Cardiologists perform historic heart, liver transplant
Indian doctors at the Apollo Hospitals, Chennai, have performed a complex combined heart and liver transplant on a 30- year- old man. This is the first time the complex surgery known as en-Bloc CHLT, has been attempted in Africa and Asia.
Described by physicians at Stanford University as a “technically demanding surgical technique, best left in the hands of experienced surgeons”, the CHLT procedure has been performed only by a few specialists in the world.
Consultant Cardiothoracic Surgeon and Head of the surgical team that performed the procedure, Dr. Paul Ramesh, said the patient had been diagnosed with a congenital condition called Ebsteins anomaly – a failure of the right side of the heart to develop properly, which was the cause of the liver failure.
Ramesh stated that this left the team with no other option than to seek a combined heart and liver transplant.
He said, “This is a procedure that involves surgery of the thoracic cavity (for the heart) as well as the abdominal cavity (for the liver), thus making it a highly risky procedure.
“With the heart not functioning in an efficient manner, there was high back pressure on the liver causing destruction of the liver cells leading to jaundice and cirrhosis.
“Additionally, the transplant team had to take into consideration the risk of excessive bleeding in the case of simultaneous transplant and the risk of accumulated toxins in the liver, attacking the heart, if the two organs were transplanted separately.”
The CHLT procedure can be done in three ways:
First the heart transplant – followed by the liver transplant as a second operation once the patient has recovered from the first surgery. (staged transplant)
First the heart transplant – followed by the liver transplant as an independent procedure during the same surgery where the patient is under one anaesthesia. (sequential transplant)
Simultaneous heart and liver transplant, done with both organs taken as a single entity still attached to one another. (En bloc heart and liver transplant)
Ramesh added, “ Over a decade of experience in solid organ transplants has enabled us with the skills and expertise needed to carry out a complex and demanding procedure like this. Our successful heart transplants and liver transplants performed individually, gave us the foundation, strength and operational excellence to successfully complete Asia’s first en-bloc CHLT.
“I am proud of the patient and his family whose trust in the clinical team at Apollo gave us the inspiration to carry out this procedure and move the boundaries of clinical excellence a notch higher,”
According to the cardiologist, the patient was discharged within a week of the complex operation.
Ramesh stated that survival of the patient was a testimony to the fact that both the heart and lung transplant team and the liver transplant team at the centre pulled off a feat which only a few of the transplant programmes in the world have achieved.
He, however, noted that the operation would have been impossible without the support of the government and the Organ Donation Programme in Tamilnadu.
Chairman and founder of Apollo hospitals, Dr. Prathap Reddy, stated that the achievement was a testament to the world-class abilities of surgeons, physicians, technicians, nurses and other staff at the health facility.
PUNCH.
