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Wednesday, February 25, 2009

Unique liver transplant in Delhi

Twenty specialists helped in 16-hour operation at Sir Ganga Ram Hospital

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Shourya Verma, with Dr. A. S. Soin (left), and Siya Thakur, with Sir Ganga Ram Hospital’s chief paediatric hepatologist Dr. Neelam Mohan, during a press conference in the Capital on Thursday to announce the country’s first-ever domino liver transplant.

NEW DELHI: Doctors at Sir Ganga Ram Hospital here have performed a domino liver transplant, a unique procedure in which two life-saving liver transplants are performed using one donor liver.

While 22-month-old Shourya was cured of maple syrup urine diseases (MSUD) by a transplant performed using 20 per cent of his aunt’s liver, his own liver was in turn transplanted into two-year-old Siya, who was battling terminal liver failure due to rare condition called langerhan’s cell histiocytosis. It is due to the sequential nature of the transplants that the domino transplant is so named.

Hospital chairman B.K. Rao said: “Twenty specialists helped in performing this marathon 16-hour-long operation on January 31. Domino transplants are rare because there are very few conditions in which you can cure the patient with a transplant and then transplant his or her organ into someone else without passing on the disease and MSUD is one such disease.”

MSUD is caused by lack of an enzyme and a patient with MSUD who receives a liver transplant is able to make enough of the enzyme in the new liver to overcome the shortage elsewhere in the body. In turn, an MSUD patient’s liver which is otherwise entirely normal, can be transplanted into another person without passing on the disease, because that patient’s other cells still make the enzyme lacking in the liver.

For the surgery, the team at Sir Ganga Ram Hospital was divided into three units and it prepared the donor liver, Shourya’s own liver and Siya’s diseased liver for removal sequentially in three separate operating theatres. First the donor liver and then Shourya’s own liver were removed and prepared on the bench for transplantation by re-constructing the vital blood vessels with complex vein grafts. Shourya was transplanted first and then his liver was transplanted into Siya.

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