A 45 year old patient undergoes successful liver transplant at BLK Super Speciality Hospital, after receiving liver from a donor after his cardiac death - what is called as 'Donation After Cardiac Death' or DCD.
As per the available data, there are reported cases of DCD of kidney in India but none for liver. The degree of complexities involved in this case as against kidney transplant, makes it more challenging and special. The success of this case also demonstrates the growing capabilities and expertise of our Indian surgeons.
While Western countries have used DCD for a long time, somehow India has lagged behind due to reluctance of families to donate organs. This case, feel doctors, could pave way for a new trend and can go a long way in addressing donor gaps in the country."
Dr Sanjay Singh Negi, Sr. Consultant and Director, Department of HPB Surgery & Liver Transplant, BLK Super Speciality Hospital, said, "Usually organ transplants in the country are done from brain dead donors where the blood circulation is intact, cells are normally perfused and organs are still functioning at the cellular level. In case of DCD, blood supply to organ is briefly absent, causing the tissues to become starved of oxygen, a condition known as ischemia.
Unlike kidneys which have long warm ischemia time of about 2 hours, the challenge in liver transplant is shorter ischemia time of 30 minutes requiring the graft to be re-perfused very fast. We are glad at having achieved this feat, which is certainly a rare one, and opens up avenues for many needy patients."
What went in favour of patient Atul Saluja was the deceased family's readiness to donate.
"Since time is of critical significance in a DCD transplant, we swiftly operated post death determination, as the heart was no longer pumping blood to organs" said Dr Amit Singhal, Associate Director, Liver Transplantation and HPB Anaesthesia at BLK Super Speciality Hospital, who played a pivotal role during the intra-operative and post-operative period.
DCD can help bridge the wide gap between demand and supply of organs. In India, less than 5,000 kidney transplants are carried out annually against an estimated requirement of over 175,000. Similarly, only 1,000 liver transplants are performed every year in a country where over 50,000 die due to end stage liver disease, mostly related to preventable causes like hepatitis B and hepatitis C. The annual requirement of hearts is estimated to be around 50,000 and lungs about 20,000. But the rate of organ donation is as low as 0.3 per million population (PMP).