Delhi: Incompatible liver transplant saves Afghan national

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Rohit Shishodia

Doctors at Delhi’s Manipal Hospitals managed to save the life of 63-year-old Afghan national by successfully performing ABO incompatible liver surgery. The ABO incompatible transplant

surgery takes place in cases when the organ donor and organ recipient have different blood groups.

This is the first time when such a surgery has been carried out by doctors at the Manipal Hospitals.

According to the hospital, the patient was suffering from liver failure because of Hepatitis B and had recently come to India for his surgery.

The procedure requires extensive advance preparations – a month before the final surgery – to avoid Antibody Mediated Rejection (AMR) risk.

This includes three rounds of procedures to achieve the target antibody levels. In the first round, the patient is given anti-CD20 to suppress antibody producing plasma cells. The second stage includes neutralizing of remaining antibodies and in the third stage plasma filtration is done to remove antibodies from the patient’s body. After achieving the target levels, the transplant takes place.

After thorough examination, Dr Shailendra Lalwani, HOD, Liver Transplantation and Hepato-Pancreatic Biliary Surgery, Manipal Hospitals, suggested ABO incompatible transplant where his son was the donor.

Intensive treatment for removal of antibodies was done before surgery to minimise the risk of rejection. The surgery was uneventful and the patient was discharged on July 5, 2021. Due to the intensive nature of the case Dr Lalwani and his team meticulously planned and cautiously executed the surgery.

Dr Lalwani pointed out that the ABO incompatible liver transplant surgery is a complicated procedure which requires medical expertise, infrastructure, good post-operative care and an infection-free environment. Since the patient did not have a matching blood group donor in his family, we opted for this procedure, he added.

“The need for a transplant is decided by the extent of damage and how badly the liver is diseased. We are happy to announce that the 12-hour surgery concluded successfully, and the patient is getting better every day," said Dr Lalwani.

“While it takes three weeks for recovery after this procedure, our patient recovered in just two weeks, and was discharged in only a few weeks,” he explained.

Samad, the patient’s son, said, “My father is the reason I have lived a healthy life. And, on the occasion of Father’s Day, I could not think of a better present than sharing a part of myself with him in gratitude. I am also thankful to the liver transplantation team at Manipal Hospitals for looking after my father and helping him with a speedy recovery.”

 Mr Raman Bhaskar, Hospital Director, said, “Armed with the correct knowledge and expertise, technology and infrastructure makes way for medical breakthroughs. This case was extremely tricky and required an experienced hand.”

“We were only able to save the patient because of the skill and proficiency displayed by Dr Shailendra Lalwani and his team. At Manipal Hospitals, we have piloted several complex surgeries in the past, and we are happy to have successfully given another patient a new lease of life,” added Dr Bhaskar.


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