Rare twin transplant frees 25-year-old from years of insulin dependence
Doctors said insulin-dependent patients with Type 1 diabetes and kidney failure face a severely reduced life span
MUMBAI: A 25-year-old college student from Kolkata, Rishi Sharma, who has been living with Type-1 diabetes since the age of three and had been relying on insulin to survive since the age of five, now lives insulin-free. After undergoing an uncommon simultaneous pancreas-kidney (SPK) transplant two months ago at the Nanavati Max Super Speciality Hospital in Vile Parle, his new pancreas now produces insulin.
Over the years, uncontrolled diabetes led to progressive complications for Rishi Sharma, including eye damage and stunted growth. Three years ago, Sharma developed end-stage kidney failure and was forced into a cycle of dialysis sessions, in addition to insulin dependence. His health, however, continued to deteriorate steadily. After a thorough evaluation, doctors concluded that his kidneys and pancreas needed to be replaced simultaneously.
Doctors said insulin-dependent patients with Type 1 diabetes and kidney failure, like Sharma, face a severely reduced life span. “In such cases, pancreas transplant is the only treatment that can truly reverse diabetes and free patients from lifelong insulin dependence,” explained Dr Gaurav Chaubal, director, liver and multi-organ transplant at Nanavati Max Hospital.
Sharma was waiting for six months on the national organ transplant waitlist for a suitable donor.
The procedure awaiting Sharma was extremely complex because it involves transplanting two organs simultaneously, which requires a highly experienced and well-coordinated team, said Dr Akshay Shingare, a nephrologist at Jaslok Hospital, who was not involved in the procedure. Doctors also said that it demands precise vascular connections and careful management to prevent rejection and complications.
{{/usCountry}}The procedure awaiting Sharma was extremely complex because it involves transplanting two organs simultaneously, which requires a highly experienced and well-coordinated team, said Dr Akshay Shingare, a nephrologist at Jaslok Hospital, who was not involved in the procedure. Doctors also said that it demands precise vascular connections and careful management to prevent rejection and complications.
{{/usCountry}}Since 2019, 14 SPK transplants have been conducted in Mumbai, with none before; and only one pancreatic transplant in the state, according to data from the Zonal Transplant Coordination Centre. Simultaneous transplants remain rare in India due to limited cadaveric donations, strict eligibility criteria, and the high complexity of the procedure.
{{/usCountry}}Since 2019, 14 SPK transplants have been conducted in Mumbai, with none before; and only one pancreatic transplant in the state, according to data from the Zonal Transplant Coordination Centre. Simultaneous transplants remain rare in India due to limited cadaveric donations, strict eligibility criteria, and the high complexity of the procedure.
{{/usCountry}}“In the last five years, we have performed 10–12 pancreatic transplants. But simultaneous pancreas-kidney transplants account for only 1–2% of total kidney transplants in India,” informed Dr Chaubal.
{{/usCountry}}“In the last five years, we have performed 10–12 pancreatic transplants. But simultaneous pancreas-kidney transplants account for only 1–2% of total kidney transplants in India,” informed Dr Chaubal.
{{/usCountry}}“Pancreatic donations are already rare in India due to a lack of awareness, and Type-1 diabetes itself is uncommon, so very few patients even qualify for this surgery. Not every centre in the country is equipped to perform it. That is why simultaneous pancreas-kidney transplants remain extremely rare in India, with only a few such operations occurring once in a while,” he said.
The breakthrough for Sharma came when a 41-year-old patient at Nanavati Max was declared brain-dead following severe internal bleeding in the skull. His family consented to donate his organs, including pancreas, kidneys, liver, and heart. Sharma was identified as an ideal match for the pancreas and kidneys.
Unlike standard kidney transplants, which only replace a failing organ, SPK transplants also restore the patient’s ability to produce insulin naturally. “We treated not just kidney failure but the underlying metabolic defect,” said Dr Jatin Kothari, senior director of nephrology and chief consultant, Renal Transplant Medicine. The procedure frees the patient from daily injections and helps prevent future diabetic complications affecting the eyes, heart, and nerves.
After 21 days of post-operative care, Sharma was discharged and has since returned to Kolkata, where he lives completely free from insulin injections for the first time in over two decades.
