Rare transplant saves 63-year-old 

Doctors at VPS Lakeshore Hospital, Kochi performed a difficult liver surgery on Surajmal, 63, who was suffering from a rare complication 
Surajmal with team of doctors at VPS Lakeshore Hospital
Surajmal with team of doctors at VPS Lakeshore Hospital

KOCHI: In a commendable feat, a team of doctors at Kochi’s VPS Lakeshore Hospital successfully cured a patient suffering from hepatopulmonary syndrome by employing a novel treatment technique of liver transplantation. According to Dr Abhishek Yadav, head of the Comprehensive Liver Care Institute at the hospital, Surajmal, 63, from Chennai, was suffering from a rare complication of liver cirrhosis called severe hepatopulmonary syndrome, a condition in which the normal oxygen exchange in the body is compromised. Surajmal had just about 35 per cent of oxygen in his blood compared to 100 per cent in a normal individual. 

The low oxygen level made him dependent on an oxygen cylinder at home and even the slightest exertion like walking to the bathroom would leave him breathless. “Liver transplantation is the only cure for this rare condition,” said Dr Yadav. The team of doctors at the hospital successfully managed the condition by rare liver transplantation on July 27. The surgery was performed by the team of doctors, led by Dr Abhishek Yadav and included Dr Nitha George, Dr Malli, Dr Mohan Mathew, Dr Maya, Dr Mahesh Subramaniam, Dr Jacob Mathew, and Dr John Mathew.

Liver transplantation in severe hepatopulmonary syndrome is a high-risk procedure with high mortality. The biggest challenge in this case was to take the patient off the ventilator after the surgery. Here, the team of doctors used a novel technique of using oxygen mixed with nitric oxide, which enabled the patient to be taken off the ventilator the morning after the surgery. 

“Nitric oxide is an inhalable gas that may help improve oxygenation in such patients by improving the oxygen level in the blood. He required nitric oxide for 12 days and was successfully weaned off to a condition where he could be discharged from the hospital on Saturday,” said Dr Nitha George, Critical Care expert. After 23 days of the surgery, the patient’s oxygen level is now at 85 per cent.

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