Introduction

Horst Kruessmann, 72, was diagnosed with type 2 diabetes in 2010. It affected the kidney function over a period of time that eventually led to chronic renal failure (Type 4) in 2016. At the time, his creatinine levels were around 4 milligrams (mg) per deciliter (dL), about 3 fold than the normal range.

Upon visiting the doctor for consultation, Horst was informed that his kidney function has deteriorated and was advised to undergo a renal transplant procedure.

Having worked and stayed in Kenya for a long time before, Horst first looked for kidney transplant surgery options there itself. Horst’s wife, Claudia Boke Chacha, was his donor. However, the challenge was that the length of the renal vein of his wife (donor) was short as per the DTPA scan. This is why the surgeons in Kenya were skeptical about performing the surgery. So, Horst and Claudia started to look online to find better medical facilities overseas for kidney transplant surgery. Through the online search, he came across MediGence and connected with them by filling the inquiry form on MediGence website.

MediGence’s responsiveness to his queries from time to time with the most accurate information led Horst to choose MediGence as his medical tourism facilitator for his treatment overseas.

Reviewing the recommendations of expert surgeons and hospitals as shared by the MediGence team, Horst chose his surgery to be done by Dr. Amit K Dewra, Kidney Transplant Surgeon and Dr. Anil Prasad Bhatt, Nephrologist at Jaypee Hospital in Noida, India. To clear his concerns, the team even arranged a telephonic consultation with Dr. Dewra before they traveled.

Pre-treatment

Horst arrived in India on July 21st, 2019 accompanied by his wife, Claudia (aged at 40). They were received and safely accommodated to their hotel by the Patient Care team at MediGence. Horst’s first consultation with Dr. Bhatt took place on 22nd of July 2019 at Jaypee Hospital wherein he was advised further medical investigations considering his history of diabetes and hypertension.

During his pre-investigation tests, no major issues were discovered with respect to cross match and compatibility. After a detailed investigation, Horts’s medications for diabetes and hypertension were changed since his ongoing medication was not working for him. Along with it, Horst was also strongly advised to completely quit smoking before the surgery. MediGence’s Patient Care team guided him every step of the way on how to prepare himself for the surgery.

As for the donor’s medical investigations, the repeat DTPA scan revealed that Claudia’s renal vein length was completely normal for both her kidneys, in contrast to the reports from Kenya.

However, during gynecology clearance, it was observed that she had recurrent fibroids. Having a previous history of two surgeries to remove fibroids, the doctors suggested that it would not be possible for them to give clearance with her current status. Leading this situation, Claudia was given two options:

• To get myomectomy and biopsy done before Kidney Transplant Procedure (KTP) so as to get biopsy clearance and opt for uterus removal after 6 months of KTP
• To get a hysterectomy and go for KTP after 6 months

Considering Horst’s deteriorating health and immediate need for KTP, she opted for option 1 and got myomectomy done. The gynecology clearance was given after Claudia recovered from the surgery. Soon, the Ethics committee meeting took place and the date for kidney transplant surgery was fixed.

Horst’s kidney transplant surgery was scheduled for the 8th of September, 2019. They were admitted on the 6th of September, 2019.

Process

Horst’s surgery was completed successfully on the 8th of September, 2019 as scheduled. Although the surgery was critical owing to Horst’s fluctuating blood pressure it was managed well by the operating surgeon.

The recovery process was challenging for Horst. His sugar levels shot up and hypertension was not under control. So he was put on insulin for a few days after the surgery. He continues to take insulin even after discharge from the hospital.

Before his discharge, a 2D echo and ultrasound were planned for him to see that everything is working fine. After receiving the clearance, he was discharged on the 18th of September, 2019 while his donor was discharged on the 12th of September, 2019.

Over the course of one week from the date of surgery, his creatinine levels continued to improve and sugar level also gradually stabilized.

Post-treatment

The surgery was conducted successfully. MediGence assisted Horst and Claudia throughout their treatment journey right from helping them choose the right doctors and hospital, to managing their travel operationally as well as initiating conversations with Dr. Bhatt and Dr. Devra on their behalf before their arrival in India.

Following the surgery, constant follow-ups were attended by both Horst and Claudia at the hospital for control tests, to see that his body is getting adapted to the new kidney and vice versa. Horst and his wife were totally satisfied and really happy with the overall clinical care, support and outcomes they received during and from his treatment.

Team MediGence wishes Horst and Claudia a great and healthy life ahead!

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