Written By: Debjani Arora | Published : February 7, 2015 12:02 PM IST
In a first of its kind surgery, a man was given a new lease of life by two donors to undergo dual lobe liver transplant which was performed on the 31 year old male who was suffering from end stage liver cirrhosis. The surgery was conducted by Prof. Mohamed Rela and Dr Ravi Mohanka at the Global Hospital, Mumbai.
The background
The 31 year old Mr Sonawane, a resident of Jalgaon, was admitted at Global Hospitals with swollen feet and fluid accumulated in the abdomen and around the lungs. Also, he was breathless and had persistent cough. His tests revealed that he had advanced liver cirrhosis with a very high bilirubin and high risk of bleeding. He was advised liver transplant for which he underwent tests, was found to be suitable and was listed for a cadaveric liver transplant. Here are five foods that can prevent liver diseases.
However, his liver disease was worsening and waiting for a cadaveric liver transplant did not seem to be a feasible option. He was therefore advised a living donor transplant with one of the family members donating part of their liver for his transplant. Since he was overweight, he needed a large liver for a successful transplant. He lost weight from 95 to 80 kgs for the operation. Here are few reasons why you should take unexpected weight loss seriously.
Searching for a donor
Two family members, his sister, 29 and uncle, 48, underwent tests for liver donation, but both of them were found to have a small liver for his requirement, despite his reduced weight, and therefore were not suitable as donors for his transplant and therefore waiting for a cadaveric transplant seemed to be the only option.
Meanwhile, on serial follow-up, he was found to repeatedly accumulate fluid in his lungs which made him breathless and required oxygen for even daily activities and his clotting abilities were severely impaired which put him at high risk for serious bleeding in the internal organs. He was hospitalized for almost 2 months prior to his surgery because it was unsafe for him to go to his hometown.
He was therefore advised a dual lobe transplant, which is like doing 2 liver transplants on one patient where both donors would donate part of their livers for his transplant and he would get enough liver for a successful transplant.
What is a dual lobe transplant? How is it done?
All the three surgeries were done in three different operation theatres simultaneously involving 9 surgeons, 5 anesthetists and 20 operation room staff. The surgery of the patient lasted for 15 hours starting from 6 am in the morning. It involved removing his old liver which was severely diseased and transplanting 2 liver lobes, the right lobe harvested from his sister on the right side and the part of left lobe taken from his uncle on the left side and joining all the blood vessels and bile ducts to his own blood vessels and bile duct. Repeated ultrasounds were performed during the surgery to make sure that all the tiny vessels had good blood flow in them. He received 6 units of blood for the operation and none of the donors required any blood products.
Both the donors remained in the ICU for 1 day and 5 7 days in the hospital. The recipient was weaned off the ventilator the next day in the ICU, was shifted to the ward out of ICU on 5th day and was discharged 15 days after transplant with a well functioning liver.
Prof. Mohamed Rela, Group Director, Institute of Liver Diseases Hepato-Pancreato-Biliary Surgery and Transplantation, Global Hospitals, said, Dual lobe liver transplant is a complex procedure which requires two donors with healthy functioning livers and one recipient. The entire Global Hospitals group has successfully completed over 900 liver transplants, out of which this is the first of its kind in Western India.
Dr. Samir Shah, Head of Department of Hepatology, Liver Intensive Care & Transplant Hepatology, Global Hospital, Mumbai, added, Cirrhosis is the last stage of chronic progressive liver disease. It not only causes portal hypertension, nutritional deficiency, jaundice but also prevents the liver from functioning normally. Hepatitis infection and alcoholism are some of the major causes for this condition; however it can also be caused by other illnesses.
Dr. Ravi Mohanka, Chief Surgeon and Head of Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Global Hospital, Mumbai, said, In cases like these where the small size of the donor s liver becomes a challenge, the technique of dual lobe liver transplant is quite useful. The success of this procedure is a breakthrough, for many more patients with liver failure can be offered a life saving transplant in the future.
Image Courtesy: Getty images
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