Hyderabad October 08, 2020: A Team of Nephrologists led by Dr K S Nayak, Nephrologist at Virinch Hospital in Hyderabad had successfully performed kidney transplantation surgery despite various uneventful hurdles and save the life of a 35 year old person.
Going into the details, Raj Kumar Ramagalla (35) suffering from both kidneys shrunken and permanently damaged was admitted to Virnchi Hospital in July. Since he was fairly stable initially the doctors offered pre-emptive kidney transplantation for him after extensive testing, including a 24 hour creatinine clearance test, whereby patients do not have to undergo dialysis before undergoing the kidney transplant. Fortunately his wife K S Revathi aged 28 years was the prospective kidney donor and extremely keen to donate a kidney to her husband. Both wife and husband were tested for Covid-19, though husband was found negative, his wife tested Positive for Covid-19 because of which he surgery was postponed for a month.
Again on 27th July (transplant surgery scheduled for 28th July), the patient Raj Kumar developed fever because of which again kidney transplant surgery had to be postponed due to development of fever at the 11th hour. Subsequent to this, his Serum Creatinine started rising due to the fever, and he had to be initiated on dialysis through a temporary Internal Jugular dialysis catheter in the neck(plan of pre-emptive transplant aborted).
He was stabilised and again scheduled for surgery but postponed a second time because of some minor health conditions. After intense deliberations and counselling, detailed testing of Ms Revathi, they underwent surgery successfully on 25th September, exactly a month after her report was positive for COVID-19.
Ms Revathi was discharged on 1st of October, in excellent health 6 days after surgery.
Her husband Mr Raj Kumar was discharged on 3rd October, also in excellent health with a normal Serum Creatinine and negative RT-PCR COVID-19 test. "Though the NOTTO (National Organ & Tissue Transplant Organization) and American Society of Transplantation(AST) have recently come up with guidelines regarding kidney donation after getting Corona infection (28 days after RT-PCR positivity) with other tests such as proteinuria negative, very few worldwide have undergone renal transplant surgery under these circumstances. Our kidney donor was in a way lucky, that she recovered so fast, probably because she was young and most of all her determination to donate her kidney was instrumental. I think this case will serve as an example to the medical community at large, that given the right medical criteria, a COVID-19 positive donor can donate a kidney safely and successfully," observed Dr Jayaram Reddy, head of Surgical team that conducted the successful kidney transplantation.
This case illustrates the determination of the lady Ms Revathi, helped by favorable medical circumstances whereby her recovery was quick to normalcy after the COVID-19 attack, and excellent team work & coordination by the medical staff and hospital administration in helping us perform this kidney transplant successfully, in spite of three postponements.
The Department of Nephrology at Virinchi Hospital has been having an excellent track record in performing Kidney Transplantation, both from Living Related and Cadaver Donors with ‘Zero’ Infection rates in post-operative period. This is attributable to the ‘State of the Art’ operation theatres and the four dedicated Kidney Transplant ICU Suites right next to the Post-Operative ICU, which ensures ‘round the clock’ Senior Intensivist availability. The nursing care is of the highest standards, following the strictest guidelines of ‘barrier nursing’.