By Sachin Murdeshwar

Mumbai: A team headed by Dr Ravi Mohanka & Dr Anurag Shrimal and consisting of more than 50 members successfully carried out a first rare same blood group-swap liver transplant of Western India. Donors Mrs Sharmeen Sheikh and Mr Shreeneel Patne donated a part of their liver to Mr Abhay Patne and Mast Hammad Sheikh, respectively. After the transplant, all four are doing well.

A swap liver transplant is known as the one where a patient’s relative donates his/her organs (like a part of the liver/ or kidney) to another patient in need of the organ. In turn, the latter patient’s relative will also donate organ to the first patient. In this unusual case, a 5-year-old Hammad Sheikh from Mumbai was diagnosed with Progressive Familial Intrahepatic Cholestasis (PFIC-III). It is a disorder that leads to progressive liver disease and ultimately causes liver failure. Likewise, a 67-year-old Indian businessman from Dubai was diagnosed with liver cirrhosis (which can be described as a life-threatening liver condition that causes the scarring on the liver), and liver cancer.  Both these patients were referred to Global Hospital where they got a fresh lease of life.

Dr Ravi Mohanka, Liver Transplant Surgeon at Global Hospital, Parel, Mumbai, said “Mr Abhay Patne needed a timely transplant because of liver cancer. His son Shreeneel wanted to donate his part of the liver to him. To donate to an adult recipient, Shreeneel would have to donate the right lobe of his liver. In that case, the liver which is left in him that is called the future liver remnant (FLR) would be less than 30%. Hence, it wasn’t safe for him to donate the right lobe to his father, but he could safely donate a part of his liver (left lateral lobe, around 20% of total liver volume) to a child without any complications to him.”

Dr Prashantha Rao said “Hence, after discussing with both the families, a swap liver transplant was carried out December 12, 2019. With meticulous planning, all four surgeries were carried out at the same time. A team of more than 50 medical professionals worked together. We started at 6:00 am and continued till 8:00 pm. Both the donors and the recipients responded well and recovered fast. They were discharged within 2 weeks after the transplant.

Dr Anurag Shrimal, Paediatric Liver transplant surgeon at Global Hospital, Mumbai, said“Hammad is suffering from PFIC III and has developed Decompensated Chronic Liver Disease with Ascites (fluid in his belly) and Upper Gastrointestinal bleeding requiring multiple episodes of endoscopy. He needed a timely liver transplant as a life-saving surgery. His father and uncle were unfit to donate their part of the liver. His mother Sharmeen wanted to donate a part of her liver. It wasn’t advisable for her to donate the left lateral lobe to her son as there were three very small arteries supplying the left lateral lobe. It was impossible to join these 3 small arteries with Mast Hammad’s arteries safely. But she could safely donate the right lobe her liver to an adult recipient.

Patient Hammad’s mother Sharmeen Sheikh stated, “It was difficult for me to see Hammad in pain. He developed jaundice and itching. His tummy will rapidly fill up with fluid requiring multiple hospital admissions. He required repeated endoscopies for control of upper gastro intestinal bleed. He stopped gaining weight and wasn’t able to go to school. After transplantation, he is absolutely fine now. We thank Patne family and the doctors from the Global Hospital for their limitless efforts.”

Patient Abhay Patne said, “My world came crashing down when the doctor informed me that I will have to undergo a liver transplant as it was a last resort to save my life. Life was miserable as I suffered from liver cirrhosis and liver cancer. My health deteriorated further, and I couldn’t do my daily activities with ease.  Though my son Shreeneel came forward to donate his part of the liver, it wasn’t suitable for me. I would appreciate Global Hospital for helping me to live life the way I want to, and also the Sheikh family, who volunteered for organ donation.”

“Our hospital is the leading transplant center in Western India with experience of more than 375 liver transplants comprising paediatric and adult cases. This speaks the volume of expertise, multi-specialty approach and proficiency to perform high end transplant cases with ease. Hitherto swap transplants were done for patients having blood incompatibility. However, this case in particular was a challenging surgery as it involved a swap liver transplant between paediatric and adult patient with same blood group, which is extremely rare. This also expands the horizon of treatment possibilities for many patients. Both the recipients were uneventfully discharged from hospital and have resumed their normal life.” concluded Dr Vivek Talaulikar, Chief Executive Officer, Global Hospital, Mumbai.