital. They streamline the organ donation and allocation process. In cases like Mr. Barlewar’s, where time is of the essence due to deteriorating health or a fast-declining donor organ viability, the efficiency and coordination provided by NOTTO become paramount. They ensure a swift match between the available compatible organ and a suitable recipient, optimizing chances of a successful transplant—essentially, they save lives. It’s a life-critical bridge between donor family consent and the operating room.
WTN: What are the long-term implications and challenges for a patient following a third kidney transplant?
Dr. Vance: Long-term care is crucial. Patients must diligently manage their overall health and adhere to immunosuppressant medication treatment plans. Regular monitoring of kidney function, blood pressure (hypertension management), and for signs of organ rejection is essential. Dietary adjustments are often necessary to support kidney health. Lifestyle choices—such as regular exercise and a balanced diet—become crucial factors in the long-term success of the transplant. Regular check-ups and consistent communication with the medical team are not merely advisable but absolutely crucial for maintaining a positive outcome.
WTN: What are the biggest advancements that have made this kind of procedure possible?
Dr. Vance: Several factors have enabled procedures like Mr. Barlewar’s.Advancements in immunosuppressant drugs dramatically reduce the risk of transplant rejection. Minimally invasive surgical techniques reduce the trauma associated with the procedure.Improved pre-operative assessment of patients is critical for identifying and managing underlying health challenges, enhancing the patient’s ability to endure such complex procedures. the development and implementation of robust organ allocation systems, like the one highlighted in this case, ensures the accessibility of viable organs for suitable recipients.
WTN: What are some practical recommendations for those whose families might face similar situations?
Dr. Vance:
Early detection and management of chronic kidney disease (CKD) are paramount. early intervention frequently enough delays the need for transplantation.
Consult with renal specialists and transplant experts early in the disease process. This ensures that families understand the process fully, including potential scenarios such as multiple transplants.
Become familiar with national organ donation and transplantation programs. Understanding the procedures, organ allocation, and donation process could be invaluable.
Maintain positive communication with the medical team. Open, informed communication is pivotal to ensuring the best patient outcome.
WTN: Thank you,Dr. Vance, for these exceptional insights.This extraordinary case highlights the miracles of modern medicine and the crucial role of organ donation. What are your closing thoughts?
Dr. Vance: Mr. Barlewar’s story underscores the hope that organ transplantation offers. It’s a powerful testament to the dedication of medical professionals and the transformative power of organ donation. This medical feat should encourage others to register as organ donors and speak with their families about their wishes. It gives a profound sense of perspective on the importance of such programs and the perhaps life-altering impact on others. we invite readers to share their thoughts and experiences in the comments below.