Apollo Hospitals performs Asia's first CHLT

The patient, Ponnar, hailing from Tiruchengode, a small town in Namakkal District, Tamilnadu, noticed swelling in his abdomen, shortness of breath and found that he was turning yellow.

It was diagnosed as cirrhosis of the liver, leading to liver failure and he was advised a liver transplant but when he presented himself for Liver Transplant, it was discovered that Ponnar had a congenital condition called Ebsteins anomaly, a failure of the right side of the heart to develop properly, which was the cause of the liver failure.

This left the patient with no other option but a combined heart and liver transplant. This is a procedure that involves surgery of the thoracic cavity (for the heart) as well as the abdominal cavity (for the liver).

“With the heart not functioning in an efficient manner, there was high back pressure on the liver causing destruction of the liver cells leading to jaundice and cirrhosis. Additionally, the transplant team had to take into consideration the risk of excessive bleeding in the case of simultaneous transplant and the risk of accumulated toxins in the liver, attacking the heart, if the two organs were transplanted separately,” recalls Paul Ramesh, Consultant Cardiothoracic Surgeon, Apollo Hospitals, Chennai.

The CHLT can be done in three ways:

1.       First the heart transplant – followed by the liver transplant as a second operation once the patient has recovered from the first surgery. (Staged Transplant)

2.       First the heart transplant – followed by the liver transplant as an independent procedure during the same surgery where the patient is under one anaesthesia. (Sequential Transplant)

3.       Simultaneous heart and liver transplant, done with both organs taken as a single entity still attached to one another. (en bloc heart and liver transplant)

“Over a decade of experience in solid organ transplants has enabled us with the skills and expertise needed to carry out a complex and demanding procedure like this. Our successful heart transplants and liver transplants performed individually, gave us the foundation, strength and operational excellence to successfully complete Asia’s first en-bloc CHLT. I am extremely proud of Ponnar and his family whose trust in the clinical team at Apollo gave us the inspiration to carry out this procedure and move the boundaries of clinical excellence a notch higher,” added Ramesh.

“This outstanding achievement is a testament to the world-class abilities of our surgeons, physicians, technicians, nurses and other staff who are committed to serving our patients and providing them with healthcare of international standards. The surgery is a result of days of meticulous planning by both our cardiac and liver transplant teams and showcases our strength in terms of infrastructure, and medical expertise. The collaborative efforts taken by both the transplant teams to analyse, strategize and orchestra the whole surgery is laudable,” said Prathap C Reddy, Chairman & Founder of Apollo Hospitals.