The transplant team from Apollo Chennai performed a complex triple-transplant, harvesting 3 organs – pancreas, liver and small intestine – at once. The high-risk operation was performed in Sri Ramachandra Hospital, Chennai.
Although the surgeons have carried out complex liver transplants, they have done just one pancreatic transplant in the past, and no intestinal transplant. “Transplanting pancreas and intestines is very rare, and the combination makes it more complex . Intestine transplant has high failure rates. One surgery in Chennai had failed,” said a transplant surgeon. The surgeons could not speak in detail after the 12-hour transplant, but said they used refined techniques, effective immunosuppressive drugs and had better quality donor organs this time.
Although similar operations have been carried out in the past, the magnitude of risk and precision involved in this case was unprecedented. More than a decade back, transplant specialist Dr Shanmugha Bhaskar performed a bowel transplant at Madras Medical Mission. However the operation could not be a success. In November 2012, Delhi-based Medanta Hospital did a small intestine transplant on a 30-year-old patient. “This is the first time we are doing a small intestine transplant, and we have combined it with two other organs,” the surgeon said.
In most cases if intestinal failure, patients develop nutrition related complications. This was avoided as doctors performing the surgery first ensured the patient was fit for surgery. While the patient was being prepped for surgery, another team procured the harvested organs and rushed them to Sri Ramachandra Hospital. For the 12 ensuing hours, the team transplanted the liver, small intestine and pancreas into the patient. The patient is currently isolated in ICU observation and recovering well.
However, doctors are still skeptical about terming the transplant a success. “Post-operative care is the most difficult part in a cluster organ transplant. The recipient’s system may reject the organs or the patient may develop infection,” said liver transplant surgeon Dr R Surendran of MIOT Hospitals. The patient will be kept on high doses of immunesuppressive drugs to ensure that his body does not reject the new organs. This in turn increases chances of infection. “A sterile environment in post transplant medication and round-the-clock care is needed,” he added.