Abu Dhabi: Surgeons transplant Emirati's kidney into own body to remove tumour
The 11-hour surgery is the first of its kind performed in the UAE.
UAE national Ali Shamsi has become the first person in the UAE to receive his own kidney as transplant back in to his body, after surgeons removed it from his body, dissected a growing tumour from it and placed it back.
This is the first time such a complex bench reconstruction surgery has taken place in the UAE.
Al Ain resident Ali Shamsi, 64, was born with just one kidney, part of which was surgically removed a few years ago after a cancer diagnosis.
Years later, he returned to Cleveland Clinic Abu Dhabi, complaining about chest pain. Shamsi had been a chronic smoker for most of his life. He was then enrolled in the hospital’s smoking cessation programme, but the damage was already done.
After undergoing a range of tests, doctors found out that his cancer had returned to the kidney.
“I was in shock. I had come to hospital about my smoking and suddenly I was diagnosed with cancer again in my only kidney. I didn’t know what to do. I thought about travelling abroad but I decided to put my faith in God and my doctors, and stay in my country to be treated near my family and friends,” Shamsi said.
Luckily his cancer had not spread but the tumour was located deep inside his kidney. An operation to remove the tumour with the kidney in place was impossible.
“With Shamsi having only one kidney and the tumour deep in the renal vein, we were limited in our treatment options. If we simply removed his kidney, he would need years of regular dialysis before an eventual donor transplant, all of which carries its own set of risks," said Dr Waleed Hassen, department chair of urology and the surgical oncologist who performed Ali’s surgery at Cleveland Clinic Abu Dhabi.
"We determined that the best course of action for Ali was a complex surgery to remove his kidney, dissect the tumour, reconstruct the kidney and transplant it back into him.”
The 11-hour surgery, known as a renal bench reconstruction, required a team of three highly skilled surgeons covering transplant, microsurgery and surgical oncology.
During the first stage of the operation, a transplant surgeon removed Ali’s kidney as they would from a donor.
Once outside the body, the kidney was placed in a slush solution to keep it cool while a surgical oncologist and microsurgeon worked together to carefully dissect it to reach the tumour.
“Having the kidney outside the body means we have much better access. Leaving it in place in the body would not only mean operating on it in a tight space but also a high risk of causing significant bleeding,” explained Dr Kashif Siddiqi, the urologist specialized in microsurgery at Cleveland Clinic Abu Dhabi, who took part in Ali’s surgery.
"Once outside and in a slush solution, we have more time and space available to us. That means we are able to use an optimal approach to reach the tumour, causing as little damage to healthy tissue as possible before putting it back together."
After accessing the tumour and removing it under strong magnification, surgeons repaired Shamsi’s kidney and began the delicate work of transplanting it back into his body.
“This was a very complex operation that really required a high level of skill and coordination across our team with extensive experience in both transplant and surgical oncology. There are not many places in the world that can perform this surgery,” said Dr Bashir Sankari, chair of the surgical subspecialties institute at Cleveland clinic Abu Dhabi, and the transplant surgeon that participated in the procedure.
"From Ali’s perspective, this approach meant he woilf not need dialysis, a transplant or immunosuppressants and can live his life normally, free of cancer."
Following his successful surgery, Shamsi spent almost three weeks recovering in hospital before returning home to Al Ain. He then began dialysis at Cleveland Clinic Abu Dhabi – Al Ain while his kidney continued to recover.
“When doctors told me my kidney had recovered enough and I could stop dialysis, I was flying. It was the best news I ever heard. I feel amazing now, I was even able to fast this Ramadan because I felt so strong," said a grateful Shamsi.
"Through this journey, I really feel that Dr. Hassen has become like a brother to me. The UAE has the best healthcare in the world.”
Cleveland Clinic Abu Dhabi is the UAE’s sole multi-organ transplant center and performed the UAE’s first heart, liver and lung transplants.
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