Doctors at the Aster CMI Hospital in Bangalore have performed India’s first bloodless liver transplant on Jehovah’s Witnesses from Nigeria. The surgery was challenging compared to a normal liver transplant due to patient’s religious beliefs. The doctors could not use blood or blood products such as platelets, fresh frozen plasma, Cryoprecipitate and more. Few such surgeries have been conducted worldwide and were successful.
The patient named – Jehozadak from Nigeria was suffering from end-stage liver disease. Without a liver transplant, his chances of survival were less than 10% in the next 2 years.
The team of liver specialists – Dr. Rajiv Lochan, Dr. Sonal Asthana, Dr. Mallikarjun Sakpal, Dr. Arun V – Anesthesiologist and Dr. Prakash Doraiswamy – Intensivist, reviewed the patient’s medical history before recommending surgery and charted out a feasible pathway.
“During a liver surgery, patients lose a lot of blood which needs to be replaced for the patient’s survival. Generally, doctors keep 3-4 units of blood and a similar quantity of platelets/plasma on reserve for the patient. In this case, we had to figure out and alternative,” said Dr. Mallikarjun Sakpal, Hepatologist at Aster CMI.
The doctors used ‘Normo-volemic hemodilution’ technique where doctors took two units each of both patient and donor’s blood and were connected to the system throughout the surgery using special equipment so there is no break in the blood circulation loop. This procedure was discussed with the patient before surgery and it was in line with their beliefs.
During the surgery, the patient lost about 2 units of blood which were compensated with the use of ‘cell-salvage’ technique to collect and reuse the blood. The surgery lasts for 12-hours and two teams of specialists with close to 25 doctors were involved in this surgery.
In a period of two weeks, the patient and his brother, who was a donor, were discharged from the hospital.
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