Noida, 22nd November 2024: In a rare and complex case, Doctors at Fortis Noida successfully performed a life-saving kidney transplant on a 14-year-old girl from Uzbekistan suffering from chronic kidney disease (CKD). The patient faced severe restrictions on her food and lifestyle due to her condition with critically low heart pumping capacity of just 10-15%. Despite these challenges, a multi-disciplinary team of doctors led by Dr Anuja Porwal – Director, Nephrology and Dr Piyush Varshney – Director, Urology & Kidney Transplant, Fortis Hospital, Noida undertook the correct line of treatment and conducted a successful kidney transplant. The patient was discharged a few days later in a stable condition.
The girl had been on dialysis since the age of 10, undergoing treatment three times a week. Over time, her parents realized that dialysis was only a temporary solution, and a kidney transplant was necessary as a long-term resolution to her condition. During pre-transplant evaluation, it was discovered that her heart was severely compromised, with a pumping capacity reduced to just 15-20%, compared to the normal 60 – 65%.
Due to the complexity and her deteriorating heart function, many hospitals in Uzbekistan declined to perform a transplant on the young girl. The family was eventually referred to Fortis Hospital Noida, where she was admitted for further evaluation. Upon admission, it was found that her kidney failure had caused significant fluid accumulation in her body. In addition, her heart function was critically low with extremely low blood pressure (90/60), often dropping further during dialysis sessions.
To stabilize her condition, the medical team administered medications to elevate her blood pressure, which allowed for the removal of excess fluid from her lungs and body. This process was essential before proceeding with surgery.
After several days of thorough planning, fluid management, and stabilization of her overall condition, the patient was declared fit for a kidney transplant. The procedure, an ABO-compatible kidney transplant, ensured blood type compatibility between the donor and recipient, significantly reducing the risk of organ rejection. Her mother served as the donor, and the surgery, lasting 3.5 hours, was successfully completed without any complications.
Giving details of the case, Dr Anuja Porwal – Director, Nephrology, Fortis Hospital Noida said, “The girl was not only battling chronic kidney disease (CKD), but also had severely compromised heart function. Due to critically low heart pumping, her blood pressure was continuously very low, as a result she was not able to tolerate the dialysis procedure which made her weak candidate for kidney transplant surgery. Her chances of survival were slim, especially since she was not responding to dialysis as in such cases, survival typically ranges from 6 months to 1 year. She required a few weeks of meticulous management for the excessive fluid removal before the surgery without compromising her health further, and then she was posted for the surgery. After kidney transplant, patients usually have very good urine output. However, in this case due to weak heart function, the patient initially did not exhibit this response. As a result, the medical team had to administer specific medications and carefully manage her fluid intake during the post-operative period. Over time, her condition gradually improved, and she was eventually discharged in a stable condition.”
Dr Piyush Varshney – Director, Urology & Kidney Transplant, Fortis Hospital, Noida said, “It was a very challenging case as apart from CKD, the patient was suffering from a poor heart pumping making the surgery difficult. Due to low blood pressure, there was risk of her blood pressure getting very low during the surgery, that may lead to damage to the newly transplanted kidney, which further complicated the surgery. However, after careful planning and coordination, the team successfully performed the transplant, which lasted for 3.5 hours and they were able to manage the blood pressure well. The surgery was ultimately a success, and now the patient is recovering well.”
Mohit Singh, Zonal Director, Fortis Hospital, Noida said, “It was a challenging case considering the age and complexity of the patient. In such cases, it is very important to consult a multi-specialty hospital which is well equipped with best medical facilities, medical devices and well-trained doctors. The team of doctors led by Dr Anuja Porwal and Dr Piyush Varshney meticulously handled the case and executed the surgery with great precision, care and a multi-disciplinary approach along with the anesthesia team.”