First successful combined liver and kidney transplant in India during pandemic
Delhi to Chennai, a journey from despair to hope
Hyderabad: Gleneagles Global Health City (GGHC), a leading multi-organ transplant centre in Asia successfully performed India’s first liver and kidney transplant during the Covid-19 pandemic with help from two live donors.
35-year-old patient was airlifted to GGHC from Delhi with a medical history of a renal failure & chronic liver problem (fatty liver) which necessitated an urgent need for kidney & liver transplant. During his treatment at a hospital facility in New Delhi, the doctors decided to defer the transplant surgery due to patient’s health condition as he was also suffering from cardiac shock and low BP. However, the family was apprehensive and contacted GGHC’s liver transplant team for a second opinion and decided to get medical treatment at GGHC, Chennai. The entire transit process from Delhi to Chennai was seamlessly co-ordinated as it was highly challenging since the patient had multiple complications and was also obese (130 kgs).
Upon arrival at GGHC, the patient was in an unconscious state with low BP and had to be kept on dialysis. The medical team at GGHC examined him and observed fungal growth in his blood along with other multiple complications and he was therefore admitted in the specialized liver ICU unit for 2 weeks and was provided with necessary supportive medical care including anti-fungal treatment and 24/7 dialysis for 3-4 days. Meanwhile, a complete medical evaluation was carried out on the patient’s wife and sister to assess their viability for being the liver donor and kidney donor respectively.
Speaking about the success of the surgery - Dr Joy Varghese, Director - Hepatology & Transplant Hepatology, Gleneagles Global Health City said “The combined live donor liver & kidney transplant surgery which involved a team of liver, renal and critical care specialists went on for more than 14 hours. After the successful dual organ transplant surgery, patient regained consciousness and later came to know from his family about being airlifted to Chennai and his treatment at GGHC. Patient was discharged from the hospital on the 16th day post surgery. Patient as well as his sister and wife are hale & healthy.”
“This type of complicated surgery was possible only because of dedicated multidisciplinary approach of the hospital. I would like to thank the patient for being very positive and brave. My special thanks to his wife and sister for their strong will and motivation to save the patient and also trusting us. This case gives a good insight into our culture and great family values in our country and ‘never give up’ attitude by near & dear ones” - stated Dr Rajanikanth Patcha, Clinical Lead - Liver Transplant Surgery, Gleneagles Global Health City.
“We leveraged advanced cardiac output monitoring to improve patient’s blood pressure and removed close to 20 litres of excess fluid from his body. A dedicated team of critical care specialists and nurses made sure that the patient and both the donors remained safe from COVID infection”, said Dr Selvakumar Malleeswaran, Head of Liver ICU – Gleneagles Global Health City.
“We were confronted with many challenges in performing the living donor renal transplant during the pandemic. Both the patient and donor were obese, highest level of infection control measures had to be implemented and there was a need for continuous coordination among multiple consultants, technicians, paramedics & support staff. We faced a big challenge in performing dialysis for the patient with such low BP and had to perform ‘Continuous Renal Replacement Therapy’ before & during the surgery. Taking the best possible pre-surgical precautions, we could do keyhole kidney retrieval from the renal donor and successfully transplant the same into the recipient. In-spite of many odds, kidney started producing urine immediately after implantation. The positivity of the donors and recipient aided in their quick and smooth recovery” – added Dr K Muruganandham, Senior Consultant – Urology and Renal Transplantation Surgeon & Dr P Muthukumar, Senior Consultant – Nephrology & Renal Transplant Physician, Gleneagles Global Health City.
Congratulating the team on the success, Dr Alok Khullar, CEO – Gleneagles Global Health City, Chennai, said “The determination of both donors and their iron strong resolve supported by the extended family to save the life of their loved one were instrumental in motivating the entire team of GGHC to give their best quality care. The multi-disciplinary approach coupled with technical expertise helped us to ensure the success of the surgery despite various challenges. This successful outcome is bound to give hope to many patients with debilitating conditions and complications and help them live healthier lives.”
The pioneering transplant was led by Dr Joy Varghese, Director - Hepatology & Transplant Hepatology, Dr Rajanikanth Patcha, Clinical Lead - Liver Transplant Surgery, Gleneagles Global Health City, Dr Selvakumar Malleeswaran, Head of Liver ICU, Dr K Muruganandham, Senior Consultant – Urology and Renal Transplantation Surgeon & Dr P Muthukumar, Senior Consultant – Nephrology & Renal Transplant Physician.