In a first, HCMCT Manipal Hospitals, Dwarka – a multi-speciality medical facility – recently performed an ABO incompatible (donor and recipient of different blood groups) liver transplant surgery on a 63-year-old patient from Afghanistan, giving him a new lease of life. The patient was suffering from liver failure because of Hepatitis B and had come to India for his surgery. The team of doctors led by Dr Shailendra Lalwani – HOD, Liver Transplantation & Hepato-Pancreatic Biliary Surgery and his team performed the complex surgery in a carefully crafted procedure.

The ABO incompatible transplant surgery takes place in cases when the organ donor and organ recipient do not have the same blood group. The procedure involves advance preparations – a month before the final surgery – to avoid Antibody Mediated Rejection (AMR) risk. This includes three rounds of procedures to achieve the target antibody levels. In the first round, the patient is given anti-CD20 to supress anti-body producing plasma cells, the second stage is to neutralize remaining antibodies and third is of plasma filtration to remove antibodies from the patient’s body. After achieving the target levels, the transplant takes place.

The patient was accompanied by his 24-year-old son and a daughter and was presented to Dr Lalwani at Manipal Hospitals. After thorough examination, Dr Lalwani suggested ABO incompatible transplant where his son was the donor. Intensive treatment for removal of antibodies was done before surgery to minimize the risk of rejection. The surgery was uneventful and the patient was discharged on July 5, 2021.Due to the intensive nature of the case Dr Shailendra Lalwani – HOD, Liver Transplantation & Hepato-Pancreatic Biliary Surgery, and his team, meticulously planned and cautiously executed the surgery.

While talking about the procedure, Dr Shailendra Lalwani – HOD, Liver Transplantation & Hepato-Pancreatic Biliary Surgery said, “The ABO incompatible liver transplant surgery is a complicated procedure which requires medical expertise, infrastructure, good post-operative care and an infection-free environment. Since the patient did not have a matching blood group donor in his family, we opted for this procedure. The need for a transplant is decided by the extent of damage and how badly the liver is diseased. We are happy to announce that the 12-hour surgery concluded successfully, and the patient is getting better every day. While it takes three weeks for recovery after this procedure, our patient recovered in just two weeks, and was discharged in only a few weeks.”

Samad, the patient’s son, said, “My father is the reason I have lived a healthy life. And, on the occasion of Father’s Day, I could not think of a better present than sharing a part of myself with him in gratitude. I am also thankful to liver transplantation team at HCMCT Manipal Hospitals for looking after my father and helping him with a speedy recovery.”

Adding to this Mr Raman Bhaskar, Hospital Director, said, “Armed with the correct knowledge and expertise, technology and infrastructure makes way for medical breakthroughs. This case was extremely tricky and required an experienced hand. We were only able to save the patient because of the skill and proficiency displayed by Dr Shailendra Lalwani and his team. At HCMCT Manipal Hospitals, we have piloted several complex surgeries in the past, and we are happy to have successfully given another patient a new lease of life.”

Dr Shailendra Lalwani is the HOD of Liver Transplantation & Hepato-Pancreatic Biliary Surgery at HCMCT Manipal Hospitals, Dwarka. With over 16 years of surgical experience, he has performed over 1000 successful liver transplants and holds expertise deceased and living donor, adult and paediatric, swap, combined liver-kidney and domino liver transplantation.