Royal Melbourne Hospital celebrates landmark kidney transplant
Forty-six years after its first live-donor kidney transplant, the Royal Melbourne Hospital this week performed its 1000th transplant. In the landmark surgery, a wife gave new life to her husband.
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Forty-six years after undertaking its first live donor kidney transplant, the Royal Melbourne Hospital this week performed its 1000th.
Providing further reason to celebrate, Tuesday’s landmark operation saw a wife giving new life to her husband so they can look forward to a future with their two young children.
With three out of 10 kidney transplants at the RMH now due to the selflessness of living donors, the Herald Sun stepped into theatre to see the remarkable life-giving efforts of medics and donors.
It’s 8.30am and Veeran Naran is about to undergo the transplant he hopes will give him an active new life with his young family, yet all his thoughts focus on the immediate welfare of his wife Bec.
She is just a few metres away in the Royal Melbourne Hospital’s operating theatre eight, enduring her own major surgery to retrieve the kidney Veeran desperately needs.
“There was a moment when I was about to go into surgery and it finally hit me: I knew she was next door, asleep, cut open and literally having a body part taken out of her for me,” Veeran, said.
“Now there is an extra special bond that I have with her, as well as a level of respect.
“I can’t explain it ... she is just so brave and courageous.”
Weakened by hereditary kidney disease and having lived on dialysis for the past three months, Veeran, 44, was admitted to the RMH on Monday afternoon to prepare for surgery.
After enduring a sleepless night at their Coburg home, Bec, 43, arrives after dawn on Tuesday and is allowed five minutes with her husband before going to surgery for the first operation of her life.
“He was super calm — he always is,” Bec says, while admitting she cannot calm her own nerves.
It has years of pain for the couple to get to this stage.
Diagnosed with polycystic kidney disease at 40, friends volunteered to become live organ donors, though none were suitable and the need was not yet critical.
With a strong chance their children Remi, 5, and Arki, 4, may inherit the condition the couple decided it was best not to know if Bec’s kidneys match Veeran, just in case one is more needed later.
But when Veeran’s kidney function dropped to just 40 per cent Bec decided she had to act and she began suitability testing in February.
“Veeran has always been such a sparkly and bright personality. He is over the top, just effervescent, so much energy and the most positive guy,” she said.
“But over the last couple of years his light has gone out, he has fizzled out and it happened over a long period.
“It was a situation of save my children or save my husband but I don’t know if my children will even have it, and we won’t find out until they are in their late teens.
“I don’t want my kids to grow up with an unhealthy father and just remembering him being sick.
“If I can help out, I will.”
At 8am Bec finally gets to sleep — albeit at the hands of an anaesthetist.
Guided by cameras in theatre eight transplant surgeon Nancy Suh begins digging her way through Bec’s organs to find her right kidney.
A nurse uses a hammer and chisel to break ice into a bucket nearby.
The kidney is more hidden than the dozens of other organs Dr Suh has retrieved over the past decade but, at 8.39am, the “cute little thing” is completely exposed and the surgeons work to clamp off its connections.
“This kidney is a little bit hidden away ... there you go, that is the kidney in my hand now,” Dr Suh says.
“I’ve already cut the urethra so I can’t put it back in”.
At the point of no return a call is made to the theatre next door at 8.48am to begin anaesthetising Veeran.
Constant “beeping” sounds echo through the theatre with every cut Dr Suh makes — her harmonic scalpel uses sound waves to cut tissue without bleeding to minimise the impact on Bec.
As the all-important renal artery connection is severed with two clamps Dr Suh calls out the time so it can be officially recorded: “9.18”.
This is the moment the kidney is no longer Bec’s.
Cradling the kidney in both hands Dr Suh turns around, takes two steps and places it in the waiting ice.
As she cleans the kidney colleagues undertake the process of closing up Bec and completing her involvement in the transplant.
“The female kidney is smaller and she is not a big lady so it is a small kidney, but it has good function and it should do Veeran some good for many many years to come,” Dr Suh said.
Still in its blue bucket of ice, the kidney is taken next door into operating theatre nine, where transplant surgeon Emma Tully is runs through a checklist of identification codes and consent forms with her team.
As Ms Tully prepares the kidney for transplant the sleeping Veeran is prepared for the second phase of the transplant.
She is thrilled with Dr Suh’s efforts to maintain long sections of blood vessels that make for an easier fit into a new host.
Ms Tully is also pleased with the state of her own patient, but conscious of the risk of operating on two parents.
“He is a beautiful patient to operate on. He is fit and healthy, anatomically great,” Ms Tully said.
“We get a bit antsy when it is young people donating and a husband-wife with little kids.
“It doesn’t make it harder, but you know you have parents of little kids who are both having operations at the same time so it raises the pressure for different reasons.”
Unlike Bec’s retrieval operation, Veeran’s transplant is an open surgery.
It takes until 10.35am for Ms Tully and her team to clamp open his abdomen and create a cavity for a third kidney.
Satisfied with its new home, at 10.54am Ms Tully uncovers the donated kidney which has turned white without Bec’s blood flowing through it.
She places the organ inside Veeran and begins stitching its connections before calling out the time: “11.01”
The record of when the kidney became Veeran’s is written on a whiteboard.
Moments later the kidney turns red as Veeran’s blood passes through it for the first time, as Nancy pops in to check on the success.
In rooms 59 and 60 so they can recover close to each other, Veeran and Bec have contrasting reactions in the days after surgery.
“For me, I gain a kidney so I feel better,” Veeran said.
“It is very overwhelming. The idea of having a new body part inside me, I’m still trying to get my head around, especially your partner’s.
“But Bec loses one so she automatically halves everything. And, because they had to move her body parts around and touch all those things that gives her heaps of nausea.
“Seeing her in pain makes me feel helpless.”
Despite suffering severe pain from surgery even though there was nothing wrong with her own body, Bec has no regrets.
“My biggest fear was that the kidney would not take and it would all be for nothing,” she said.
“So it has been really good to hear it has gone well and taken to him perfectly.”
Visits from Remi and Arki, as well as Veeran feeling healthier than he can remember, has the couple finally looking to the longer term.
“Everyone says ‘take one day at a time’, but it is hard to look at the future, epically when you have kids,” Veeran said.
“Now it is all about planning going forward — making sure we do all the proper things to keep us healthy and away from diseases.
“It’s kind of sweet knowing your life partner is a match in more than one way.”