Rare liver surgery performed in state-run hospital

Hyderabad: Doctors at the state-run Osmania General Hospital (OGH) here claimed to have performed a rare surgery of 'Auto Transplantation of Liver' on a 24-year-old patient, which they said is only second such transplant in the world.

The specialists at the Department of Surgical Gastroenterology at the OGH led by Dr Ch Madhusudhan, HOD, Surgical Gastroenterology and Dr Raghu Ram, HOD, Anaesthesiology, performed the surgery claimed to be first-of-its-kind in the country.

This complex surgery was performed free of cost for patient Naga Raju, a security guard with a private firm from Khammam district of Telangana, according to a release today.

Naga Raju was diagnosed to be suffering with rarest and critical liver disease -- Chronic Budd-Chiari syndrome since childhood.

Budd-Chiari Syndrome (BCS) is due to non-development of important and major blood vessels of Liver (Inferior Vena Cava and Hepatic veins) leading to occlusion of hepatic veins that drain the liver. This rare phenomenon is seen in 1 out of a million individuals, it added.

"He consulted all major corporate hospitals for treatment and was advised to undergo liver transplantation as a treatment of choice," the doctors said.

Raju hailing from poor family with both his parents being agriculture labourers, couldn't afford the cost of Rs 20- 30 lakh quoted by these hospitals for a liver transplantation, they said.

Due to BCS, Naga Raju was found to be suffering with dilatation and engorgement of all blood vessels below the chest due to blockage of major blood returning vein to the heart - Inferior Vena Cava (IVC).

He was also having recurrent episodes of bleeding from these blood vessels. Meanwhile, his liver function had started deteriorating, the doctors explained.

At OGH the wait for a cadaveric liver organ for him for the past two months and attempts with interventional radiological procedures proved futile, they said.

"The patient came to know about the first successful

Auto Tranplantation of Liver for chronic BCS syndrome carried out in Toronto, Canada. Autologous Transplantation of Liver involves surgically removing patient's own liver, clearing the occlusions in the blood vessels and re-implanting the liver in the patient," the doctors said.

"We discussed with the family members thread bare about the surgery and the risks involved including bleeding, liver failure and death. After this a marathon surgery spread over ten hours the medical team removed the liver from his body after securing bunches of blood vessels. The liver was cooled with cold preservative solutions for 4 hours to prevent its damage due to lack of blood supply," they said

"Then his own liver was transplanted back in his body. During this process the blood circulation to heart was maintained by extracorporeal circulation," they said.

The patient has since recovered, is doing well, taking normal diet.