Hyderabad 6th April 2022: First ever Indian Dr.Gaurav Chaubal, Director –Liver, Pancreas & Intestine Transplants and HPB Surgery, Global Hospital successfully performs the first Living Donor Intestinal transplant on a 7-year old patient, who also had terminal pseudo obstruction by birth (the inability of muscles to contract) as well as multiple liver complications.Chronic intestinal pseudo-obstruction is a rare disorder that this 7YO patient had, in which motility (the ability of muscles to contract) is compromised and the contractions between muscles, nerves and hormone in the digestive tract gets uncoordinated, impacting the digestive system and leading to intestinal failure.
In the history of Singapore, this is the first instance of a successful surgery of an Intestine transplant with a Living Donor.
The gang rape & murder case of Nirbhaya in 2012 stood to be the case reference for Singapore as Nirbhaya was airlifted for her treatment where she succumbed to her grievous injuries as she was in the waitlist for an intestinal transplant in Singapore.Due to lack of living and cadaver donors & medical expertise, the transplant couldn’t take place.
After a decade, in 2022 the healthcare industry has seen a major evolution in Singapore where India has a major role play to make change.Intestinal transplant which was in an experimental stage back then has now saved the life of 7-year-old.
The 7YO Singaporean girl had symptoms of inability to eat and constant vomiting since birth.She was put on Total Parenteral Nutrition (TPN) that involves management of macro & micro nutrients, fluids, and electrolytes via central vein.
Her health deteriorated and only option left was intestine transplant.The surgery was a great success.
Total of 150 cms of terminal ileum was resected from the donor.The dysfunctional bowel was resected in the recipient and the donor bowel was transplanted.
The transplanted bowel showed good perfusion and function on the table.Post operatively, on day 1, the transplanted bowel looked healthy.
According to Dr.Gaurav Chaubal, Director-Liver, Pancreas, Intestine Transplant Program and HPB Surgery at Global Hospital, Mumbai, Parel said “Intestine transplants are complex and rare worldwide.This is the first time such a transplant has been performed in Singapore.As per our experience, living donors can safely donate around 30-40% of their intestine.
Diagnosed to have pseudo obstruction of Intestine, the recipient was on TPN for 7 years.Meticulous planning was done before the transplant as it involves Transplant surgeons, Gastroenterologists, Anaesthetists, Nutritionists and Intensivists along with Nursing and other para clinical staff.
The prospective Donor and recipient underwent multiple tests to ensure the immunological matching of the organs.Post-surgery, both father and daughter are doing fine and she will be on the road to recovery soon.
The transplant is a result of international collaboration between Sing Health’s Transplant Division, Duke University’s Abdominal Transplants division and Dr Gaurav Chaubal.Prof Prema Raj, Chairman, Sing Health Intestinal Transplant Committee along with Dr.Debra Sudan, Chief Division of Abdominal Surgery, invited Dr Gaurav to be a part of this historic transplant as he has worked on the largest series of Intestinal Transplants (Both living and cadaveric) in India.
Dr Sudan, Director of Abdominal Transplant Surgery Duke University Hospital, USA and the primary surgeon for this intestinal transplant said “For this young girl, complications of parenteral nutrition were life threatening and her only hope for long term survival and improved quality of life was intestine transplantation.
Thankfully her father was able to donate a portion of his intestine and the surgeries both went very well.Both are recovering very well and we have every expectation that she will do well with this living donor intestine transplant”.
