A 52 year old kidney transplant beneficiary, who was also diabetic, can now look forward to an insulin free life This is the first of its kind to be performed in South India reinforcing Chennai as a haven for medical prowess. Post the surgery, the patient Parameshwari, who has been diabetic for over 20 years, can now look forward to an insulin free life over a few months as her condition gets better.
Diabetes affects every system in the body; It can be Type 1 or burnt out Type 2 diabetes. Type 1 is typically seen in children and young adults. Type 2 diabetes is what we see commonly in adults. In the eyes, it affects the retina and is the leading cause of blindness. It affects the blood vessels supplying to the heart and is a common cause of heart attacks. It accelerates atherosclerosis which is a common cause of strokes/paralysis, heart failure and kidney failure. Uncontrolled sugars affect the nervous system too and once the peripheral nervous system is affected, sensation in the hands and feet come down. Continued injury is one of the leading causes of the loss of limb.
Simultaneous Kidney-Pancreas transplant is an operation to replace kidney and pancreas at the same time in a patient who has kidney failure and also suffers from diabetes, needing very high insulin dose to control sugars. Diabetic patients with kidney failure need a kidney transplant to prolong their life. Steroids used as immunosuppressants make treatment of diabetes difficult and poorly controlled sugar levels will continue to affect the rest of the body including the transplanted kidney. However, performing pancreas transplant simultaneously eliminates these problems by optimally controlling sugar levels and by protecting the transplanted kidney from the adverse effects of diabetes. Additionally, it will also help reverse the effects of diabetes on other systems including peripheral neuropathy thus, protecting the limbs.
Commenting on the surgery, Dr. Anand Khakhar, MultiVisceral Transplant surgeon at Apollo Hospitals, said "On an average 700 pancreas transplants are performed annually in USA. However in India, it is still in its infancy and will pick up with increasing cadaver donor organ donations. The recipient is known to have had diabetes for over 20 years and developed kidney failure about 6 months ago and she needed 50 units of insulin per day. She has done well , is completely relieved of her insulin intake and is free from dialysis. Speaking on the occasion, Dr. Manish Varma, Transplant surgeon said that pancreas transplant can also be done following kidney transplant ( Pancreas after kidney transplant ) and as pancreas transplant along ( PTA) for select indications".
Dr. Manish Varma and Dr. Anand Ramamurthy also said in rare situations, Type 1 diabetics who have developed advanced neuropathy and are unable to appreciate low glucose levels (hypoglycemia unawareness) will benefit from pancreas alone transplant(PAT), even though they don't have kidney failure. They will be on unrestricted diet, free from frequent sugar checks and insulin injections.
Dr. Bhama, Director Medical Services , Apollo Hospitals recognised the Centre for Liver Disease and Transplantation, Apollo Hospitals as the most comprehensive solid organ transplant program in India today.
Dr. Preetha Reddy, Managing Director, Apollo Hospitals said "we will be setting up multiorgan transplant programs with the same facilities to include Pancreas, Intestine, Liver and Kidney transplants at the Apollo Hospitals in Hyderabad and Bangalore".
Date:27th November 2016
Venue: Auditorium, Indraprastha Apollo Hospitals, New Delhi