Imagine living with not one, not two, but five kidneys—two that are failing, two that have been transplanted but are non-functioning, and one that is a new implant sustaining you. This is the incredible reality of 47-year-old researcher Devendra Barlewar, whose relentless battle with chronic kidney disease led a groundbreaking third kidney transplant. After years of dialysis, unsuccessful surgeries, and the crippling effect of COVID-19, his survival is not only about living but a result of the extraordinary progress in modern medicine. Here's how a group of expert doctors in India made history with one of the rarest transplant cases on record.

Mr. Barlewar's story is a testament to the advances of medicine and the strength of the human spirit. Having fought chronic kidney disease (CKD) for more than 15 years, he had his third kidney transplant after two earlier failed attempts. His situation poses a special surgical challenge and immunological risk, an unprecedented accomplishment in organ transplantation.

The battle of the scientist with kidney disease was first encountered in 2008 when he was diagnosed with high blood pressure. Lacking any underlying conditions, his health rapidly worsened, and he became dependent on dialysis by 2009. In the following years, he received two kidney transplants, one in 2010 and the other in 2012, both of which failed, making him depend on dialysis again. The second kidney transplant survived for a number of years before it was sabotaged by COVID-19 in 2022, leading to total organ failure. Lacking close family members for a live donation, he enrolled for a deceased donor transplant at Amrita Hospital in 2023. His turn arrived on January 7, 2025, when a matching kidney from a brain-dead donor was made available.

Challenges of Kidney Transplant

A third renal transplant is very uncommon and has special medical complications, such as:

Immunological Risks: As he had two non-functioning native kidneys and two formerly transplanted kidneys, his immune system was extremely sensitized, which raised the risk of organ rejection. To counteract this, physicians used cutting-edge immunosuppressive techniques to hinder a reaction by the immune system against the newly transplanted organ.

Surgical Complexity: Four kidneys created a space limitation inside the abdominal cavity. The surgeons needed to tread carefully to provide space for the new kidney without compromising its blood supply.

Vascular Limitations: The blood vessels used in his previous transplants had already been utilized, making it crucial to identify and connect the new kidney to the largest available abdominal blood vessels. Extensive preoperative imaging and surgical expertise were required to navigate this challenge.

Dr. Ahmed Kamaal, Senior Urology Consultant, who was a member of the surgical team, added, "This was an unprecedented case. With four existing kidneys, there were huge immunological risks involved and the need for special protocols. We maximized the patient with immunosuppression pre-transplant to preserve his new kidney transplant from the threat of rejection."

Role of the Organ Donor

Organ donation was instrumental in making this operation feasible. The 50-year-old farmer was certified brain dead after suffering a stroke. His family decided to donate his organs out of kindness, and the kidney that was a perfect match for Mr. Barlewar was one of them. Being a long-standing member of the transplant program's registration history, he was prioritized to undergo the procedure.

The operation itself involved careful planning and execution. The surgical team utilized high-tech medical imaging, immunological testing, and microvascular equipment to achieve precision. The four-hour operation entailed:

Preoperative Planning: High-resolution CT scans were employed to establish the most appropriate position of the kidney and check viability of the blood vessels.

Immunological Preparation: Advanced laboratory testing was performed to assess antibody levels, ensuring compatibility and reducing rejection risk.

Surgical Performance: The kidney was attached to the largest blood vessels in the abdomen, with utmost care being taken to prevent any complications.

Postoperative Care: After the transplant, the patient was transferred to intensive care for careful monitoring of vital signs, kidney function, and complications like internal bleeding, infection, or graft rejection.

Dr. Kunal Gandhi, Senior Nephrology Consultant, stressed, "Two non-functioning kidneys pose severe immunological issues, especially during the initial post-operative period. They cause organ rejection if not treated. High-tech medicine and in-house immunology testing were a must to provide the optimal result."

After the successful transplant, Mr. Barlewar's new transplanted kidney started secreting urine within hours, an important sign of graft function. He spent some days in intensive care, where he was continuously monitored to ensure his body received the organ well. After ten days, he was discharged with stable kidney function and his levels of creatinine normalized within two weeks, which was a major improvement in his condition.

Dr. Sameer Bhate, Head of Cardiac Surgery and Senior Consultant, emphasized the importance of the surgical skill involved: "The anastomosis of renal vessels to the largest abdominal blood vessels is a delicate process that calls for skillful surgery."

Although Mr. Barlewar's case is medically unprecedented, it also highlights the significance of organ donation and the evolution of transplantation methods. His experience shows the strength of patients with chronic illnesses and the life-changing effects of novel medical treatments.

Now dialysis-free for the first time in years, Mr. Barlewar is independent once more and back in his routine daily activities. His case provides a precedent within the medical profession, hope for thousands of patients around the globe who are waiting for kidney transplants.

The successful third kidney transplant of Mr. Devendra Barlewar is an affirmation of the latest advances in medicine, unparalleled surgical skill, and organ donor generosity. The tale emphasizes the significance of organ donation in saving lives and the pursuit of medical perfection in addressing complicated medical problems. With ongoing developments in transplantation research, the case is an inspiration to patients and the international medical community as well.

All the doctors who were part of the surgical team are practising doctors at Amrita Hospital in India

The World Health Organization (WHO)'s Montreal meeting focused on wearable technology like smartwatches and activity trackers as a reliable source of health tracking. The meeting discussed that wearables could in fact generate objective real-time data, which helps governments design targeted and evidence-based health interventions.

Physicians in the Montreal meetings discussed that wrist-worn devices are more reliable than traditional self-reported surveys. This is because the self-reported surveys could underestimate the levels of physical inactivity.

“Metrics such as step count, moderate-to-vigorous physical activity and sedentary time directly correlate with cardiovascular disease, diabetes and mental health outcomes. Having population-level data allows for early and preventive strategies,” said Dr Venkat Nani Kumar, consultant in internal medicine.

WHO Montreal Meeting: How Have Doctors Reacted The Shift To Wearables?

Doctors in India have welcomed this shift to wearable devices as a better way to generate data and make policies. Dr Kiran Madhala, professor at Gandhi Medical College, Secunderabad, said WHO’s shift reflects rapid advances in artificial intelligence and digital health tools, calling it a progressive step towards improved monitoring of physical activity worldwide.

City-based doctors also underlined the need for inclusive validation of devices. “Wearables must recognise varied movement patterns and step equivalents, especially in ageing populations,” a physician said, while stressing the importance of data privacy and ethical use of health information.

WHO Montreal Meeting: What Are Wearable Health Devices?

As per a 2022 study published in JMIR MHealth and UHealth, wearables refer to devices that are worn by individuals. In health care field, they assist with individual monitoring and diagnosis. Wearables are “seamlessly embedded portable computers...worn on the body," notes another 2018 study published in Telematics Informatics.

A 2018 study published in the journal Sensors noted that wearable health devices are increasingly helping people to better monitor their health status both at an activity/fitness level for self health tracking and at a medical level providing more data to clinicians with a potential for earlier diagnostic and guidance of treatment.

WHO Montreal Meeting: What Are Some Examples Of Wearables?

Blood Pressure Monitor

This is a blood pressure monitor that consists of a cuff that is placed in upper arm with a digital display that provides real time reading of systolic and diastolic blood pressure.

Glucose Monitoring Device

This device estimates your glucose levels in every few minutes. It can be worn in upper arm, with a phone sensor connected to measure readings. It also includes real time glucose alarms to make informed decisions.

Wearable ECG Monitor

ECG patches are interconnected with smartphones, where one can see their readings. They not only measure electrocardiograms, but also detect any abnormalities.

Fitness Tracker

Smartwatches or fitbits that could be worn on your wrist. They help track real time data of your health, steps, heart rate, calorie consumptions, and even sleep patterns. It can also help keep track of oxygen levels.

Integrated Activewear

These activewears come with microscopic sensors to safeguard wearer's body or assist them in reaching their fitness objective.

Atrial fibrillation (AFib) is an irregular and often very rapid heart rhythm, also called an arrhythmia and can create blood clots in the heart, which can increase your risk of having a stroke by five times.

When a person has AFib, the normal beating in the upper chambers of the heart (the two atria) is irregular and blood doesn't flow as well as it should from the atria to the lower chambers of the heart (the two ventricles).

In this case, the risk of developing blood clots in your heart increases, which can not only cause a heart attack but also damage vital organs such as your brain. An AFib may happen in brief episodes, or it may be a permanent condition.

Common symptoms include palpitations (the feeling that your heart is racing, pounding, fluttering or like you have missed heartbeats), chest pain, finding it harder to exercise, tiredness, shortness of breath, dizziness or feeling faint.

READ MORE: You Can Stop A Heart Attack With This Medicine, Cardiologist Reveals Heart Attack 101

The death rate from AFib as the primary or a contributing cause of death has been rising for more than two decades.

Over 454,000 people with AFib are hospitalized in the US each year, out of which 158,000 die of the cause. It is estimated that 12.1 million people in the US will have AFib in the US will have AFib by 2050.

Who Is At Risk Of Having AFib?

• Advancing age.
• High blood pressure.
• Obesity.
• European ancestry.
• Diabetes.
• Heart failure.
• Ischemic heart disease.
• Hyperthyroidism.
• Chronic kidney disease.
• Moderate to heavy alcohol use.
• Smoking.
• Enlargement of the chambers on the left side of the heart.

Treatment for AFib includes medications to control the heart's rhythm and rate, therapy to shock the heart back to a regular rhythm and procedures to block faulty heart signals.

A person with atrial fibrillation also may have a related heart rhythm disorder called atrial flutter. The treatments for AFib and atrial flutter are similar.

How To Improve Your Heart Health

Experts recommend following the below to reduce yor risk of stroke or developing AFib and maintaining heart health:

• Don't smoke or use tobacco.
• Aim for at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity (or an equal combination of both) each week. Eat a heart-healthy diet.
• Stay at a healthy weight.
• Get quality sleep.
• Manage stress levels
• Get regular health screening tests.
• Eat a fiber, nuts and fish-rich diet
• Limit salt intake
• Reduce saturated fat intake

Changes in your voice, whether in tone, volume, speed or overall quality, can act as early warning signs for a wide range of medical conditions, experts say.

Your voice is produced by the coordinated effort of your respiratory system, vocal cords (also called vocal folds), and the resonating chambers of your throat, mouth, and nose. Even subtle shifts in hormone levels, hydration status or tissue health can noticeably affect how you sound.

Recent research shows that subtle changes in speech, for example, slurring or vocal cord tremors, may be signs of disease or illness like Parkinson’s disease, depression, cardiac and mental health problems, as speech requires coordination with the brain, muscles and respiratory system.

Which Conditions Can You Identify By A Change In Voice?

• Diabetes: High-pitched, raspy voices or vocal strain can be linked to diabetes, with AI studies showing up to 75% accuracy in prediction.
• Cardiovascular Disease: Voice analysis can detect high, fluttering voices associated with coronary artery disease, caused by stress or fluid changes in the vocal cords.
• Hypothyroidism: A deeper, softer, or huskier voice can indicate thyroid dysfunction.
• Respiratory Illnesses: Conditions like COVID-19 or COPD are often associated with a breathy voice, coughing, and short, interrupted sentences.
• Throat Cancer: Persistent hoarseness and raspy voice, especially lasting more than 2-3 weeks, can indicate laryngeal cancer.
• Parkinson’s Disease: Identified by a monotone voice, reduced volume, increased breathiness, and vocal cord tremors.
• Alzheimer’s Disease/Dementia: Characterized by slower speech rates, hesitation, frequent pauses, and simplified vocabulary/sentence structure.
• Stroke or Brain Injury: Indicated by slurred speech or difficulty finding words (global aphasia).
• Cerebellar Disorders (caused by damage to the nerves in the brain's cerebellum): Manifest as loud, staccato speech (bursts of broken sounds).
• Depression: Linked to a flatter, softer, and more monotone voice with a reduced pitch range.
• Anxiety/Stress: Often presents as a higher-pitched, faster, and more tremulous voice.
• Schizophrenia: Indicated by monotone, disorganized speech.

What Else Can Affect Your Voice?

Apart from serious medical conditions, voice changes may also be linked to aging and lifestyle factors. Fluctuations in testosterone, estrogen, progesterone, and thyroid hormone levels may also influence the structure and function of the vocal cords.

Dehydration is one of the most common causes of voice problems, as cords need adequate moisture to vibrate efficiently. Aim for at least 64 ounces of water daily, and more if you use your voice professionally or live in a dry climate.

Smoking irritates and inflames the vocal cords, causing chronic hoarseness and increasing the risk of vocal cord cancer. Even secondhand smoke and vaping can affect voice quality.

Diet also plays a role in vocal health. Caffeine and alcohol are diuretics that can dehydrate your vocal cords. Spicy foods and acidic beverages may trigger reflux, irritating the throat.

Dairy products can increase mucus production in some people, affecting voice clarity. Voice overuse or misuse, common in teachers, singers, and public speakers, can lead to vocal fatigue and damage. The following table compares how different lifestyle factors impact your voice.

How Can You Take Care Of Your Voice?

Whether the cause is hormonal changes, medical conditions, aging, or lifestyle factors, most voice problems can be improved with proper diagnosis and treatment. Here are some things you can do to take care:

• Stay hydrated by drinking water throughout the day and using a humidifier in dry environments
• Warm up your voice before extended speaking or singing with gentle humming or lip trills
• Avoid shouting or whispering, both of which strain the vocal cords
• Take voice breaks during prolonged speaking to prevent fatigue
• Manage stress through relaxation techniques, as tension affects voice quality
• Treat allergies and sinus problems promptly to reduce postnasal drip
• Maintain good posture to support optimal breathing and voice production