Bengaluru, 26 July 2024: In a significant clinical milestone, Fortis Bannerghatta Road successfully conducted Living Donor Liver Transplant on a 52-year-old lady for end stage chronic liver disease and early stage liver cancer. The patient got a new lease of life as her son stepped forward to donate a part of his liver. The clinical team involving liver transplant surgeons, Dr Kishore GSB and Dr Piyush Sinha along with medical gastroenterologist Dr B S Ravindra gauged all the risk factors, considering the patients critical condition and went forward with the complex surgery.
In the year 2021, Patient Mrs. Leela suffered from jaundice and consulted a local doctor in Hassan. An ultrasound examination revealed liver cirrhosis – the end stage of chronic liver disease, which impairs liver function and structure. Additionally, she was diagnosed with ascites, a condition where fluid collects in the abdomen. Despite medical management, her liver condition severely impacted her lifestyle, leading to frequent hospital visits and the urgent need for a liver transplant. Consequently, she was referred to the Gastro team at Fortis Bannerghatta Road.
Upon evaluation, Mrs. Leela was also found to have bile duct stones, necessitating endoscopy and stenting. These stones led to cholangitis (inflammation of the bile ducts, the tubes that carry bile from the liver to the gallbladder and small intestine), requiring her admission. Despite medical management by the gastro team, on evaluation of her liver cirrhosis, she was found to have early-stage liver cancer. Given her complex condition, the doctors recommended a liver transplant to simultaneously treat her liver cirrhosis and liver cancer. Her 31-year-old son, Rakesh, selflessly stepped forward and donated a part of his liver to save his mother’s life.
Explaining the procedure, Dr Kishore GSB and Dr Piyush Sinha, Liver Transplant Surgeons, Fortis Hospital, Bannerghatta Road, Bangalore said, “Mrs. Leela was in a complex situation due to the end stage of her chronic liver disease compounded by the presence of her early stage liver cancer. The decision for a liver transplant was critical as it was the only treatment modality which would have given a chance of survival and improved quality of life. The surgery involved careful planning and execution to ensure optimal function of the transplanted liver post-operation. This case highlights some very important facts that people need to know. Organ donation can save lives. In living donor liver transplants, only a part of the donor’s liver is used, and the remaining portion of the donor’s liver will begin to regenerate immediately and return to its normal size in six to eight weeks. Most liver donors are able to return to an independent life one week after surgery. Liver cancer, which can develop in cirrhotic patients, can be cured with liver transplant if detected at an early stage.”
Dr B S Ravindra, Director, Department of Gastroenterology and Hepatology, Fortis Hospital, Bannerghatta Road, said “Referring patients for liver transplantation at the right time ensures that they get the best chance of survival. The medical team plays a crucial role in optimizing patients before transplant by managing ascites, endoscopic banding of varices (treating enlarged veins in the stomach to prevent bleeding) and periodic screening. In fact, Mrs. Leela’s liver cancer was picked up on screening CT scan. Treating a cirrhotic patient with cholangitis can be challenging and we are glad we were able to extract stones from the common bile duct successfully and place stents. The patient and family had enormous trust in the treating team and they were convinced that liver transplantation was the right way forward.”
Following the liver transplant, a multidisciplinary team of doctors including surgeons, gastroenterologists, anaesthesiologists, intensivists, nephrologists, and cardiologists closely monitored Mrs Leela’s recovery trajectory and meticulously managed her immunosuppression to prevent any potential rejection of the transplanted liver. They devised a careful regimen aimed at optimizing liver function, which included tailored medication plans and comprehensive supportive therapies specific to her needs. Their goal was to ensure a robust recovery and provide the best possible chance for sustained health and well-being. The patient was discharged within 16 days post-surgery.
Mr. Akshay Oleti, Business Head, Fortis Hospitals Bengaluru, said, “I extend my heartfelt congratulations to the entire team of doctors for their dedication and commitment to clinical excellence. The successful completion of the liver transplant for liver cirrhosis with liver cancer in this case represents the epitome of state-of-the-art medical technology and compassionate care that Fortis Healthcare embodies. This showcases our hospital’s steadfast dedication to providing top-tier healthcare services and placing the well-being of our patients at the forefront.”
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