A52-year-old woman got a new kidney after suffering from renal failure — only to learn later that a cancerous tumour had begun to grow near the transplanted organ and it would be too risky to remove it.

The Pedder Road resident finally got another lease of life this month when doctors at Cumballa Hill Hospital removed the six-cm-long tumour that others had previously refused to take out or treat.

While cancer being detected near a transplanted organ is not unheard-of, doctors found the woman’s case particularly challenging because three major arteries had become attached to the tumour.

“I had given up hope after two top oncologists told me that it would not be possible to remove the tumour. Chemotherapy was also ruled out as there was a possibility that I might lose my new kidney,” said the patient, who requested anonymity fearing social stigma.

She added: “After four years of complications, starting from dialysis, kidney transplant and the tumour, I can finally lead a normal life again.”
The woman suffered acute renal failure in 2007, and was put on dialysis. Her family members offered to give her a kidney, but their organs were not compatible. On December 30, 2008, a kidney from a brain-dead patient was transplanted into her.

CANCER DERAILS RECOVERY
The woman thought her life was back on track until four months ago she started experiencing pain in her abdomen.

“I had started leading a normal life when I suddenly started feeling pain in the right side of the abdomen. Initially, I dismissed it as a gastric problem, but soon it became difficult to even walk,” she said. “I consulted a doctor and that’s when the cancerous tumour was detected.”

While three in 10 transplant patients are likely be diagnosed with cancer within 20 years of the procedure, the tumour developed near Pedder Road resident’s kidney in just four years.
She discussed the option of undergoing surgery or chemotherapy, but doctors told her it was too risky. “I didn’t opt for either of the procedures as I didn’t want to lose my new kidney. I started accepting the fact that I might not live for long,” she said.

Finally, doctors at Cumballa Hill Hospital, Kemps Corner, took the risk of operating on the 52-year-old on February 12. During the complex, six hour surgery, they removed the tumour without causing any damage to her kidney.

POST-TRANSPLANT DRUGS TO BLAME
“The six-cm-long tumour had developed due to side effects of immunosuppressive drugs that the patient had been taking after the renal transplant,” said onco-surgeon Dr Amit Gandhi, who led the team.

“Such drugs reduce the risk of rejection of transplanted organs, but at the same time, they also decrease a patient’s immunity and cancer surveillance.”
Dr Gandhi said that he had never come across such a case before. “Surgery was the only option as three major arteries around the kidney were attached to the tumour, which was compressing the organ,” he said. Heart surgeon Uday Jadhav and anaesthetist Arvind Bwere others on the team.

Dr N K Hase, the head of KEM Hospital’s nephrology, described the woman’s case “one in a thousand”. He said, “We always warn transplant patients about side effects of long-term use of drugs.”