Abu Dhabi surgeons complete rare 11-hour procedure to reattach Emirati man's kidney after tumour removal

Doctors discovered the tumour in Ali Al Shamsi's only kidney

Surgeons perform the UAE’s first full heart transplant at Cleveland Clinic Abu Dhabi. Photo Courtesy: Cleveland Clinic Abu Dhabi
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An Emirati man, 64, had his only kidney removed and then transplanted back into his body in a rare 11-hour procedure.

Born with one kidney, retiree Ali Al Shamsi was told last year that this kidney had a tumour and that surgery was essential for his survival.

A regular kidney transplant was not an option for the father of one from Al Ain, who would have had to wait around three years and receive strong medication before eventually being eligible.

Dr Hassen and the team truly saved my life and I owe them the world for that

Instead, a team of doctors at Cleveland Clinic Abu Dhabi decided to perform what is known as a renal bench reconstruction, which first involved the removal of Mr Al Shamsi's kidney.

Once outside the body, the kidney was placed in a slush solution – an iced saline mixture of solids and liquid – to keep it cool, while a surgical oncologist and microsurgeon worked together to carefully dissect and remove the tumour.

When the tumour was removed, the kidney was placed back into the body.

The surgery was performed by oncologist Dr Waleed Hassen, Department Chair of Urology at Cleveland Clinic Abu Dhabi.

After surgery, it was expected that Mr Al Shamsi would be on dialysis for at least two years, but three weeks later his kidney began functioning normally again.

Dr Waleed Hassen, a urologist at Cleveland Clinic Abu Dhabi. Courtesy Cleveland Clinic Abu Dhabi

"Before the operation, I was very scared. I cried on my way to the operating room," Mr Al Shamsi told The National.

"I had never heard of such an operation where they take out your kidney and then put it back. Dr Hassen and the team truly saved my life and I owe them the world for that."

Dr Bashir Sankari, chair of the Surgical Subspecialties Institute at Cleveland Clinic and a transplant surgeon who took part in the procedure, said Mr Al Shamsi will not need dialysis, a transplant or immunosuppressants and can live his life normally, free of cancer.

"When doctors told me my kidney had recovered enough and I could stop dialysis, I was flying," Mr  Al Shamsi said.

"It was the best news I'd ever heard. I feel amazing now. I was even able to fast this Ramadan because I felt so strong."

Mr Al Shamsi was diagnosed last June after going to Cleveland Clinic complaining of chest pains.

"I never imagined that I would go to the hospital over chest pains and then discover that I have one kidney and that one kidney would have a tumour," he said.

Within a few days, he had decided to have the complex surgery in the UAE.

Abu Dhabi, United Arab Emirates - February 20th, 2018: Dr Bashir Sankari, the chief of the surgical subspecialties institute at Cleveland Clinic Abu Dhabi. Press conference to celebrate the clinical milestone of the UAE's first transplants from deceased donors for all four major organs "The Gift Of Life - Major Organ Transplants in The UAE". Tuesday, February 20th, 2018. Cleveland Clinic, Abu Dhabi. Chris Whiteoak / The National

"I had the option of doing it in the United States but anything that could be done in the United States could be done here."

"And if I died, I wanted to die in my country surrounded by my family and friends," Mr Al Shamsi said.

"This is a rare and complex procedure, with only a handful performed," Dr Hassan said.

"Patients will always do better with their own kidneys rather than have a transplant. It is always better to try to save the kidney."

He said if Mr Al Shamsi had received a kidney transplant, he would have needed years of regular dialysis before an eventual donor transplant, all of which carries its own set of risks.

"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," Dr Hassan said.

“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."

Dr Kashif Siddiqi, a urologist who specialises in microsurgery at Cleveland Clinic Abu Dhabi, said with more time and space they were able to reach the tumour without causing too much damage to healthy tissue.

“This was a very complex operation that really required a high level of skill and co-ordination across our team with extensive experience in both transplant and surgical oncology," said Dr Siddiqi.

"There are not many places in the world that can perform this surgery.

"From Ali’s perspective, this approach means we are able to save his kidney, which is a huge benefit."