The Hindu : National : Simultaneous liver and kidney transplants in Delhi

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Wednesday, May 09, 2007
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Simultaneous liver and kidney transplants in Delhi

Staff Reporter

Boy undergoes simultaneous liver and kidney transplant

— Photo: Sandeep Saxena

CAUSE FOR CHEER: Fifteen-year-old Ganesh Nehru, who underwent simultaneous liver and kidney transplants, flanked by Hemlata (his mother who donated kidney) and Mohan Ram (his uncle who donated half liver), at a press conference at Sir Ganga Ram Hospital in New Delhi on Tuesday.

NEW DELHI: A team of doctors at the Sir Ganga Ram Hospital here have performed what is said to be the world's first successful simultaneous liver and kidney transplants from two live donors on a 15-year-old boy diagnosed with primary hyperoxaluria.

The boy, Ganesh Nehru, is now well and ready to be discharged from the hospital just three weeks after the path-breaking surgery.

According to medical experts, in primary hyperoxaluria patients the liver lacks an enzyme called alanine-glyoxylate aminotransferase that results in accumulation of (calcium) oxalate crystals in the body resulting in kidney failure and death by the second or third decade of life. A timely dual liver and kidney transplant is the only way to save such patients.

Ganesh underwent a marathon 18-hour surgical procedure on April 17. It involved a multidisciplinary team of more than 50 doctors and paramedical staff from 14 departments of the hospital.

Addressing a press conference on Tuesday, transplant surgeon A. S. Soin, the doctor in charge of the case, said: "Ganesh's mother Hemlata donated one of her kidneys and her brother Mohan Ram donated half of his liver to Ganesh for this life-saving dual transplant.''

"The first challenge of the operation was to select two suitable donors — one each for the kidney and liver in a way that Ganesh and both his donors were well matched. We have been lucky to find these donors well in time for our patient.

``Also, the surgery had to be timed like clockwork since it involved operating on three persons simultaneously in three different operation theatres. Ganesh was first given his new liver and later the kidney,'' said Dr. Soin.

Wants to be an engineer

Ganesh, who wants to become an engineer when he grows up, was happy as he answered questions about his life and dreams. Post-surgery now, according to doctors, he should be able to lead a near- normal life, though he will need to be on medicines to prevent rejection of the new organs.

Dr. Neelam Mohan, paediatric hepatologist at the hospital, said: "Ganesh, who stays with his parents in California in the U.S., was on a visit to Tirupati last year when he started vomiting and needed medical attention. Later medical examinations showed that he was afflicted with primary hyperoxaluria. The family approached us with the case and we told them that a combined surgery was the boy's only chance of survival.''

Preparations for the surgery — which cost the family Rs. 19 lakh — began six weeks in advance. "We had to clear the extensive oxalate deposit in his body before putting in the new liver and kidney. If this was not done, the oxalate could have blocked the new kidney and rendered it useless within a day or two of the transplant,'' said Dr. Dinesh Khullar, senior nephrologist at the hospital.

"I plan to go home to the U.S. as soon as I can. I feel great!'' said the teenager sitting alongside his mother and uncle.

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