Hope for Type II diabetes patients with kidney-pancreas transplant at PGIMER Chandigarh

Transplant using organs of 12-year-old child who died in road accident

Hope for Type II diabetes patients with kidney-pancreas transplant at PGIMER Chandigarh

Naina Mishra
Tribune News Service
Chandigarh, April 14 

PGIMER performed the first simultaneous pancreas-kidney transplant in a patient with Type 2 Diabetes with high success in putting the patient off insulin.

A 54-year-old patient from Roorkee became the first person to receive the treatment at PGI. He was on dialysis three times a week, requiring insulin 3 to 4 times every day along with blood sugar monitoring.

The patient had diabetes for the last 10 to 15 years and was had kidney failure for four years. He was initiated on dialysis because of his kidney failure and was listed for deceased donor kidney transplantation.

Last month, a family from Kaithal in Haryana lost their 12-year-old child in a road accident and approached the transplant coordinator to donate all his organs, including the pancreas.

Dr Ashish Sharma, an expert in Nephrology, Renal Transplantation treatments at PGI said, “When we first talked to him regarding the possibility of a simultaneous pancreas-kidney transplant, the patient thought it is a better solution than doing a kidney transplant alone. After the transplant, he is now able to eat whatever he wants and his blood sugar is well-controlled without the need for any insulin therapy. This patient illustrates that adding a pancreas transplant to a patient with diabetic kidney failure can prove to be a boon for these patients.”

“A successful pancreas transplant can also significantly lower the cost of medicines like insulin and other drug therapy to manage diabetes alone can cost between Rs 3,000 to 5,000 per month for these patients,” he adds.

At present, the utilisation of the pancreas remains very poor due to a lack of trained transplant surgeons in this area which results in higher complications.

At PGI Chandigarh, 25 simultaneous kidney-pancreas transplants have been performed in patients with type 1 diabetes, but no such transplant had been performed in patients with type 2 diabetes. The vast majority of patients with type 2 diabetes and kidney failure end up having kidney transplant alone.

Driven by the success of pancreas transplant at PGI, it has been decided to initiate simultaneous pancreas-kidney transplant in type 2 patients as well. This was the first-ever simultaneous pancreas-kidney transplant at PGI in a patient with type 2 diabetes.

Dr Sanjay Badada, associate professor, endocrinology, PGIMER, said, “Diabetes is fast becoming the most common cause of kidney failure in India. Having diabetes as a cause of kidney failure not only reduces patient survival after kidney transplant. Diabetes can also affect the newly transplanted kidney and again cause kidney failure.”

A pancreas transplant was recommended in type I diabetic patient who presents with kidney failure however, patients with type II diabetes were discouraged from undergoing pancreas transplant as it was thought that there is insulin resistance in these patients and doing the pancreas transplant would not be useful in these individuals.

“However, in the last few years, this thinking has been challenged and a few successful simultaneous Pancreas kidney transplants have been done in patients with type 2 diabetes in the US and other developed countries,” said Dr Badada.

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