THE PROCEDURE

The patient, who happens to be the only son of his parents, was in the state of coma. Besides, his mother also had to undergo a major Hepatectomy to donate her liver to save his life. The donor (mother) underwent a battery of investigations and consultations to determine her fitness to undergo the procedure. Documentation and committee clearance as per government guidelines were performed on an urgent basis. The patient underwent an emergency living donor Liver Transplant. The team performed a left Hepatectomy (Segment II, III , IV) on the mother to retrieve a liver graft which was eventually implanted into the boy. The graft was first attached to the ostia of the LHV-MHV to establish an outflow from the graft. Portal vein was attached next to established inflow to the graft liver. After establishing the portal anastomosis, the liver was reperfused by removing the clamps. After a good 10-12 hours of intense work in the operation theatre the patient and mother were shifted to the organ transplant ICU in the wee hours of the morning. The graft liver immediately turned pink and supple which is a good sign for a well-functioning graft. Arterial and Biliary Anastomosis were then performed.

THE RESULT

After a stormy course in the post-operative period in which the patient was admitted in the ICU for 21 days under the vigilant eyes of Dr. Amit Singhal, Associate Director, HPB Surgery & Liver Transplantation, Anaesthesia & Critical Care and his team, the patient was eventually discharged on 31st day post-operatively. Post-operative management of such patient is full of ups and downs akin to a roller-coaster ride considering huge fluid shifts, immunosuppression and infections; but our team of dedicated specialists and staff were up to it. Currently, after three months, the boy is on regular follow-up and medications with adequate growth and weight gain. He can now look forward to living a healthy and fulfilling life.

“Recipient and donor surgery were aligned as clockwork to minimise the warm and cold ischemia time, which can be very detrimental to graft.”