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Past events at MIOT

MIOT International has successfully performed an across-blood group (ABO-Incompatible) Liver Transplant, an exceptionally risky and rare procedure, saving the life of a 32-year-old patient. The patient was suffering from acute-on-chronic liver failure and bile duct disease (scarring in the tubes that carry bile from the liver to the small intestine). He required an urgent, life-saving liver transplantation.

However, due to an unpredictable waiting time and rapid decompensation, a cadaveric transplant was not a viable option. Additionally, the absence of a compatible blood-group living donor posed a major challenge. Furthermore, his bile duct disease significantly increased the risk of the transplant. MIOT’s liver transplant team with their expertise, successfully overcame the associated risk of bile duct disease and complexities of blood group mismatch and completed the ABO-incompatible liver transplantation.
ABO-incompatible transplants are typically more resource-intensive and costly due to the need for specialised medications and protocols to reduce organ rejection risks. However, recognising the patient’s financial constraints, the MIOT team strategically managed the procedure in a cost-effective manner under the Chief Minister’s Comprehensive Health Insurance Scheme, ensuring equitable healthcare access for all.

32-Year-Old Patient with Liver Failure

Mr. Premnath, a 32-year-old patient from Mettupalayam, Tamil Nadu, is a father of 3 children and works at an IT company in Coimbatore. He had been experiencing health issues for 1.5 years, including abdominal swelling and swelling in his legs. Initially, diagnosed with jaundice, he was hospitalised for 15 days and underwent plasma therapy and other treatments. However, since there was no improvement, he sought medical care at a private multispeciality hospital in Coimbatore.

There, he was diagnosed with liver cirrhosis and later confirmed to have liver failure. He was advised to undergo a liver transplant. Unclear about his underlying health condition and ongoing treatment, he decided to consult MIOT International.

At MIOT, he was diagnosed with severe jaundice, bile duct disease, and acute-on-chronic liver failure. Evaluations revealed that due to his bile duct disease, bile had accumulated in his liver, causing damage and ultimately leading to liver failure. He was under persistent intensive care optimisation. Despite that his condition continued to deteriorate and he needed an urgent liver transplantation to save his life.

Liver Transplantation

Liver transplantation is recommended for patients with end-stage liver disease (chronic liver failure). It is performed for those whose liver no longer functions properly by replacing it with either a cadaver liver (deceased donor liver) or a portion of a healthy liver from a related living donor with matching blood group.

Unavailability of a matching donor for Mr. Premanth

Generally, the donor’s blood group must be compatible with the recipient’s for a liver transplant to be performed. Due to his rapid decompensation, waiting for a cadaveric liver transplant from a matching blood group donor was not an option. Secondly, blood relatives are the ideal living donors for a successful liver transplant. However, Mr. Premnath had no relatives with a matching blood group who could donate, making the surgery challenging.

Across-Blood Group Liver Transplantation for Mr. Premnath

Considering the critical and deteriorating health condition of the patient, MIOT’s experts decided to proceed with an across-blood group liver transplantation. This procedure involves transplanting the liver from a donor whose blood group is incompatible with that of the recipient. Mr. Premnath, who has an A(-) blood group, received a liver transplant from his wife, who has a B(+) blood group.

Challenges in Mr. Premnath’s Liver Transplantation

Across-blood group liver transplantation is rare and carries a high risk of organ rejection.
To prevent this, Mr. Premnath was administered high doses of various immunosuppressive agents, which weakened his immune system, making him more susceptible to infections. Additionally, he underwent plasma exchange therapy to remove circulating anti-B antibodies. These procedures were challenging, as we have to balance opportunistic infections as well.Moreover, ABO-incompatible transplantation presents significant technical challenges, including the risk of hepatic artery clotting and biliary complications.

MIOT’s Expertise

Despite numerous challenges, MIOT’s liver transplant team successfully performed
Mr. Premnath’s ABO-incompatible liver transplantation, leveraging their expertise. Using specialised protocols tailored to his condition, they managed the risks associated with bile duct disease and the complexities of across-blood group transplantation while effectively preventing organ rejection.With meticulous care, MIOT’s experts also safeguarded him against infections and successfully carried out the procedure, ultimately saving his life.

Recovery of Mr. Premnath and his Wife

After the surgery, Mr. Premnath and his wife showed significant improvement every day and recovered well. Both of them regained their strength and liver function steadily. They have now smoothly transitioned back to their normal life.

MIOT – A Leading Centre for Organ Transplantation

The MIOT Liver Transplant team has decades of experience in liver surgery, consistently delivering transplant outcomes on par with international standards. The success of a liver transplant depends on the quality of the donor organ as well as access to the right facilities and expertise. MIOT’s liver transplant team include world’s top liver transplant specialists who have performed more than 2000 liver transplants. The MIOT Hepato-Pancreatico-Biliary Centre for Surgery and Transplantation is equipped with the world’s latest operating theatre technologies that regulate and manage blood flow and reduce infection rate to less than 0.02%, which is crucial to the success of HPB surgeries.

Our expertise and cutting-edge technologies include:

Chief Minister’s Comprehensive Health Scheme

Across-blood group liver transplants are more expensive due to the need for advanced medical resources and specialised procedures. To successfully prevent organ rejection, the patient undergoes advanced pre-transplant treatments and is closely monitored post-operatively by a highly skilled multidisciplinary team, all of which contribute to the overall cost.

However, recognising the patient’s financial limitations, the MIOT team meticulously planned and executed the procedure in a cost-effective manner. By optimising available resources, MIOT’s experts successfully carried out the transplantation under the Chief Minister’s Comprehensive Health Insurance Scheme. This initiative not only alleviated the financial burden on the patient but also reinforced MIOT’s commitment to providing equitable, high-quality healthcare to all, ensuring that life-saving treatments remain accessible regardless of financial constraints.

Mr. Premnath has completely recovered after 2 months of the surgery. With his health steadily improving, he and his wife have now returned to their normal lives. Mr. Premnath is now preparing to resume to work next month as he continues his journey toward a full and healthy life.