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Innovative Split Cadaver Liver Transplantation Saves Two Lives

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Mumbai: A split cadaver liver donation surgery resulted in saving the lives of two persons at the Jaslok Hospital on Monday. The two patients were suffering from end-stage liver disease (liver cirrhosis).

The decision to donate the organs was taken by the family of a 54-year-old man who was suffering from an irreversible brain stroke and was declared dead on August 6 at Jaslok Hospital. The family did not wish to identify him. Doctors at Jaslok Hospital extensively evaluated the medical condition of brain dead patient, and after a little hesitation, the deceased brother and wife  consented to donate his organs, including the heart, lungs, liver, and kidneys thus paving the way for the life-saving surgeries.

For the liver transplant recipients, Jaslok Hospital identified a 45-year-old male with cirrhosis who had been awaiting a suitable organ for three months and a seven-year-old critically ill child at  Wadia Children’s Hospital at Parel who urgently needed a liver transplant to survive acute liver failure.

Challenging procedure

The surgical team led by Dr A.S. Soin, director, Liver Transplant Programme at Jaslok Hospital, undertook the challenging procedure of splitting the liver into two functional lobes. The larger right lobe was transplanted into the adult recipient , while the smaller left lobe was meticulously transported to Wadia Hospital and transplanted into the pediatric recipient.

Dr Soin said while technically demanding, the Split Cadaver Liver transplantation is a testament to the expertise of their surgical team and the collaboration among various medical specialists. With the successful execution of this procedure, they hope to encourage further adoption of this practice across the country to benefit patients in need.

“The Split Cadaver Liver transplantation technique has effectively expanded the donor pool and provides hope to patients on waiting lists. In India, this technique remains relatively uncommon, but Jaslok Hospital’s successful implementation marks a significant step towards addressing the organ shortage,” he said.

Liver transplant

A liver transplant is a last resort for people who have end-stage chronic liver disease, cirrhosis, liver failure, acute and chronic hepatitis, Biliary Atresia (a rare disease of the liver and bile ducts that occurs in infants), Budd-Chiari (a rare syndrome characterized by narrowing and obstruction (occlusion) of the veins of the liver (hepatic veins), metabolic diseases, liver cancer, bile duct cancer, hepatoblastoma and Non-Alcoholic Steatohepatitis (NASH) that is a fatty liver disease involving liver inflammation and scarring which can lead to cirrhosis.

Dr Aabha Nagral, Director Gastroenterology, Hepatologist and Liver Transplant Physician at Jaslok Hospital and Research Centre said, “Through the innovative technique of Split Cadaver Liver donation, they were able to transform tragedy into hope. The success of this procedure underscores the importance of a skilled surgical team and seamless coordination among medical professionals.

“Apart from it being a logistically and technically challenging undertaking, accomplishing a successful liver split requires surgical skill and expertise, a lot of which is gained from experience in complex hepatobiliary surgery and living donor liver transplantation,” she said.

Profound impact of organ donation

Dr Pravin Agrawal, Sr Consultant Liver Transplant & HPB Surgery at Jaslok Hospital and Research Centre, said that this case highlights the profound impact of organ donation and reminds us of the importance of spreading awareness about this noble cause. Both adult and paediatric recipients are currently in stable condition and on their way to recovery. However, the aim is of course to be able to obtain and successfully transplant two grafts (partial liver grafts) in two different recipients who are in dire need of a lifesaving liver transplant. 

“We in Mumbai have the expertise to split livers, and this will benefit not only two patients but also children who otherwise so far could get their transplants only from living donor. This landmark procedure underscores the potential of innovative medical solutions to bridge the gap between organ demand and supply, offering renewed hope for patients awaiting life-saving transplants,” he concluded. 

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Published on: Tuesday, September 12, 2023, 02:07 AM IST

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