Rare and complex Combined Liver and Kidney Transplant performed at Apollo Hospitals!

(From Left 3 to 6 standing) Mr. Radhey Mohan, Vice President - International Marketing; Dr Naveen Polavarapu, Chief Transplant Hepatologist; Dr Ravi Andrews, Consultant Nephrologist & Dr Manish Varma, Chief Transplant Surgeon, Apollo Hospitals, Huderabad, with the team which performed the Rare and complex Combined Liver and Kidney Transplant surgery on the fifty-seven-year-old Tanzanian patient, Gabriel Ceaser Sisa (sitting centre), flanked (L&R) by Mr Godfrey, Kidney Donor & Mrs Elizabeth, Liver Donor.

Rare and complex Combined Liver and Kidney Transplant performed at Apollo Hospitals!

Hyderabad, 12th April 2021Apollo Hospitals, Hyderabad, performed a Complex Combined Liver and Kidney Transplant, using organs from two different living donors, for the first time in India. The Complex surgery was performed by Dr Manish Varma, Chief Transplant Surgeon; by Dr Ravi Andrews, Consultant Nephrologist and Dr Naveen Polavarapu, Chief Transplant Hepatologist at Apollo Hospitals, Hyderabad, on a fifty-seven-year-old Tanzanian patient, Gabriel Ceaser Sisa. The uniqueness of the case was further compounded by the usage of a blood group mismatched organ, the liver. That made the task extremely perilous, but the hands-on experience and the immense expertise, the Transplant and Support Teams at Apollo Hospitals command, steered the outcome to success. The patient has since recovered and is all set to be discharged.

This case is unique, as it is the first time in our country that a multi-organ transplant has been performed using one organ that is mismatched blood group and the other organ of a matching blood group. Monitoring such patients, especially for rejection is a big challenge. As it is, blood group mismatched transplant of a single organ is a complex endeavor, undertaken only in select centers globally. It is noteworthy that the same team had performed the first mismatched blood group transplant of the city about six months ago.

Gabriel Ceaser Sisa first visited Dr Naveen Polavarapu, Apollo Hospitals, Hyderabad in 2017 with Liver related problems. It soon transpired that he had chronic Liver and chronic Kidney disease. Over the course of the next three years his Liver and Kidney diseases progressed despite being on active medical treatment and close monitoring. As he reached end stage Liver disease and end stage Kidney disease requiring hemodialysis, he was advised to undergo a combined liver and kidney transplant. Usually, such transplants are performed using organs from a single cadaveric donor, which avoids complications associated with multiple living donors including blood group mismatch, post-surgery donor recovery etc. In fact, rejection of the blood group mismatched organ by the recipient is very high and is an immense challenge, needing constant monitoring.


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