Unique multi-organ transplant in 8-yr-old conducted successfully

Bengaluru: In a remarkable feat, Apollo Hospitals, Seshadripuram, has successfully conducted a unique combined liver, kidney transplantation in an 8-year-old girl child from Tamil Nadu. This is yet another milestone in the case of Apollo Hospitals which is making a huge mark in successfully completing complex multi-organ transplants in India. This is first case in India where aquadex was used from waynia for simultaneous liver – kidney transplantation, in a critical patient, for preparing her for the operation theatre.

Lakshmi (name changed) was diagnosed with congenital hepatic fibrosis and autosomal recessive polycystic kidney disease. It is a genetic disease that manifested in her at the age of 6. Lakshmi faced severe liver disease complications and kidney failure, leaving her in dire need of a life-saving transplant. Her journey, fraught with obstacles, led to a collaborative effort involving top medical experts across disciplines, ultimately culminating in a miracle.

After meticulous planning and extensive consultations with specialists in Chennai, her family came to Apollo Hospital, Seshadhripuram embarked on a mission to save Lakshmi’s life. Though her mother and father had decided to donate their organs, fate had different plans. Both of them had cross match positivity (which means the organs after transplantation may be rejected if transplanted from either of the parents). But fate intervened, and Lakshmi received the gift of life from a 14-year-old generous organ donor.

Apollo Hospitals, armed with cutting-edge technology and a dedicated team of experts from the departments of Urology, Hepatology and Nephrology successfully executed the unique and complex procedure. The transplantation was carried out on October 2023, and the patient is recovering well.

“We faced a significant challenge during the procedure. Removing her native kidneys and inserting this new kidney posed a unique challenge due to the risk of infection from the cystic native kidneys. Additionally, accommodating a 14-year-old kidney presented spatial constraints, leading us to opt for the left side,” said Dr. Manohar T, Chief of Urology Services, Uro-oncology, and Kidney Transplantation, Laser, Laparoscopic, and Robotic Surgeon. Drawing on his extensive expertise, Dr. Manohar made the crucial decision to proceed with kidney transplantation without native kidney nephrectomy, showcasing his skill and innovative approach to complex surgical scenarios.

Lakshmi’s journey to recovery was not without its hurdles. Battling tense ascites and daunting fluid accumulation, innovative solutions like Aquadex-Aquaresis provided a beacon of hope. Dr. Arun Kumar N’s expertise and the team’s relentless pursuit of excellence ensured that Lakshmi was primed for surgery, defying the odds at every turn.

The Senior Consultant Nephrologist and Transplant Physician, who spearheaded the Aquadex procedure, alongside meticulously managing the immunosuppression protocol for kidney, post, combined, and liver-kidney transplantation, Dr. Arun Kumar N said, “This case exemplifies the excellence of our hospital.

We take great pride in our ability to consistently perform such intricate procedures with exceptional outcomes.”

Dr Sanjay Govil, Sr. Consultant HPG and Multi-Organ Transplantation and his team (Dr. Jayanath Reddy, Sr. Consultant Comprehensive Liver Care, HPB Surgery and Multiorgan Transplant, Dr. Sandeep Satsangi, Consultant Hepatologist and Liver Transplant Physician, Dr. Rajegowda, Sr. Consultant HPB Surgery and Liver Transplantation, Dr. Anindita Mukherjee, Sr. Consultant HPB and Transplant Anaesthesia, Dr. Nagesh P N, Sr. Consultant, HPB and Transplant Anaesthesia) who were involved in doing the liver transplantation surgery remrked, “This is a very unique case that required a combined effort from various experts. We are happy that the hospital’s skilled group of surgeons backed by the ultra-modern facilities, was able to pull this off successfully.”

The Vice President and Unit Head, Apollo Hospitals, Seshadhripuram, Uday Davda said, “This surgery is a proof of the tremendous investments that Apollo has done over the years, pushing the envelope significantly in areas of technology and modern medical infrastructure are concerned.

We have never left any stone unturned in offering our patients world class medical care at all times, and remain committed to retaining the highest standards in surgical care.”

The surgery itself was a marvel of modern medicine, overcoming intricate surgical challenges with precision and skill. From navigating small blood vessels to strategically placing organs, every step was a testament to the expertise and dedication of the Apollo Hospitals team.

The CEO, Karnataka region, Apollo Hospitals, Dr. Manish Mattoo said, “We have witnessed the incredible strength of this young fighter. Her unwavering determination, courage, and resilience in the face of adversity are truly inspiring.

The family was devastated upon learning that both parents were carriers of this disease. This transplantation presented unparalleled challenges, given the child’s size, nutritional status, previous hospitalizations, potential infection risks, and the necessity of lifelong immunosuppressants.”

Lakshmi’s story is more than a medical triumph; it’s a testament to the indomitable spirit of the human heart and the boundless possibilities of modern medicine.

As Apollo Hospitals continues to push the boundaries of medical innovation, Lakshmi’s journey stands as a shining example of hope, resilience, and the extraordinary impact of

compassionate care.