AINU (Asian Institute of Nephrology & Urology) Doctors Transplant Man’s Own Kidney and Use His Appendix to Restore Urinary Function

In a remarkable demonstration of surgical excellence and innovation, doctors at the Asian Institute of Nephrology and Urology (AINU) in Hyderabad successfully saved both kidneys of a 65-year-old man suffering from a rare and life-threatening condition—by transplanting one of his own kidneys to a new position in his body and using his appendix to replace a damaged ureter on the other side.

The patient, hailing from West Bengal, developed severe complications following a routine kidney stone removal procedure (RIRS) performed elsewhere in 2023. Post-surgery, both his ureters—the tubes that carry urine from kidneys to the bladder—became completely blocked, causing a life- threatening rise in creatinine levels, intense pain, and recurrent fever.

With his kidneys in critical condition and temporary tubes (nephrostomies) draining them externally, the patient reached Hyderabad after being turned away by multiple centers in other states. Upon detailed evaluation, doctors found that both ureters had long-segment, high-grade obstructions, an extremely rare and challenging scenario.

For the right kidney, the surgical team used a highly unconventional method: they repurposed the patient’s own appendix to replace the blocked ureter. The appendix, being similar in size to the ureter, was meticulously repositioned using robotic-assisted surgery—a rarely performed but scientifically documented technique known as appendix interposition.

“This is one of the most creative and minimally invasive ways to reconstruct a long ureteric defect. It’s not commonly done, but it was the perfect solution in this patient’s case.” said Dr. Syed Md Ghouse, Senior Consultant Robotic Surgeon and Urologist, AINU.

Following the procedure, the right kidney resumed normal function, and the external drainage tube was successfully removed.

Auto-Transplant: Transplanting the Kidney Back Into Himself Two months later, the left kidney still remained compromised. Since the appendix exists only on the right side and other alternatives like intestinal interposition posed complications, the surgical team opted for a bold, rarely attempted solution: renal autotransplantation.

In this complex procedure, the patient’s left kidney was surgically removed along with its blood vessels, then reimplanted lower down in the abdomen, bypassing the diseased ureter and allowing natural urine flow into the healthy segment. “Renal autotransplantation is performed only in the most advanced centers and is considered a last-resort, high-precision procedure. We essentially gave his kidney a new home within his own b

“Renal autotransplantation is performed only in the most advanced centers and is considered a last-resort, high-precision procedure. We essentially gave his kidney a new home within his own body, Dr. Vijay Kumar Sarma Madduri, Consultant Urologist explained."

The patient is leading a normal life. His kidney function is stable, his creatinine levels are within the normal range, and he is completely free from pain or complications.

"This case stands as a rare medical milestone—where two distinct, cutting-edge surgical solutions were used to save both kidneys of a patient. One involved the innovative use of the appendix, and the other, an autotransplant of his own kidney, a technique few patients in the world have undergone successfully," said Dr. C Mallikarjuna, Managing Director & Chief Consultant Urologist, AINU.

The team of doctor includes Dr. C. Mallikarjuna, Managing Director & Chief Consultant Urologist, Dr. Syed Md. Ghouse, Senior Consultant Robotic Surgeon and Urologist; Dr. Vijay Kumar Sarma Madduri, Consultant Urologist; Dr. Taif Bendegeri, Senior Consultant Urologist, and it was supported by resident doctors Dr. Karthik and Dr. Asit.

About Asian Institute of Nephrology & Urology

Asian Institute of Nephrology & Urology is India’s largest single specialty hospital network in Urology & Nephrology. It has seven hospitals across four cities with a leading team of nephrologists and urologists. Recognized for its clinical expertise in the field of Urology and Nephrology, the hospitals offer services such as Uro-Oncology, Reconstructive Urology, Pediatric Urology, Female Urology, Andrology, Functional Urology, Kidney Transplants and Dialysis. It is one of the pioneers of Robotic Urology surgery in India. The hospital has a network of over 500 beds in the country and has treated over a lakh patient. AINU has accreditation from NABH, DNB (Urology & Nephrology) and FNB (Minimal Invasive Urology).