Gods smile on namesake couple in challenging liver transplant

A 29-year-old Bihar man, suffering from liver cirrhosis, received a new lease of life after undergoing a transplant surgery in New Delhi for liver donated by his wife, doctors said on Thursday.

The 12-hour-long surgery was challenging as their blood groups didn't match, they said.

The challenge was that the blood group of the recipient Shiv is 'B+', and it was not matching with any of his siblings.

Although his wife, 21-year-old Parvati, was willing to donate her liver, her blood group is 'A+', they said.

The transplant surgery was performed recently at the Sir Ganga Ram Hospital in central Delhi.

About six months ago, Parvati had found that her husband was lying unconscious in bed.

She immediately sought medical attention and care for him.

On investigations, it was found that Shiv was suffering from liver cirrhosis with advanced liver failure which led to hepatic encephalopathy, a medical condition that led to unconsciousness, the SGRH said in a statement.

The family was devastated as Shiv is the sole breadwinner of the family of six which includes his two children and an aged mother, it said.

They visited many hospitals in their native state Bihar, and in New Delhi before coming to the SGRH, doctors said.

He was further evaluated and found to be suffering from jaundice (yellowness of skin and soft tissues), coagulopathy (increased chances of bleeding).

He was advised to undergo liver transplantation procedure and asked to search a suitable donor within the family, said Dr Naimish Mehta, chief liver transplant surgeon at SGRH.

"The challenge for us was that the blood group of the recipient and the donor were not matching," doctors said.

"Therefore, the family was then counselled about 'blood group incompatible' liver transplantation (ABOi) which can be performed with adequate pre-operative preparation. His wife, Parvati, who was willing to donate part of her liver, with blood group 'A+', was investigated further, and found fit for donation," he said.

Mehta said in such cases, blood antibody level against blood group 'B' needs to be reduced to an optimum level with use of multiple sittings of plasmapheresis so that Shiv's body would not reject Parvati's partial liver.

Once optimum levels of antibody titres were achieved, liver transplantation procedure was scheduled, where a team of 21 personnel were involved, including doctors and technicians, he said.

Dr Jayashree Sood, chairman, department of anaesthesia at the SGRH, said maintaining adequate organ perfusion during the liver transplant procedure is very critical as any error giving a mismatch blood transfusion can lead to "a catastrophic event".

The anxious family waited with bated breath as surgery, held 15 days ago, lasted for almost 12 hours, hospital authorities said.

Mehta said there are "potential risks" involved with blood group incompatible liver transplant, especially in adults, as children have high resilience in accepting a different blood group organ.

Successful results can be achieved with adequate preparations and in experienced centres.

Dr Ajay Swaroop, chairman, board of management, Sir Ganga Ram Hospital, applauded the transplant team's effort, saying the hospital has been at the forefront of providing such cutting-edge technology in the field of liver transplantation, where the team has overcome the blood group barrier.