SUCCESSFUL SIMULTANEOUS SWAP LIVER TRANSPLANATION SURGERY ON TWO ADULTS.

Two Sri Lankan Donors’ livers swapped to save lives of their respective Liver transplant patients in the family.

• Simultaneously four surgeries performed on two donors & two recipients
• Innovative surgical procedure to significantly address acute shortage of organs and pave way to save more lives.

7-6-2011, Chennai: 

The Liver Transplantation Team at Global Hospitals, which is acknowledged as the world’s most comprehensive centre for Liver & Pancreas diseases and transplantation, performed the Country’s first Living Donor simultaneous Liver "SWAP" Transplantation surgery on two adults. In this unique procedure, two families with donors whose organs were incompatible for the patients in their respective families have exchanged their organs for transplantation under a “Paired Donation Program”. This surgical procedure is by far the most complex and comprehensive exercise where simultaneously four surgeries were performed, on two liver donors and two liver recipients. Prof. Mohamed Rela, world’s foremost liver transplant surgeon and Director HPB & Liver Transplantation at Global Hospitals Group along with a team over 50 members comprising of Surgeons, Hepatologists, Intensivists, skilled technicians & support staff performed this over 16 hour non-stop surgical marathon successfully. The complex procedures were performed simultaneously in four different operation theatres supported with three Surgeons per theatre, Physicians, anaesthesiologists, technicians, support staff along with blood bank and other support systems functioning in complete synchrony. 

The successful SWAP Liver Transplantation procedure performed on two adults  addresses the acute shortage of organs and helps in optimising the small pool of living donors who want to donate a part of their liver to a family member but cannot do so due to issues such as incompatible blood types and other medical suitability issues.  

Mr. Mohamad Nazeem, 50 year old male from Kandy, Srilanka was diagnosed to have cirrhosis of liver due to an unknown cause (Cryptogenic) few months ago and was referred to Global Hospitals & Health city, Chennai for liver transplantation. His family members were willing to donate part of their liver but unfortunately they were either medically not suitable or their blood group did not match that of the patient. His wife was medically suitable but had an incompatible blood group.

At the same time Mr. Mohamed Nazir, 48yrs old from Kandy, Srilanka too was diagnosed to have chronic liver disease and was advised to go to Global Hospitals & Healthcity, Chennai for further treatment. After a complete evaluation, the Hepatologists at Global Hospitals & Health city diagnosed him as a case of end stage liver disease, secondary to hepatitis C and advised him to undergo liver transplantation. 
Mr. Nazir’s son came forward to donate a part of his liver to his father, but blood groups were not matching.

Both families were at an “end of the road” situation, not able find suitable living related donors. This unfortunate situation of the families triggered the innovative thinking of the Liver Transplantation Team, headed by Prof. Mohamed Rela. The Team gave a ray of hope to the families by suggesting a SWAP Liver Transplantation option to them. Interestingly the organ suitability between these families’ donors and recipients was found to be appropriate if organs were to be swapped.

SWAP liver transplantation / Paired liver transplantation is a procedure in which a family member of a liver transplant patient who is not compatible as a donor exchanges organs with another incompatible pair. The liver transplantation team suggested this option to these families and explained in detail to both the donors and recipients involved on the implications, outcomes and complications of the procedure. The open minded families understood the concept well and immediately opted for this procedure.

Having made the decision, the Liver Transplantation Team at Global Hospitals & Healthcity, was faced with the most important task in SWAP transplantation – EXECUTION. The unique aspect of swap transplant is, to perform the transplants simultaneously. The planning of logistics, availability of infrastructure and expertise of the transplant team is vital to the successful execution of 2 simultaneous Living donor Liver transplantations, in effect 4 surgeries.

The Liver transplant of Mr.Nazeer from Mr.Nazim’s wife as donor and that of Mr.Nazim, with Mr.Nazeer’s son as donor was performed in 16 hours with almost 55% - 60% of the liver taken from the donors and successfully transplanted into the recipients. The donors and recipients recovered quickly, the donors were discharged in about a week and the recipients in 2 to 3 weeks.  They are currently one month post Liver transplant and are doing well.

The vast experience of Prof. Mohamed Rela, world renowned liver transplant surgeon and his team of 5 dedicated transplant surgeons, anaesthetists, support staffs and world class infrastructure of the hospital have made this SWAP liver Transplantation a successful one.

Speaking on this occasion Prof. Mohamed Rela said, “The burden of liver disease in the country and ofpatients needing liver transplantation is very high; on the other hand, there is a huge shortage of organs. The option of cadaveric transplantation, which is available in western countries, is also limited in India. In such situations, it becomes important to think of innovative ways to optimise the scarce resource of living donors”.

Dr. K. Ravindranath, Chairman & Managing Director, Global Hospitals Group said, “At Global Hospitals, we are completely committed to delivering medical services of the highest quality. This complex surgical exercise is a testimony for highly skilled consultants, technical staff and technology working perfectly with enormous dedication and team work. Through cutting edge clinical solutions, research, extraordinary patient care and infrastructure of world class standards, we are certain, concerns around human suffering on complex and end-stage diseases will be significantly addressed. Every step of ours has always been on this direction.”