Delhi: India’s first successful kidney auto-transplant for paediatric cancer saves young Uzbek boy’s life

Delhi: A six-year-old boy hailing from Uzbekistan was successfully cured of Bilateral Wilms Tumour (nephroblastoma), a rare and complex form of paediatric kidney cancer, in the national capital.

According to the doctors at Fortis Escorts, privy to the development, the boy’s condition was critical, with tumours affecting both kidneys, endangering his life.

The doctors explained that despite undergoing chemotherapy in his home country, the child’s chances of survival were uncertain. This uncertainty led his parents to explore advanced treatment options in India.

“The child was brought to Fortis Escorts, Okhla, where a team of skilled doctors, headed by Dr Paresh Jain, Director of Urology & Kidney Transplant, carried out a highly complex kidney auto-transplant procedure,” the doctors shared.

They added, “The surgery, which lasted for eight hours, was successful. The boy recovered smoothly without any complications, following the post-surgery observation period.”

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The doctors explained that upon the child’s admission to the hospital, a thorough assessment revealed tumours in both kidneys. However, the left kidney was heavily impacted by cancer, making it unsuitable for complete tumour removal without risking damage to the organ itself.

“The cancer had also caused the enlargement of the lymph nodes, which are crucial to the body’s immune system,” the medical team noted.

To address the situation, they decided to perform a laparoscopic right partial nephrectomy, also known as Nephron-Sparing Surgery (NSS), to remove the affected portion of the right kidney in August 2024.

“During the procedure, we carefully removed the right-sided lymph nodes, along with the enlarged left-sided lymph node,” they added. “Additionally, a biopsy of the left kidney was conducted in the same laparoscopic session, minimising the need for multiple surgeries.”

The doctors shared that after the surgery, the child underwent a prescribed chemotherapy regimen in Uzbekistan. He then returned to Fortis Escorts Okhla for a re-assessment in November of the previous year.

“A follow-up PET-CT scan showed no signs of cancer in the right kidney, and there was significant regression of the tumour in the left kidney,” they reported.

They added, “Encouraged by these positive results, the medical team proceeded with further treatment for the remaining tumour in the left kidney.”

The doctors explained that during the second stage of surgery, it was discovered that the left kidney was surrounded by thickened tissues due to previous treatments and surgeries. This made it extremely challenging to safely separate the tumour from the healthy kidney tissue.

“Given the complexity of the situation, the doctors decided to remove the kidney through a small incision in the lower abdomen, performing an Auto Kidney Transplant,” they said.

“This approach allowed for safer and more precise tumour removal, reducing the risk of cancer cell spread. The kidney was carefully dissected to remove the tumour, and the doctors skilfully reconstructed the blood vessels and urine drainage pathways. Once the kidney was free of cancer, it was successfully re-implanted back into the child’s lower abdomen. Following the procedure, the child experienced a gradual and smooth recovery,” they added.

Dr Paresh Jain, Director of Urology & Kidney Transplant at Fortis Escorts, Okhla, New Delhi, provided further details about the case, stating, “This medical achievement is particularly significant as only 16 similar cases have been documented globally, with none reported in India. Wilms tumour, typically diagnosed in children aged 3-4 years, presents considerable challenges due to its rarity and complexity. Its advanced stage can be particularly difficult as it may affect both kidneys, becoming life-threatening if not treated promptly.”

He also noted, “Globally, most procedures like this are not performed laparoscopically and usually require two separate surgical teams—one for paediatric oncosurgery and another for kidney transplantation. However, in this case, both procedures were successfully carried out by a single specialised team, showcasing their exceptional surgical expertise and coordination.”

Dr Jain highlighted the significance of the surgery, explaining, “One of the key goals was to avoid maternal kidney donation. This approach spared the child’s mother from having to donate a kidney, thus preserving her health and kidney function.”

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He further said, “The procedure also eliminated the need for lifelong immunosuppressive medications, which are typically required after transplants. By preserving the child’s own kidney, we avoided potential harmful side effects, increased infection risk, and reduced the financial burden.”

Dr Jain further added, “Given the child’s young age, he would have likely needed at least three kidney transplants over his lifetime. This surgery successfully preserved his natural kidney function, eliminating the need for multiple transplants.”

The patient’s mother said, “We came to India with hope after our son’s condition did not improve in Uzbekistan. The doctors gave us the confidence that our son would recover. We are extremely thankful to Dr Paresh Jain and the entire team of doctors for their hard work and for saving our son’s life. He is now back to playing and smiling, and we are beyond grateful for this second chance at life.”

Dr Vikram Aggarwal, Facility Director, Fortis Escorts, Okhla, said, “This rare case marks India’s first reported successful surgical intervention, underscoring the hospital’s leadership in multidisciplinary care. Our dedicated team, led by Dr Paresh Jain, assessed all parameters and conducted the procedure with exceptional precision. This case was uniquely challenging, and our success is a testament to the dedication, skill, and collaboration of our team.”

The patient’s mother shared her emotional journey, saying, “We came to India with hope after our son’s condition didn’t improve in Uzbekistan. The doctors here gave us the confidence that our son would recover. We are incredibly grateful to Dr Paresh Jain and the entire team for their hard work and for saving our son’s life. He’s now back to playing and smiling, and we’re beyond thankful for this second chance at life.”

Dr Vikram Aggarwal, Facility Director at Fortis Escorts, Okhla, spoke about the significance of the case, stating, “This rare case marks India’s first reported successful surgical intervention, highlighting the hospital’s leadership in multidisciplinary care. Our dedicated team, led by Dr Paresh Jain, carefully assessed all parameters and performed the procedure with exceptional precision. This case was uniquely challenging, and our success reflects the dedication, skill, and collaboration of our team.”