MGM Healthcare, a leading quaternary care super-specialty hospital announced a rare feat by successfully carrying out a living donor liver transplant on a 45- year-old patient overcoming the challenge of the blood group incompatibility. The 12hr long procedure was led by Dr Thiagarajan Srinivasan, and his team of transplant specialists including Dr Karthik Mathivanan & Lead Anaesthetists Dr Dinesh and Dr Nivash.
ABO incompatibility between a donor and a recipient is generally considered a barrier to kidney or liver transplant. The doctors at MGM Healthcare by employing a new technology in the form of using a highly selective blood group antibody absorption device (glycosorb) in a series of four patients. The patient Unnikrishnan from Kerala had developed chronic liver failure was waiting for a liver transplant for more than three years after visiting several hospitals in India. With a huge demand supply mismatch Unnikrishnan was not able to get a suitable cadaveric organ and further to his dismay there was no blood group compatible living donor in his family.
Dr Thiagarajan Srinivasan, Director institute of liver transplant and HPB surgery who headed the multidisciplinary team of doctors at MGM Healthcare said, “This opens hope for the many who have been waiting for transplants and is also paving way for faster recovery. Our team had a cumulative experience of more than 40 such liver transplants across blood groups but there were multiple challenges in the form of increased infections and rejections. But after employing the new technology in the form of using a highly selective blood group antibody absorption device glycosorb the results were excellent.
He further said the facilities and resources required for performing these complex protocols are not commonly available even in best of centres and can be only performed in advanced centres where specialized liver specialties are available.
Explaining the procedure, Dr Thiagarajan said first we stop the production of new blood group antibodies by rituximab and removal of existing blood group antibodies with the glycosorb filter and using specialized induction agent(basiliximab) and living donor liver transplant is performed with a blood group incompatible donor and successfully followed up lifelong.
Dr Karthik Mathivanan, Senior Consultant & Associate Director Institute of Liver Transplant & HPB Surgery said, “Liver Transplantation is the best and only option for a patient who is diagnosed with either end-stage liver cirrhosis or cancer. Unfortunately, there is a huge divide between the demand for donor liver and liver donation so we face a shortage of organs. Yet, with advancements in the field, transplantation using ABO-incompatible (ABOi) grafts – is an alternate strategy for increasing donor availability.”
“At MGM Healthcare, Chennai, the Institute of Liver diseases, Transplant and HPB Team has so far performed 4 ABOi Liver transplants successfully using the new technology within 1 yr. ABOi transplants are not just for the liver but for kidneys too. ABOi transplantation has become possible in Chennai now and it is affordable to people from all walks of life.” He further added.
Lead Anaesthetists Dr Dinesh and Dr Nivash said, “Anaesthesia risks are high in live liver transplant. But having a carefully coordinated plan with innovative solutions for complex problems and optimising the patient well before and during surgery has helped in the successful outcome.”
Harish Manian, CEO MGM Healthcare said, “The recent advancements in technology have led to successful outcomes in the field of transplant surgery with ABO incompatibility. MGM Healthcare is proud to have adopted such techniques coupled with clinical expertise of renowned doctors who perform such feat of cutting-edge surgeries with a cost assurance programme from us. MGM Healthcare by employing a new cutting edge technology in the form using a highly selective blood group antibody absorption device will continue to render more quality healthcare services at MGM Healthcare”.
