A multidisciplinary medical team from the Peradeniya Teaching Hospital, the Sirimavo Bandaranaike Specialised Children’s Hospital, and the Faculty of Medicine of the University of Peradeniya has successfully separated a pair of conjoined twins joined at the pelvic girdle, following what doctors described as the world’s first kidney transplant performed between conjoined twins prior to separation.
Consultant Surgeon at the Sirimavo Bandaranaike Specialised Children’s Hospital and Senior Lecturer at the University of Peradeniya, Dr. Mathula Hettiarachchi, said one of the two kidneys in one twin had been surgically removed and transplanted into the other child before the separation surgery, describing it as a first in global medical history.
The twins were born by caesarean section in 2021 to a mother from Mawanella at the Peradeniya Teaching Hospital under the care of Consultant Obstetrician and Gynaecologist Dr. Chaminda Kandauda. The kidney transplant was performed in 2024, and after both children achieved stable kidney function, the separation surgery was carried out on 10 June 2026.
Dr. Hettiarachchi said the twins had remained in the intensive care unit since the operation and were expected to be transferred to a general ward in the coming days.
He noted that Sri Lanka had previously performed only one conjoined twin separation, but said this was the first time anywhere in the world that such a separation had involved removing a kidney from one twin and transplanting it into the other.
He explained that the surgery had been delayed for nearly five years because the children first needed to gain sufficient weight to safely undergo the complex operation under general anaesthesia.
Professor Bandula Samarasinghe, Consultant Surgeon at the Peradeniya Teaching Hospital and the University of Peradeniya’s Department of Surgery, said the hospital’s experience of performing around 200 paediatric kidney transplants had played a vital role in the success of the procedure.
Consultant Anaesthetist and Senior Lecturer Dr. Ashani Rathnayake said the twins were kept under anaesthesia for approximately 14 hours, from 7 a.m. to 9 p.m. She said maintaining the normal function of their hearts, lungs, circulatory systems, and brains throughout the lengthy operation had been critical to its success.
She added that safely reviving the children after such prolonged anaesthesia required close coordination among doctors, nurses, and the entire surgical team.
Consultant Orthopaedic Surgeon Dr. Akalanka Jayasinghe said the twins were joined by an unusually positioned pelvic girdle, with their legs crossing each other at a 90-degree angle relative to their heads. He said separating the children while preserving the nerves and blood supply to their legs had been one of the most technically demanding aspects of the operation.
The surgery involved a team of 30 healthcare professionals, including 15 consultant specialists. Dr. Hettiarachchi said the twins were recovering well but would require several additional reconstructive surgeries in the future.
Dean of the Faculty of Medicine, University of Peradeniya, Prof. Saman Nanayakkara, Deputy Director of the Peradeniya Teaching Hospital Dr. Senaka Navaneliya, and Consultant Anaesthetist Dr. Kavisha Dissanayake also addressed the media on the achievement.
