Single donor enables doctors at private hospital to perform two ‘novel’ transplants

Asia’s first combined bowel and abdominal wall transplant surgery performed on a teenager; 35-year-old woman gets new lease of life

12/03/2020, SPECIAL CORRESPONDENT,CHENNAI

Doctors at the Apollo Hospitals have claimed that they have performed Asia’s first combined bowel and abdominal wall transplant surgery on a teenager.

An 18-year-old brain-dead donor gave a new lease of life to two patients — a teenager with ultra short bowel syndrome and a 35-year-old woman on dialysis for end-stage renal disease — and enabled doctors to perform two “novel” transplants on them.

The teenager underwent combined small bowel and abdominal wall transplant.

The woman with a renal disease received a kidney that was perfused with Hypothermic Oxygenated Machine Perfusion (HOPE) at the Apollo Hospitals.

Lack of awareness

J. Shyamala, paediatrician, said that only a few bowel transplants were performed in the country — the reasons being lack of awareness among recipients, reluctance to donate abdominal wall and small bowel, need for a high level of preparedness, intensive care, pre and post-operative care.

“The 17-year-boy from Andhra Pradesh had extensive small bowel gangrene and underwent complete removal of the small bowel. He had lost 20 kg over two months, and came to us in March 2019. We put him under aggressive nutrition rehabilitation. He gained 18 kg in eight months and returned home,” she told reporters on Wednesday.

The patient had two episodes of central-line infection and Total Parental Nutrition-induced liver injury.

“Eleven months after his first admission, he underwent combined small bowel-abdominal wall transplant and was discharged on the 15th post-operative day. He is gradually gaining weight,” she said.

Doctors said that intestinal transplants were taking baby steps in India and that it still had a long way to go.

The kidney harvested from the donor was perfused with HOPE and preserved for 11 hours.

Graft function

Explaining this, Mohan Kumar, urologist, said: “It improved graft function, increased utilisation and reduces rejection.”

Venkatesh Rajkumar, nephrologist, said that kidney diseases were increasing in the community and kidney failure patients requiring transplants were 20-25 per lakh population.

Suneeta Reddy, managing director, Apollo Hospitals Group, spoke at the event.