Domino liver transplant at Apollo offers hope to 2 men

CHENNAI: For the fi rst
time in India, a team of surgeons
at Apollo Hospitals
here has successfully performed
a Domino transplant
using a liver with a rare
metabolic disorder called
Familial Amyloid Polyneuropathy
(FAP).
The surgical team was led
by Dr Anand Khakhar, Senior
Consultant, Transplant
and HPB Surgeon, Apollo
Hospitals. An Apollo release
here on Wednesday said the
hospital’s organ transplant
program has performed the
fi rst successful adult domino
liver transplant in the
country.
The procedure, spanning
over 15 hours, was conducted
simultaneously in
three operation theaters led
by four transplant surgeons
Dr Anand K Khakhar, Dr
Anand Ramamurthy, Dr
Mahesh Gopasetty and Dr
Manish Varma.
Dr Khakhar said ‘this extraordinary
procedure allowed
us to use one donated
liver to save two lives. This
procedure is technically
more diffi cult but allows us
to expand the number of patients
who can benefi t from
this life-saving surgery. Person
who was suffering from
FAP, a metabolic disorder.
Patients with this disease
have’.
The fi rst transplant recipient
(A) was a 34-year-old
p a mutation, which leads
to deposition of abnormal
proteins in various tissues
of the body. It manifests as
crippling gait and balance
disorder, bowel and bladder
disturbances among others
and it progresses over time.
The diagnosis was usually
made in the third decade of
life and patients succumb
within 10-15 years of diagnosis
without curative
treatment. “As most of the
abnormal protein is synthesised
in the liver, liver transplant
is a curative option
that enables them to lead
a normal healthy life”, Dr Khakhar said.
The second patient (B) was
suffering from end-stage liver
disease with decompensation.
He was recently listed
for a liver transplant and was
not expected to get a liver
through the waiting list any
time soon.
Liver transplantation was
the only solution for both
patients, Dr Khakhar added.
Dr Anand Ramamurthy
said with three transplant
teams performing simultaneous
surgeries, the patient
(A) with FAP, received a
new liver from a deceased
donor. His liver was then
transplanted or ‘dominoed’
into the second patient (B).
“Even though patient (B)
received a liver with a metabolic
disorder, it will not
impact his health. His body
will be capable of clearing
the amino acids and will
be symptom-free,” he added.
This procedure was a useful
innovation for patients suffering
from end-stage liver
diseases who were awaiting
liver transplantation.
At present, the demand for
livers far outweighs the supply
of deceased donor organs
and about 50 per cent
of patients either succumb
to complications of liver
failure or become too sick to
undergo a liver transplantation
while waiting.