Apollo Hospitals successfully completes two novel Transplants from a single donor
- Asia’s first Small Bowel transplantation combined with Abdominal Wall Transplant;
- Kidney transplantation using Hypothermic Oxygenated Machine Perfusion (HOPE)
Chennai: Apollo Hospitals, Asia’s largest and most trusted multi-specialty
chain of hospitals, has achieved two new milestones. Organ transplant team
completes Asia’s first combined Bowel and (sentinel) abdominal wall transplant
surgery on a young boy who was suffering from Ultra Short Bowel Syndrome and a
complicated Kidney transplantation using Hypothermic Oxygenated Machine
Perfusion (HOPE). Apollo Hospitals brings the organ preservation device Vita
Smart HOPE to India that keeps the Kidney outside the body for a longer period
of time with continuous oxygen supply which is better for transplantation.
Seventeen year-old Chinni Krishna was
admitted to Apollo Hospitals with muscle wasting and malnourishment, he had
lost 20 KGs in two months (from 50 KGs he became 30 KGs). He was previously
admitted to a local hospital in Kuppam, his home town in Andhra Pradesh where
he was diagnosed with acute mesenteric ischemia a syndrome of sudden loss of
blood supply to the small intestine which causes permanent damage to the small
intestine. Usually this is treated with angioplasty or open surgery. Chinni
Krishna underwent several corrective surgeries at hospitals in his home town
which eventually led to the complete removal of the small bowel with Jejunocolic Anastamosis (a surgery where
parts of the jejunum and ileum are removed, and the remaining parts are
connected to the colon).
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(L to R) Dr. Shyamala J- Pediatrician, Dr. Dinesh Babu-
Anaesthetist, Dr. Ganapathy Krishnan, Plastic Surgeon, Dr. Venkatesh Rajkumar,
Nephrologist, (Patient) Chinni Krishna, Ms. Suneeta Reddy, Managing
Director, Apollo Hospitals Group, (Patient) Ms. Kranti, Dr. Mohan Kumar, Urologist, Dr.Leela
Praveen, Plastic Surgeon, Dr. Senthil M, Transplant Surgeon
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Apollo Hospitals initiated nutritional
rehabilitation program for the patient to attend to his caloric requirement to
stabilize him and to get him ready for a bowel transplant. Over a period of 9
months Chinni Krishna gained 15 Kgs and returned home. He underwent a
transplant procedure in February 2020 on availability of Bowel and Abdominal
wall from an18 year-old deceased donor.
Team of doctors headed by Prof. Dr. Anil Vaidya-Transplant
Surgeon, Apollo Hospitals Chennai, performed Asia’s first Small Bowel transplantation combined with
Abdominal Wall Transplant on Chinni Krishna. The patient needed an abdominal
wall transplant because of the poor quality of the native abdominal wall muscle
and skin due to multiple operations. Furthermore, there is a loss of abdominal
space due to contracture of the muscle of the abdominal wall around a smaller
volume of bowel.
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(L to R) Dr. Ganapathy Krishnan, Plastic Surgeon; Dr. Venkatesh Rajkumar, Nephrologist; (Patient) Chinni Krishna; Ms. Suneeta Reddy, Managing Director, Apollo Hospitals Group; Dr. Mohan Kumar, Urologist; (Patient) Ms. Kranti; Dr. Leela Praveen, Plastic Surgeon; Dr. Senthil M, Transplant Surgeon
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Speaking about this
procedure, Prof. Dr. Anil Vaidya-Transplant Surgeon, Apollo Hospitals said, “An
intestinal transplant is a life-saving procedure as it
helps patients who have suffered over years without eating solid food and
resorting to intravenous feeding. This procedure comes as a blessing for them
as it helps them to eat and even taste food again.”
The abdominal wall transplant
is a vascularized composite graft with Skin, muscle and subcutaneous fat. The
abdominal wall not only helps to cover the underlying transplanted intestine
but, the skin serves as an advanced marker of rejection of the intestine. So if
the patient is mounting an attack to the intestine, the skin of the abdominal
wall will alert the team with the appearance of a rash about 15 days prior to
the actual intestine getting affected. This has a huge benefit for the patient
because it avoids intestinal dysfunction if the intestine gets affected. The
skin thus provides a visual canvas of inherent immunological activity to the
patient and the patient can remotely be aware of the quality and functioning of
the transplanted organ. This gives the patient control of his own transplanted
organs and empowers them.
The same team also performed a complex
kidney transplant procedure on a 35 year-old female patient who was on dialysis
for end stage renal disease (ESRD). The kidney was also harvested from the same18
year old brain dead donor and was perfused with Hypothermic Oxygenated Machine
Perfusion (HOPE) which preserved the organ for 11 hours. Preserving the organ
in this device keeps Kidney Longer and better for Transplantation.
Kidneys harvested from donors are
usually perfused and left in a cold environment surrounded by ice / cold solution
where the cooling is static. Even though theoretically it can be used for upto
24 hours after harvesting, the quality of the kidney and the outcome decreases
as the ischemic (storage) time increases. This HOPE system has the added
advantage of continuous inflow of high concentrated oxygen along with the
continuous infusion of hypothermic solution. This dual advantage is very
important especially in the case of marginal donors as well as in situations
where the ischemia time is expected to be long. Studies done in the west have
shown that the rejection rate was less in the kidneys perfused with such
preservation devices.
The harvested kidney was in cold
ischemia for 11 hours and the transplant was done successfullyand the patient
was discharged with a normal creatinine (ensures proper function of kidney) of
on the 4th post-operative day which is remarkable for a deceased donor
transplantation. This process also helps in reducing post-operative
complication like delayed graft function, dialysis requirements, biopsy and
additional hospital stays.
Speaking about two medical marvels performed by the transplant
team, Ms. Suneeta Reddy, Managing Director, Apollo Hospitals Group, said, “Apollo Transplant institute is
well known for several multi-organ transplant procedures with over 90% success
rates. Our organ transplant center is a
beacon of quality and hope for patients from across the world. As our
commitment towards delivering the best of healthcare service, we have
constantly invested in all contemporary medical equipment and technologies yet
keeping the services in affordable cost. Now we also brought the best-of-best
equipment to support organ preservation to India, the Vista Smart a Hypothermic
Oxygenated Machine Perfusion, which is a more advanced machine for kidney, and
liver perfusion. This will definitely benefit those patients in getting a
better quality of life.”
About Apollo Hospitals: It was in 1983,
that Dr. Prathap C Reddy made a pioneering endeavour by launching India’s first
corporate hospital - Apollo Hospitals in Chennai. Now, as Asia’s foremost trusted integrated
healthcare group, its presence includes over 12,000 beds across 72 Hospitals,
3400 Pharmacies, over 90 Primary Care clinics and 150 Diagnostic centers,
110 plus Telemedicine Centres, over 15
medical education centres and a Research Foundation with a focus on global
Clinical Trials, epidemiological studies, stem cell & genetic research,
Apollo Hospitals has been at the forefront of new medical advancements with the
most recent investment being the commissioning of South East Asia’s very first
Proton Therapy Centre in Chennai.
Every four days, the
Apollo Hospitals Group touches a million lives, in its mission to bring
healthcare of international standards within the reach of every individual. In
a rare honour, the Government of India had issued a commemorative stamp in
recognition of Apollo's contribution, the first for a healthcare organization.
Apollo Hospitals Chairman, Dr. Prathap C Reddy, was conferred with the
prestigious Padma Vibhushan in 2010.
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