Fortis Escorts, Okhla, conducts first auto liver transplantation in North India – ET HealthWorld
New Delhi: For the first time in North India, doctors at Fortis Escorts, Okhla, New Delhi successfully conducted a challenging auto liver transplant, on a 35-year-old female patient from Kyrgyzstan.
Auto liver transplantation is considered one of the standard treatments for treating end-stage liver disease, it can only be performed in patients that have a sufficient percentage of a normal healthy liver. Speaking exclusively with ETHealthworld, Dr Vivek Vij, Chairman-Liver Transplant, Fortis Escorts, Okhla, New Delhi explained how the surgery is performed and the complications associated with it.
The team of doctors was led by Dr Vij who performed this complex transplant wherein the surgery took eight hours. The patient was discharged on the eighth-day post-surgery. The patient was suffering from abdominal pain for the past three months.
The patient was initially evaluated in Kyrgyzstan and was diagnosed with a parasitic infection – Echinococcosis Multilocularis, which suggests a slow-growing liver tumour with subsequent damage to the liver; 75 per cent of the liver was damaged. In such cases, a liver transplant remains the only treatment option. At Fortis Escorts, Okhla, a CT scan was done which confirmed the presence of the infection and showed acute liver failure. Given the extensive damage caused to the liver and surrounding organs, the doctors decided to conduct an auto-liver transplant.
Explaining the procedure Dr Vij said, “If the whole process of transplantation is done inside the patient’s body (the whole process is called liver resection) but the chances of bleeding are more. Hence to avoid this, the liver is removed from the body and divided into two parts where the diseased part of the liver is removed, and the rest is preserved in a solution. The damaged veins are then reconstructed or replaced with artificial veins, and finally, the liver is re-implanted into the patient’s body.”
“The removal of the diseased part can be challenging as the liver was stuck with surrounding vital structures and there was a risk of injury to vital organs along with complications and bleeding. Utilising a part of the patient’s liver is a boon as immunosuppressive medicines are not required,” he further added.
In normal transplantation, because the patient receives the organ from a foreign body (either from a dead or a living donor) the patient has to be on lifelong medication. But in the case of an auto liver transplant, this can be avoided.
Dr Vij also explained that auto liver transplant cannot be performed on every patient. For that one part of the liver should be normal and in sufficient amounts. It does not follow the criteria for every patient. This can be performed on patients who have any form of cancer in their liver, or in case of any infection that involves blood vessels and the liver. Auto liver transplant can also be beneficial to someone whose liver is normal but they have colon cancer and by any chance that cancer spreads in the liver, then in such cases also auto liver transplant can be performed.
Bidesh Chandra Paul, Zonal Director, Fortis Escorts, Okhla, New Delhi said, “This is the second case of auto liver transplant performed in India as this transplant needs a lot of experience and expertise. This was a very challenging case considering the risk factors associated with it. However, the team of doctors led by Dr Vivek Vij assessed all parameters and conducted the procedure well.”
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