MGM Healthcare, a quaternary care super-specialty hospital announced an uncommon feat by successfully carrying out a living donor liver transplant on a 45- year-old patient overcoming the challenge of the blood group incompatibility. The 12 hour long procedure was led by Dr Thiagarajan Srinivasan and his team of transplant specialists including Dr Karthik Mathivanan & Lead Anaesthetists Dr Dinesh and Dr Nivash.
ABO incompatibility between a donor and a recipient is generally considered a barrier to kidney or liver transplant. The doctors at MGM Healthcare by employing a new and evolving technology in the form of using a highly selective blood group antibody absorption device (glycosorb) in a series of four patients. The patient Unnikrishnan from Kerala had developed chronic liver failure and was waiting for a liver transplant for more than three years after visiting several hospitals in India. With a huge demand supply mismatch Unnikrishnan was not able to get a suitable cadaveric organ and further to his dismay there was no blood group compatible living donor in his family.
“This opens hope for the many who have been waiting for transplants and is also paving way for faster recovery. Our team had a cumulative experience of more than 40 such liver transplants across blood groups but there were multiple challenges in the form of increased infections and rejections. But after employing the new technology in the form of using a highly selective blood group antibody absorption device glycosorb the results were excellent," stated Dr Thiagarajan Srinivasan, Director, Institute of liver transplant and HPB surgery who headed the multidisciplinary team of doctors during the procedure.
Explaining the procedure, Dr Thiagarajan said first we stop the production of new blood group antibodies by rituximab and removal of existing blood group antibodies with the glycosorb filter and using specialized induction agent(basiliximab) and living donor liver transplant is performed with a blood group incompatible donor and successfully followed up lifelong.
“Liver Transplantation is the best and only option for a patient who is diagnosed with either end-stage liver cirrhosis or cancer. Unfortunately, there is a huge divide between the demand for donor liver and liver donation so we face a shortage of organs. Yet, with advancements in the field, transplantation using ABO-incompatible (ABOi) grafts – is an alternate strategy for increasing donor availability,” said Dr Karthik Mathivanan, Senior Consultant & Associate Director, Institute of Liver Transplant & HPB Surgery.