A team of specialists at KIMS Hospitals, Secunderabad, has successfully treated a rare and aggressive intestinal lymphoma in a 42-year-old woman while preserving the transplanted kidney she received 17 years ago. The complex case highlights the growing role of multidisciplinary care in treating cancer among organ transplant recipients.
The patient, a Hyderabad resident, underwent a kidney transplant in 2009 using a kidney donated by her mother. The transplant procedure was performed by Dr. Ch. Uma Maheshwara Rao. Since the surgery, she has remained on long-term immunosuppressive medication to prevent rejection of the donor kidney, which continued to function well.
In June 2025, she was admitted to KIMS Hospitals after experiencing persistent abdominal pain, repeated episodes of vomiting and an unintended weight loss of approximately 15 kg over a three-month period. A comprehensive diagnostic work-up revealed high-grade intestinal lymphoma, a rare form of cancer that had also caused recurring bowel obstruction.
Managing cancer in transplant recipients presents a unique medical challenge. While chemotherapy is essential to eliminate cancer cells, it can further weaken an already suppressed immune system, increasing the likelihood of severe infections. At the same time, reducing immunosuppressive medication to strengthen immunity may trigger rejection of the transplanted organ.
To overcome these competing risks, specialists from the departments of medical oncology and nephrology designed an individualized treatment strategy. The patient was started on chemo-immunotherapy, with both cancer treatment and immunosuppressive medications being closely monitored and adjusted throughout the course of therapy to maintain kidney function while effectively targeting the lymphoma.
After completing three cycles of treatment, clinical evaluation and imaging showed a significant reduction in the tumour. However, the rapid response resulted in the formation of an abnormal passage between the small and large intestines. This complication led to severe diarrhoea, malnutrition and further weight loss, making immediate surgical intervention essential.
Dr. M.B.V. Prasad, General & GI Laparoscopic Surgeon, performed a complex operation to remove the diseased sections of the intestine and reconnect the healthy bowel. Surgery in patients with severely suppressed immunity carries a high risk of infection and delayed healing, but the procedure was completed successfully. Following intensive postoperative care, the patient made a full recovery within four weeks and was subsequently able to complete the remaining three cycles of chemo-immunotherapy.
A subsequent whole-body PET scan showed no evidence of active disease, confirming complete remission. Doctors also reported that the transplanted kidney remains healthy and continues to function normally.
Dr. Mounika Boppana, Consultant Medical Oncology & Hemato-Oncology, who led the treatment, said, “Organ transplant recipients are at increased risk of serious infections and certain cancers because of long-term immunosuppressive therapy. Careful planning and close monitoring at every stage enabled us to completely cure the cancer while preserving the transplanted kidney.”
Dr. V.S. Reddy, Nephrologist & Kidney Transplant Specialist, said, “Treating cancer in a kidney transplant recipient is one of the most challenging situations in medicine. We must protect the transplanted kidney while simultaneously eradicating the cancer. The coordinated efforts of the departments of nephrology, medical oncology and surgery, and the critical care team helped us overcome what initially appeared to be an impossible challenge.”
Dr. M.B.V. Prasad added, “Intestinal surgery in a severely immunocompromised patient is extremely complex. The successful outcome was possible only because of seamless multidisciplinary teamwork and comprehensive postoperative care.”
This successful outcome demonstrates the importance of integrated, multidisciplinary care in managing highly complex medical conditions. By combining expertise in oncology, nephrology, gastrointestinal surgery and critical care, the team at KIMS Hospitals not only achieved complete remission of a rare intestinal lymphoma but also preserved the patient’s transplanted kidney, offering hope for similar high-risk cases in the future.
(Photo courtesy: www.kimshospitals.com)