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Rare renal auto transplantation by Delhi surgeon

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Rare renal auto transplantation by Delhi surgeon
Posted On: 19-Dec-2014

Rare renal auto transplantation by Delhi surgeon

Dec 15, 2014 | Age Correspondent | New Delhi

A rare renal auto-transplantation, or ureteral substitution with gastrointestinal segments, has been conducted by a doctor at a city hospital.

The left kidney of a 60-year-old patient was removed by the surgeon, Dr H.S. Bhatyal, and re-implanted in the right pelvic region, joining the reconstructed renal artery to the selected segment of the external iliac artery.

The patient had been admitted to the emergency department of BLK Super Speciality Hospital in West Delhi, in a critical condition with complaints of high blood pressure and diminished urinary output.

The patient suffered from renal failure and required immediate dialysis. He was stabilised and detailed investigations revealed extensive generalised atherosclerosis (deposition of fats in form of plaques) in most of his blood vessels, involving aorta and other major blood vessels. Both his kidney arteries were blocked, which was the reason for renal failure.

“Renal angiography and stenting was not possible due to complete renal arterial block. Surgical options were explored with due diligence for revascularisation of kidneys. Angiogram revealed diseased spleenic and hepatic arteries. As the left kidney was better functioning, it was removed from its original place, and re-implanted joining the renal artery to a relatively disease free segment of external iliac artery,” said Dr Bhatyal.

Cardiologists were consulted for feasibility of angioplasty and stenting of renal arteries, but because of complete blockage it was not possible. Since kidneys were required to be revascularised for their salvage surgical options were explored. A small segment of artery was selected in the left external iliac artery in the pelvis to revascularise the kidney.

Left kidney was removed from its place, the diseased portion of the renal artery was removed, remaining part of the renal artery was reconstructed by microsurgery and the kidney was re-implanted in the right pelvic region joining the reconstructed renal artery to the selected segment of the external iliac artery. A renal vein was joined to the external iliac vein. Kidney started functioning after revascularisation and the urethra was joined to the bladder.

“The post-operative period was uneventful, his kidney started producing adequate amount of urine and his kidney parameters normalised in 3 days. The patient did not require any dialysis and medication thereafter and he is doing well,” added Dr Bhatyal.

Link: http://www.asianage.com/delhi/rare-renal-auto-transplantation-delhi-surgeon-421



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