It was 6 months ago when a 21 year women found her 29 year husband lying unconscious in bed. She immediately sought medical attention and care for her husband. On investigations it was found that Shiv was suffering from liver cirrhosis with advanced liver failure which led to ‘hepatic encephalopathy’ – a medical condition leading to unconsciousness. The family was devastated as Shiv was the sole bread-earner for the family of 6 which included his two children and an aged mother who all were dependent on him for a living.
They visited many hospitals in their native city of Bihar and in New Delhi before coming to Dr. Naimish Mehta. He was further evaluated and found to be suffering from jaundice (yellowness of skin and soft tissues), coagulopathy (increased chances of bleeding). He was advised to undergo liver transplantation procedure and asked to search a suitable donor within the family.
According to Dr. Naimish Mehta, “The challenge for us was that the blood group of recipient Shiv (Husband) which was B+ was not matching with any of the siblings. Although his wife Parvati was willing to donate her liver to save Shiva but her blood group was A+ . Therefore the family was then counselled about ‘Blood group incompatible’ liver transplantation (ABOi) which can be performed with adequate pre-operative preparation. His wife Ms Parvati, who was willing to donate part of her liver, with blood group ‘A+ve’ was investigated further and found fit for liver donation.”
Dr. Mehta further informed that in such cases blood antibody level against blood group ‘B’ needs to be reduced to an optimum level with use of multiple sittings of plasmapheresis so that Shiv’s’s body would not reject Parvati’s partial liver. Once optimum levels of antibody titres were achieved liver transplantation procedure was scheduled where a team of 21 personnel were involved including doctors and technicians.
Dr. Jayashree Sood mentioned that maintaining adequate organ perfusion during the liver transplant procedure is very critical as any error giving a mismatch blood transfusion can lead to catastrophic event. The anxious family waited with bated breath as surgery lasted for almost 12 long hours. Shiv’s’s family could see and even talk to him the next morning once he was awake and out of the effect of anaesthesia.
After the surgery Shiv was smiling and said, “In a true sense my wife has played a real role of goddess Parvati in saving my life. I am indebted to her for whole of my life. This is the best gift for me which could have come on Maha Shivratri.”
Dr. Mehta further added that there are potential risks involved with blood group incompatible liver transplant, especially in adults as children have high resilience in accepting a different blood group organ. Successful results can be achieved with adequate preparations and in experienced centres.
Dr. Ajay Swaroop applauded the transplant team’s effort and said that the hospital has been in forefront of providing such cutting edge technology in the field of liver transplantation where the team has overcome the blood group barrier.
