A groundbreaking medical achievement has been made in Delhi, where 47-year-old scientist Devendra Barlewar underwent a successful third kidney transplant, defying the odds and demonstrating extraordinary resilience and determination. Despite battling chronic kidney disease (CKD) for years and enduring two failed kidney transplants, Barlewar’s latest surgery has given him a new lease on life. His remarkable case is particularly unique, as he now carries five kidneys, though only one is functioning. His journey, however, was fraught with challenges, both medical and logistical, and serves as a beacon of hope for patients with complex kidney diseases.
The Challenges of Chronic Kidney Disease and Multiple Transplants
Devendra Barlewar’s health challenges began in 2008 when he was first diagnosed with hypertension, which eventually led to CKD. The progression of the disease required frequent dialysis, almost three times a week, severely impacting his professional life and overall well-being. He underwent his first kidney transplant in 2010 and a second one in 2012. Both transplants ultimately failed, leading him back to dialysis. In 2022, his second transplanted kidney failed after he contracted COVID-19, worsening his health further and making a third kidney transplant necessary.
For Barlewar, a kidney transplant had always been the best long-term treatment option, despite the failure of his first two transplants. After his second kidney transplant failed, he registered for a donor transplant at Amrita Hospital in Faridabad in 2023. On January 7, 2025, an opportunity arose when a cadaveric kidney from a 50-year-old farmer, who was declared brain-dead, became available. The National Organ and Tissue Transplant Organisation (NOTTO) prioritized his case, given the urgency, and the medical team had only a few hours to optimize him for surgery.
The Complexities of a Third Kidney Transplant
Performing a third kidney transplant is highly rare, as it presents multiple challenges. One of the major hurdles is finding a suitable donor. Kidney donors are in limited supply, and the likelihood of finding a match for a third transplant is extremely low. Additionally, managing the risks of organ rejection is a constant concern. Each successive transplant increases the likelihood of the immune system attacking the new organ, making pre-operative planning crucial. The surgical team must also account for the physical limitations of the recipient’s body, especially when they have previously undergone multiple surgeries.
In Barlewar’s case, his thin build and existing incisional hernia made it difficult to find enough space in his abdomen to accommodate a fifth kidney, in addition to the two native kidneys and two non-functioning transplanted kidneys. The surgeons had to navigate these complexities carefully to ensure that the new kidney could be successfully transplanted without causing additional health complications.
Dr. Anil Sharma, Senior Consultant Urology at Amrita Hospital, Faridabad, and Dr. Ahmed Kamaal, Senior Consultant Urology at the same hospital, were the surgeons who performed the surgery. Dr. Sharma explained that the transplant was a delicate procedure due to Barlewar’s heightened immune response, which increased the risk of organ rejection. As a result, careful planning was needed to ensure the transplant would be successful. Dr. Kamaal noted that third kidney transplants are rare not only due to donor scarcity but also because of the challenges associated with recipient fitness and existing surgical complications.
Why Non-Functioning Kidneys Are Not Removed
In kidney transplantation, it is common practice to leave the original, non-functioning kidneys in place. The reasons for this are primarily due to the risks associated with removing them, such as bleeding, infection, and other surgical complications. Dr. Nishchay Bhanuprakash, an MD and DM Nephrology & Kidney Transplant Consultant at KAUVERY Hospital, Marathahalli, Bangalore, elaborated on this process. He explained that the removal of shrunken and scarred kidneys often provides little benefit and can increase the risk of complications. By leaving the non-functioning kidneys in place, surgeons reduce the risk of further damage and focus on ensuring that the new kidney functions optimally.
In cases like Barlewar’s, where multiple transplants have been performed, each new kidney is placed in a different part of the abdominal cavity. This careful navigation ensures that there is adequate blood supply to each kidney and minimizes the risk of complications. Surgeons must account for existing structures and previous surgical sites while ensuring that the new kidney is positioned in the most suitable location.
The Groundbreaking Nature of the Surgery
The uniqueness of Barlewar’s case lies not only in the fact that he underwent a third kidney transplant but also in the exceptional complexities involved. The procedure required highly advanced surgical techniques and a well-coordinated effort between the medical team and the transplant coordination network. Barlewar’s case is a reminder of the advancements in medical technology and the importance of donor organ availability in saving lives. The success of this transplant has paved the way for further research into improving the success rate of multi-transplant surgeries.
Dr. Sharma and Dr. Kamaal highlighted that the procedure was especially challenging due to the limited space available in Barlewar’s abdomen, as well as the presence of multiple non-functioning kidneys. Despite these challenges, the surgery was successful, and Barlewar’s recovery has been promising. He is now in the early stages of his postoperative period, showing good signs of recovery and potential long-term success.
Long-Term Health Outlook for Barlewar
After the surgery, Barlewar will need to closely monitor his health to ensure the new kidney remains functional and to manage any potential complications. He will continue to take immunosuppressant medications to prevent organ rejection, and he must adhere to a strict regimen to keep his hypertension under control. Dr. Sharma and Dr. Kamaal emphasized the importance of regular follow-up visits and monitoring to ensure the long-term success of the transplant.
While Barlewar will need to make some dietary changes, his quality of life should improve significantly compared to his previous experience on dialysis. The ability to manage his health more effectively, coupled with the successful transplant, offers him a chance at a better future. However, the journey ahead will still require careful management and consistent medical attention.
The Impact of Organ Donation and the Importance of Awareness
Barlewar’s story highlights the critical importance of organ donation. Organ donation rates remain low in many parts of the world, and Barlewar’s case underscores the need for increased awareness and the importance of registering as an organ donor. Without the availability of a deceased donor kidney, Barlewar’s life would have been at risk, and his remarkable survival and recovery were only made possible by the generosity of the donor and their family.
The success of this transplant is also a testament to the incredible advances in medical science and the surgical expertise that made it possible. It demonstrates that even in the most challenging cases, there is hope for patients with kidney disease, and that with the right medical care and a suitable donor, lives can be saved.
Devendra Barlewar’s third kidney transplant is not just a medical triumph, but also a testament to the human spirit and the potential of modern medicine. His case, though extremely rare, offers hope to countless patients suffering from chronic kidney disease and showcases the immense potential of organ transplantation. While Barlewar’s road to recovery is far from over, his success story serves as an inspiration to both the medical community and patients worldwide. As science and medicine continue to evolve, stories like Barlewar’s highlight the critical role that organ donation plays in saving lives, and the groundbreaking progress being made in the field of transplant surgery.
