Global Hospital Successfully Performs First Dual Lobe Liver Transplant In Western India

Sister and uncle turn saviors for 31 year old

Mumbai, February 05, 2015: Global Hospitals - one of the fastest growing chain

of tertiary care, multi-super specialty and multi-organ transplant in India, has yet

again achieved a rare feat in liver surgery. The expert team of doctors in Global

Hospital led by Prof. Mohamed Rela and Dr. Ravi Mohanka performed first

ever Dual Lobe Liver Transplant in Western India on a 31 year old male, Mr.

Satish Sonawane who was suffering from End Stage Liver Cirrhosis.

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. 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.

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.

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.”