August 12, 2020
BGS Gleneagles Global Hospital, Kengeri, a pioneer of transplants successfully performed Karnataka’s first Swap Liver transplant saving the lives of two patients, suffering from chronic liver ailment. Mr. Pradeep and Mr. Srinivasulu, both middle aged individuals, were admitted to the hospital with the signs of severe liver condition. Post identifying the illness of both the patients and after detecting the unfortunate mismatch of liver between the husband and wife led to the state of predicament. The team of experts decided to go ahead with Swap Liver transplant after taking immediate approvals from the family members to avoid further delay. The timely intervention of the team of Transplant Surgeons, Transplant Anaesthetists & Intensivists and Hepatologists made this surgery successful and possible at the right time.
Today we live in a country with a wide gap between the number of transplants waiting to happen and the availability of organs in India. In most of the cases, it happens due to lack of awareness about Organ Donation. One of the types of living donation is Swap donation. If the living near-relative donor is incompatible to donate his/her organ to their family member, there are provisions for swapping of donors between two such pairs that exists. This implies that there is a mutual agreement between two pairs, and each pair consists of a taker and a giver of an organ.
The first patient, Mr. Pradeep, a 58-year-old person who runs a small business in Calicut, was admitted to the hospital on June 25th in a critical condition. After a few rounds of medical tests, doctors learned that he had high bilirubin levels, abdominal distension and showed tumour in Liver (Hepatocellular Carcinoma). The tumour was quite close to the major blood vessels of liver, indicating his critical health condition. His reports also revealed a clot in the portal vein which made the situation even more sensitive. Further delay in performing transplant would have caused risk of cancer spreading outside the liver as well. With no other alternative, doctors explained the condition to the patient’s family and suggested an immediate liver transplant. Without a second thought, his wife, Ms. Bindu stepped forward to donate her liver; however, post examining her organ, it was revealed that her liver was incompatible for transplant.
In the midst of finding an immediate solution to this problem, another couple in the hospital was going through the same dilemma.
The second patient, Mr. Srinivasulu, a 50-year-old businessman from Madanapalle, Andhra Pradesh, was admitted to the hospital with the similar condition who was also hospitalized on the same day as Mr. Pradeep. After, performing a few tests revealed that he was also suffering from jaundice, abdominal distension and was showing features of Chronic liver disease. No cadaver donations happening due to the current scenario made it difficult for the doctors to perform transplants immediately to save lives.
While studying both the cases, and looking at saving their patients’ lives as their priority, doctors decided to go ahead with Swap Liver Transplantation with approvals from both the families. Mr. Pradeep’s wife, Ms. Bindu donated part of her liver to Mr. Srinivasulu and Ms. Sunitha, wife of Mr. Srinivasulu, gave hers to Mr. Pradeep. All the senior doctors meticulously planned the whole surgery following all the protocols in COVID situation.
Dr Sunil Shenvi, Consultant, Multi-organ Transplant, BGS Gleneagles Global Hospital, said, “The hospital has started the process to form a registry of patients who want to have exchange of organs which will minimize this shortage of organs and increase transplant numbers legally. Already many families have approached for registration for swap transplant to avoid delay in surgeries.”
All four surgeries were performed simultaneously on June 28th and were a bit complex in nature due to the Covid-19 pandemic; hence it was handled with utmost care. Before going through the procedure, both the donors and recipients were kept in quarantine for 2 weeks. Everyone including the doctors, patients, donors and staff involved in the surgeries underwent multiple COVID tests to rule out any risks while performing the surgery as there were lives at stake.
The team of doctors who made this surgery possible and successful includes Dr Venugopal B Pillai (HOD and Senior Consultant, Liver Transplant), Dr Sunil Shenvi (Consultant, Multi-organ Transplant), Dr Karan Kumar (Consultant, Hepatology), Dr Kuttappa (HOD and Senior Consultant, Liver Transplant Anaesthesia), Dr Arun, Dr Sangeeta, Dr Vijay, Dr Mahesh, Dr Chandrakanth (Consultants, Liver Transplant Anaesthesia and Intensive care) and Transplant nursing team.
Dr Kuttappa, HOD, Liver Transplant Anaesthesia, who also serves as Director, Medical Services, BGS Gleneagles Global Hospital said, “Due to the pioneering work done at BGS Gleneagles Global Hospital for more than a decade, patients from other states are coming to our hospital to get the best transplant services.”
Post successful surgeries both the donors were discharged in 10 days and recipients were discharged after 3 weeks. All the patients are doing great on follow up and planning to go back to their native place shortly.
BGS Gleneagles Global Hospitals
Aug 12, 2020
The entire transplant was a success only due to collaborative efforts of the entire team of doctors and staff. Due to the dearth of organs in the current scenario, it has definitely led to a road block; however, the team is well prepared to deal with all the shortfalls.Author,
Dr Venugopal B Pillai, HOD and Senior Consultant, Liver Transplant, BGS Gleneagles Global Hospital
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