A 55-year-old man recently underwent a series of surgeries for peripheral vascular disease and deteriorating kidney health at Madras Medical Mission hospital here.
The man sought medical help at MMM in 2021 for pain in leg and difficulty in walking. Saravanan Sundararaj, director, vascular and organ transplantation at the hospital, said investigations found that the infra renal aorta was obstructed. “He said when I am walking, I have to stop after 300 m. Any of the five conditions — diabetes, hypertension, smoking, obesity and heart disease could cause leg pain. The minute we examined the groin blood vessels we knew it had no pulse,” Dr. Saravanan recalled. The patient had peripheral arterial disease.
“When you walk the muscles need oxygen but obstruction in blood vessels will prevent oxygen flow and cause pain. If untreated it could lead to gangrene,” he explained. Leg injuries would not heal leading to amputation.
The patient underwent an aortobifemoral graft (aorta-iliac reconstruction) using teflon to restore blood circulation to the legs and alleviate the pain and numbness. The man returned to near-normal life post-surgery.
But in 2024, his kidney function began to decline. “His creatinine levels were high even when we performed the surgery, and our nephrologists were keeping a watch. He was on medication to maintain kidney health. But somewhere in the three years he had opted for alternate systems of medicines,” Dr. Saravanan said. The patient also discontinued the prescribed allopathic medicines resulting in deterioration of renal health. Since the biopsy revealed a non-responsive lesion, necessitating haemodialysis, doctors suggested transplant. His wife and cousin offered to donate a kidney. The latter’s was a perfect match.
Dr. Saravanan led the transplant team as there were technical challenges in transplanting a kidney after a major vascular surgery when blood vessels in the region were reconstructed. There were concerns of infection that could lead to renal failure and peripheral vascular disease. “The timing of vascular anastomosis emerged as a pivotal factor, warranting careful consideration in surgical planning and execution,” he said.
The patient, however, recovered well and is back on his feet. He said he was feeling much better after the surgeries.
Hospital vice president Joseph Abraham Kandathil said the institution had never shied away from tough medical challenges. The recent surgery was yet another example of how their team had overcome medical challenges.
