India's first inter-hospital swap liver transplant done in Coimbatore

Two hospitals in Tamil Nadu's Coimbatore collaborated to perform the country's first ever inter-hospital swap liver transplantation, giving a new lease of life to two patients suffering from end-stage liver disease, the hospitals said on Friday.

The complex procedure was simultaneously performed through joint efforts of the GEM hospital and Sri Ramakrishna hospital, Coimbatore, on both the patients at the respective hospitals on July 3.

"Unlike the conventional living donor liver transplant where a relative donates directly to the patient, a swap transplant enables patients who do not have a compatible donor within their own family to exchange donors with another family in similar situation," a release here said.

This approach expanded the donor pool and offered a new hope to patients with end-stage liver disease who would otherwise remain on long waiting lists or have no viable curative treatment option, the release said and described it as "a historic medical feat."  The procedure was performed on a 59-year-old man from Salem in GEM hospital and a 53-year-old man from Tiruppur admitted to the Sri Ramakrishna hospital. Though their respective wives were willing to donate, their blood group was found incompatible and hence direct donation was ruled out.

As luck would have it, doctors identified that a swap transplant where the donor of each patient gives to the other was the only viable solution.

"This required navigating a host of legal, ethical, and logistical challengeswe had to obtain special clearance from the Tamil Nadu State Transplant Authority to transport the organ from one hospital to the other," founder-chairman of GEM hospitals, Dr C Palanivelu, said.

Also, the hospitals had to ensure synchronised surgeries and establish a real-time communication protocol between both the hospitals, he said.

According to the managing trustee of Sri Ramakrishna hospital R Sundar the milestone stood as a true testament to Tamil Nadu's medical excellence. "The highly skilled medical teams from GEM hospital and Sri Ramakrishna hospital undertook this complex procedure with great precision and dedication," he said and added that both the patients were recovering well.

Director of GEM hospital Dr P Praveen Raj said swap transplants were already regulated under the Transplantation of Human Organs Act 2014 but inter-hospital coordination added new layers of security.

Liver transplant surgeon of GEM hospital Dr N Anand Vijay said both the hospitals performed the surgeries simultaneously in the hospitals located five km apart.

Liver transplant surgeon of Sri Ramakrishna hospital Dr R Jayapal said the approach helped to avoid the need for costly ABO-incompatible liver transplantation, which would have been the only alternative option in this scenario.

By a compatible swap, the teams successfully reduced the financial burden on the patients thus underscoring the commitment of both the hospitals in delivering the highest quality outcomes while preventing unnecessary expenses, he said.

"This milestone opens a new economic avenue in liver transplantation, proving that cost-effectiveness and clinical excellence can go hand in hand," he added.

GEM hospital's transplant surgeon Dr Magnus Jayaraj said both the surgeries were performed under the Chief Minister's Comprehensive Health Insurance Scheme.