MGM Healthcare, a multi-specialty quaternary care hospital in the heart of the Chennai, today announced that it had successfully conducted a Cadaveric Liver Transplantation on a patient with end-stage liver disease using an innovative – Hypothermic Oxygenated Perfusion (HOPE) liver pump – for the very first time in the country. The surgery was successfully performed on 25/03/2021
A 50-member team under the leadership of Dr. Thiagarajan Srinivasan Director, Institute of liver diseases and Transplantation at MGM healthcare successfully conducted this complex liver pump procedure to expand the liver donor pool.
Speaking about the procedure, Dr Thiagarajan explained “A 44-year-old end stage liver disease patient with rare AB blood group was in the state and country’s transplant waiting list for cadaveric donor liver for the past one year. Given that the patient had a rare blood group and slim chances of find a cadaveric donor liver, his situation was getting a little complicated. He did not have a matched compatible live liver donor and had a history of two unsuccessful previous near miss attempts in the waiting period to get the donor liver. However, about three months ago a cadaveric liver did become available, however the brain-dead donor was being administered high doses of blood pressure support drugs and was unstable.”
As experts from institute of liver transplant MGM Healthcare, Chennai reached out to the patient, his family decided to accept the donor liver, due to the lack of any other viable options. A thorough consultation with Dr Thiagarajan and team ensued and, the family of the prospective recipient was informed that the donor liver was pale and on biopsy had a high fat content of 40%.
Dr Thiagarajan said “We decided to use HOPE machine pump in this case due to the complexity of the case as well as the condition of the donor liver. We used the machine pump on the donor liver after retrieval in the bench for 6 hours to make the liver transplantable into the patient. We took the organ, did a biopsy and kept it in dynamic cold perfusion for 6 hours. Normally a liver after retrieval from a braindead donor is perfused by static ice cold preservative solution. But the HOPE machine pump helped us in repairing and improving the quality of the liver by pumping preservative fluid into the organ at a temperature of 4-6 degrees and oxygen was further added to the fluid through a membrane oxygenator. The liver discard rate commonly is 15-20%, and with the use of this innovative technology it would help in reducing the discard rate and give a new lease of life to a lot of end-stage liver disease patients.
“Even though normothermic machine perfusion has been used in the country but the high costs prevented the usage of procedure routinely. This HOPE procedure is low cost, innovative and revolutionary,” Dr. Thiagarajan Srinivasan said.
He further added with the state and industry support we can establish dedicated organ perfusion centers for marginal cadaveric livers which can help in expanding the liver donor pool and reducing the organ shortage and cost.