Doctors at Madras Medical Mission create ‘transplant bubble’ to treat patient with renal failure

In the middle of the second wave of the COVID-19 pandemic, a patient recently underwent renal transplant. She has since been discharged and is under observation through telemedicine.

A 40-year-old patient, who had been on dialysis for over a year, had wanted a transplant. A teacher by training, the woman opted for the transplant despite the chances of contracting the infection.

S. Saravanan, vascular and transplant surgeon and director of the Institute of Kidney Diseases, Urology and Organ Transplantation, Madras Medical Mission, decided to take up the task. He decided to create a “transplant bubble” – where the entire team of 40 healthcare workers, including transplant surgeons, anaesthetists, nurses, ward boys and staff, were isolated in the hospital.

“We need people in three shifts and they were housed in a hospital wing. We did RT-PCR tests and our surgeons, physician assistants, anaesthetists and assistants, besides 12 nurses and six ward boys were in the wing for seven days. The patient and the donor, who was her husband, had two RT-PCR tests — one was done a week ahead of and the other, a day before the surgery,” he explained. The surgery had no complications and the patient was also discharged. In a normal course, the patient would have been required to come to the hospital on alternate days or once in two days for review.

In this case, they decided to offer teleconsultation. “We hold web conferences and review her. She has to the hospital once a week, however,” Dr. Saravanan added. He said it was challenging to create the transplant bubble. It was a risk as the patient would be on immunosuppresants.

“Some patients are waiting for a year. I told them last year to postpone the transplant by a year. But with the second wave and a possible third wave, how long can patients wait? They are on dialysis and aside from the cost of dialysis they were also at risk of contracting the infection during dialysis, the patients had reasoned,” he said. Following the successful surgery, others waiting for transplant were also asking for it, he said.

Dr. Saravanan said the hospital management’s support had made it possible to conduct the surgery.


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