New Delhi: AIIMS Delhi has revived its simultaneous kidney-pancreas (SPK) transplant programme after 18 years, successfully performing the rare and complex dual-organ transplant on a 30-year-old patient from Haryana suffering from end-stage kidney failure caused by long-standing Type 1 diabetes.The surgery can potentially free patients from both lifelong insulin dependence and dialysis by treating diabetes and kidney failure together. AIIMS officials said the patient, operated upon on April 14, is stable with good graft function and near-normal blood sugar levels with minimal insulin requirement.The patient had severe diabetic complications, including neuropathy, retinopathy and cardiomyopathy, with his heart’s ejection fraction reduced to 25%, making the surgery highly complex. The transplant lasted about two-and-a-half hours, after which blood sugar levels improved rapidly and kidney function stabilised without further dialysis. The patient was discharged after about two weeks.AIIMS had previously performed only two such procedures — India’s first successful SPK transplant in 2004 on Type 1 diabetes patient Sagar Aggarwal, followed by another successful dual transplant in 2008 on Delhi-based patient Mohammad Nadeem. Doctors had then reported that both patients became free from insulin injections and dialysis after surgery.The latest transplant was performed by Prof V K Bansal and Prof Asuri Krishna, along with Dr Sanjeet Rai and Dr Sushant Soren, with support from renal transplant specialists, Prof Ashish Sharma and Dr Deepesh from PGIMER Chandigarh. The multidisciplinary team included specialists from surgery, nephrology, endocrinology and anaesthesiology, with the anaesthesia team led by Prof Rahul and Dr Nishant, nephrology support provided by Prof Dipankar Bhowmik and Prof Sandeep Mahajan, and endocrinology expertise contributed by Prof Nikhil Tandon.Pancreas transplantation is particularly challenging because, unlike kidneys, the organ cannot be donated by a living donor and requires a brain-dead cadaver donor. In this case, the organs came from a 50-year-old brain-dead donor at PGIMS Rohtak. AIIMS teams travelled overnight for retrieval, while coordination between NOTTO, ORBO, Haryana Police and Delhi Police helped create a green corridor for rapid transport to Delhi.Doctors described pancreas transplantation as among the most technically demanding organ transplants because the pancreas is extremely soft and sensitive and can get damaged easily during retrieval or surgery, leading to complications such as pancreatitis, bleeding or graft failure. They said only five or six centres in India actively perform pancreas transplants, with the total number of such procedures estimated at only 150-200 so far. Currently, AIIMS has 8-10 patients awaiting SPK transplantation.Post-operative care also remains critical because transplant recipients are highly vulnerable to infections due to lifelong immunosuppressive medicines needed to prevent organ rejection. Doctors said successful pancreas-kidney transplantation can be life-changing for severe Type 1 diabetes patients as most become almost insulin-independent and regain near-normal quality of life after surgery.
