First combined liver, kidney transplant done with live donors during COVID-19 pandemic

Chennai: Amid the continuing COIVD-19 pandemic,experts at the Gleneagles Global Health City (GGHC) here has successfully performed India's first liver and kidney transplant with the help from two live donors on an obese patient with multiple complications who was airlifted from New Delhi.

Talking to reporters on Wednesday, Hospital Director, Hepatologyand Transplant Hepatology Dr Joy Varghese said the 35-year-old patient, Mittal was airlifted from Delhi with a medical history of renal failure and chronic liver problem (fatty liver) which necessitated an urgent kidney and liver transplant. 

During his treatment at a hospital in New Delhi, the doctors decided to defer the transplant taking into account the patient's health condition as he was also suffering from cardiac shock and low BP. 

However, the family was apprehensive and contacted GGHC's liver transplant team for a second opinion and decided to get treated in Chennai.  The entire transit process from Delhi to Chennai was seamlessly co-ordinated as it was highly challenging since the patient had 

multiple complications and was also obese (130 kgs), he said.

The patient was unconscious upon arrival at GGHC with low BP and had put on dialysis. The medical team observed fungal growth in his blood along with other multiple complications and was admitted in the specialized liver ICU unit for two weeks and was provided with necessary supportive medical care, including anti-fungal treatment and 24/7 dialysis for 3-4 days. 

Meanwhile, a complete medical evaluation was carried out on the patient's wife and sister to assess their viability for being the liver and kidney donors respectively.The combined live donor liver and kidney transplant which involved a team of critical care specialists lasted more than 14 hours. 

After the successful dual organ transplant, the patient regained consciousness and was informed that he was airlifted to Chennai and the treatment at GGHC. Mittal was discharged from the hospital after 16 days of surgery and all the three, including the patient and the donors were hale and healthy.

"We leveraged advanced cardiac output monitoring to improve patient's blood pressure and removed close to 20 litres of excess fluid from his body. 

A dedicated team of critical care specialists and nurses made sure that the patient and the donors remained safe from COVID infection", Dr Selvakumar Malleeswaran, Head of Liver ICU, said. 

"We were confronted with many challenges in performing the transplants during the pandemic. Both the patient and donor were obese, highest level of infection control measures had to be implemented and there was a need for continuous coordination among multiple consultants, technicians, paramedics and support staff", doctors said. 

''We faced a big challenge in performing dialysis for the patient with such low BP and 

had to perform 'Continuous Renal Replacement Therapy' before and during the surgery. 

''Taking the best possible pre-surgical precautions, we could do keyhole kidney retrieval 

from the renal donor and successfully transplanted the same into the recipient'' the doctors 

said.(UNI)