A successful Liver Transplant performed on the heaviest patient in South India

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BGS Gleneagles Global Hospital successfully performs a complex Liver transplant on a 38-year-old morbidly obese patient, marking it to be the first in South India. The patient was suffering from liver disease called as Decompensated chronic liver disease (Liver cirrhosis) and was listed for cadaveric liver transplant for more than 3 months. With no other option in hand, a team of Transplant Surgeons, Transplant Anaesthetists & Intensivists, and Hepatologists decided to perform Liver Transplant on Mr Ravindra who weighed 160 Kg. The team of experts meticulously planned the surgery ruling out all the complications and saved the life of Mr Ravindra.

Patient, a middle-aged businessman from Kolkata, was readmitted to our hospital after he got a liver offer from a cadaveric donor on 8th January 2021 and was discharged after three weeks in a satisfactory condition.

Dr Sunil Shenvi, Consultant, Multi-organ Transplantation and HPB surgery, BGS Gleneagles Global Hospital said, “When Mr Ravindra reached out to us for his liver problem, he was very weak and required immediate medical attention. After evaluating him completely, we decided that he needs liver transplant. It was a difficult decision for us considering his weight, but we decided to go ahead. We planned everything meticulously well in advance and were geared up to transplant the heaviest patient in South India” 

Obesity has become the most significant public health problem worldwide. Many health experts have been witnessing surge in the cases of Non-alcoholic fatty liver disease (NAFLD) and Non-alcoholic Steatohepatitis (NASH) in India which are common liver problems in obese patients. Poor diet and sedentary lifestyle have taken a toll on the health of young adults which can progress to Liver cirrhosis. When the fat gets accumulated in the liver cells, gradually it causes inflammation and eventually leads to NASH (Non-alcoholic Steatohepatitis). Inadequate medical intervention during this phase can lead to scarring in liver causing End Stage Liver Disease.

Unlike any Liver transplant, this case was more unique and complex in nature, as the patient weighed way more than usual. The instruments, facilities and the treatment plan for the patient was different from the traditional treatment method. For instance, he was given nursing care in special bed particularly used for obese patients. Before his surgery, doctors wanted to enroll him in weight reduction programme or get bariatric surgery done; however, due to his liver problem it was extremely difficult to lose weight. Hence, doctors went ahead with the transplant as soon as a cadaver donor was available for transplant.

Dr Venugopal B Pillai, HOD and Senior Consultant, Liver Transplant, BGS Gleneagles Global Hospital said, “As the patient weighed 160 kg at the time of admission and also had liver cirrhosis, the team was well prepared to face any complications during the surgery. Initially, during the planning phase the team decided to get bariatric surgery (weight loss surgery) simultaneously, but the patients’ health condition was feeble at the end of the surgery, so we deferred it.” 

As the transplant was complex in nature, it took 12 hours to perform the Liver transplant. Later, the patient was given post-op care in the Transplant ICU, followed by optimal nutritional therapy and best physiotherapy care to bring him back to normalcy.

Mr Sandeep Kumar, CEO – BGS Gleneagles Global Hospital said, “Being a pioneer of liver transplant, our doctors are fully capable to handle any complex liver transplant patient. I would like to congratulate the team for successfully performing the surgery. I would also like to thank the donor’s family for their selfless gesture and giving the patient a new lease of life.” 

The team that spearheaded this complex surgery includes Prof. Dr. Venugopal B Pillai, Dr. Sunil Shenvi, Dr. Uma, from the Anaesthesia and critical care department, Dr. Kuttappa, Dr. Arun, Dr. Vijay, Dr. Ashish, and Dr. Mahesh, from Medical Gastroenterology and Hepatology, Dr. Adarsh, from Interventional radiology, Dr. Uttappa and Dr. Rohit, from Physiotherapy Mr. Mohan Babu, who made this surgery a success. 

Mr Ravindra is currently out of danger and is continuing his physiotherapy care to reduce his weight and to avoid any further health problems.