Ashvin Limbachiya, Ahmedabad.
14 July 2023:
KD Hospital in Ahmedabad became the first healthcare facility in Gujarat to perform
a dual lobe liver transplant on a 44-year-old man. The patient, who had been battling
decompensated liver cirrhosis, non-alcoholic steatohepatitis (NASH), hepatorenal
syndrome* and double vessel coronary artery disease(cardiac condition) received
partial liver donations from his wife and son. To save his life, his wife donated the
right liver lobe, while his son donated the left lateral lobe. Following the surgery, the
patient underwent a smooth recovery without any significant complications.
The patient, who worked as an auto-rickshaw driver, faced numerous challenges due
to his deteriorating health. He struggled with daily work, had a bloated stomach due
to water retention(ascites), experienced swelling in his feet, and had difficulty
breathing, sitting, and standing. Being the sole earner in the family, his illness added
an immense burden. Normally, patients with liver cirrhosis require a liver graft in
proportion to their weight. In the case of this patient, weighing 135kg, a larger liver
graft was required due to his considerable weight, posing a significant challenge in
finding a suitable donor
Although it would have been best to have a cadaver liver transplant, it was too risky
for the patient to wait for a deceased donor’s liver due to the fast worsening of his
kidneys caused by liver disease. Consequently, the liver transplant team at KD
Hospital decided to undertake the complex procedure of dual-lobe liver
transplantation.
The patient’s wife and son selflessly stepped forward to donate a part of their livers,
enabling the surgery to proceed. This act of immense generosity from the patient’s
family played a vital role in making this challenging surgery possible.
Performing a dual lobe liver transplant is an immensely complex procedure,
demanding the expertise of multiple teams comprising skilled surgeons,
anaesthetists, OT nurses, and technicians. The surgery is time-consuming as all three
surgeries are conducted simultaneously. Additionally, the postoperative
immunosuppression for the patient becomes challenging due to the integration of
organs from two separate donors.
A living-donor liver transplant involves surgically removing a portion of the liver from
a healthy living individual and transplanting it into a recipient whose liver is no
longer functioning effectively. The unique regenerative capacity of the liver allows
both the donor’s partial liver and the recipient’s liver to grow and develop into
complete organs.
Dr Divakar Jain, Senior Consultant, Liver Transplantation & HPB Surgeon, says, “The
outcome of a dual lobe liver transplant is generally good. However, the technical
complexity and challenges of this surgery make it a rare surgery.”
Dr Adit Desai, Managing Director of KD Hospital, states, “The dual lobe liver
transplant was a significant milestone for KD Hospital and a testament to our
commitment to pushing boundaries in the field of medical excellence. Liver
transplants are typically reserved as a last option for patients with end-stage liver
disease when all other treatment options have been exhausted.”
*Decompensated liver cirrhosis – an advanced form of cirrhosis where the liver is not able to perform
all its functions adequately.
*Non-alcoholic steatohepatitis, or NASH, is the most severe form of nonalcoholic fatty liver disease
(NAFLD), a condition in which the liver builds up excessive fat deposits.
*Hepatorenal syndrome (HRS) is a multiorgan condition affecting the kidneys and the liver.
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