When a transplant team from India’s leading Hospitals walked into another leading Hospital in the early hours of Friday to harvest three abdominal organs — liver, pancreas and small intestine — for transplant, they had little medical literature on what was a complex transplant within the country. But they seemed confident.
Although the surgeons have carried out complex liver transplants, they have done just one pancreatic transplant in the past, and no intestinal transplant. Transplanting pancreas and intestines is very rare, and the combination makes it more complex. Intestine transplant has high failure rates. One surgery had once failed. The surgeons could not speak in detail after the 12-hour transplant, but said they used refined techniques, effective immunosuppressive drugs and had better quality donor organs this time.
In the 2000s, one of transplant surgeon had performed a bowel transplant with organs harvested from a brain-dead patient, but the patient died. There were no attempts at bowel transplant in the state after that. In November 2012, Delhi-based leading Hospital did a small intestine transplant on a 30-year-old patient. This is the first time they are doing a small intestine transplant, and they have combined it with two other organs.
Patients with intestinal failure, on most occasions, develop nutrition-related complications. But doctors say they have ensured the patient at the leading Hospital in India was fit for surgery. While a team of surgeons were preparing the patient, another team retrieved the abdominal organs and rushed them to the transplant hospital. In the next 12 hours, doctors transplanted the three organs into the patient who had suffered multiple organ failure. The patient, who is in an isolated room of the ICU, is recovering well.
However, doctors warn that it’s too early to call the transplant a success. Post-operative care is the most difficult part in a cluster organ transplant. The recipient’s system may reject the organs or the patient may develop infection. The patient will be kept on high doses of immunesuppressive drugs to ensure that his body does not reject the new organs. This in turn increases chances of infection. A sterile environment in post transplant medication and round-the-clock care is needed. About 70 such transplants occur worldwide every year and the survival rate is quite high.
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