New Delhi:
In a rare surgery, doctors at a city hospital split cadaver liver of a 32-year-old brain dead patient and gave one lobe each to two persons in dire need of a liver transplant, thus giving them a fresh lease of life.
The donor had sustained brain haemorrhage in Dubai in May this year and was operated upon there but to no avail. He was shifted to Indraprastha Apollo hospitals in India where neuro-surgeons declared him brain dead at arrival, said Dr Shaleen Agarwal, senior consultant at the department of Liver Transplant Surgery at Indraprastha Apollo Hospitals.
His family consented to donate his organs and doctors split his liver and gave one lobe to a 29-year-old man from Jalandhar who suffered from chronic alcoholic liver failure and had been on the transplant list for five months. According to the doctors, he would not have survived if he hadn't been operated upon in next two-three months.
The other half of the liver went to a 42-year-old woman, a Delhi resident who had a chronic liver failure and was on the transplant list for a year.
Explaining the uniqueness of the case, Dr Subash Gupta, Chief Liver Surgeon at the hospital said that as the two parts of a liver are not equal, surgeons use the right half for an adult patient and the other half for a small child.
"Cadaveric liver are very rarely split and used for two adults with advanced liver disease as the left lobe is the smaller portion and may not be enough to sustain the person," said Dr Gupta.
In this case the doctors split the liver into two halves before taking it out.
"The surgery took place on June 3. Before taking out the liver, we split it into two halves. The natural anatomy of the liver is such that it has two lobes and we separated them through a specialised surgery and the right lobe was retrieved as a conventional modified right lobe graft and transplanted in the man while the left one went to the woman.
"We also had to reconstruct the vein which was draining the left lobe with a large abdomenal vein taken out from the donor's body itself," Dr Agarwal explained.
"Cadaveric organs continue to be in short supply and therefore every effort must be made to use these donated organs in as many needy recipients as possible. Splitting liver in to adults may address the perennial shortage of organs in India," Dr Gupta said.
Both the patients were discharged within two weeks after the surgery from the hospital, added Dr Agarwal.
The notion of brain death emerged in the 1960s in response to medical technology that could keep the heart and lungs functioning mechanically.
The heart continues to beat thus continuing the blood flow through the body while the ventilator delivers oxygen to the lungs but the brain stops working which means the person won't breathe if the ventilator is switched off.