Partner

Thanks to a combination of growing medical expertise in India and government support, many children with rare liver diseases have a fighting chance.

How this Chennai hospital has become a global hotspot for liver transplants
Monday, February 08, 2021 - 11:56

When doctors at a government hospital in Chennai told Aishwarya’s (name changed) parents that the nine-year-old needed a new liver, they nearly lost all hope. After all, they couldn’t even afford to travel too often to private hospitals in Chennai where they were being referred for a transplant, much less the surgery itself.

“Aishwarya was suffering from Wilson’s disease,” explains Dr Joy Varghese, Director of Hepatology and Transplant Hepatology at Gleneagles Global Health City, adding, “This is a genetic condition that leads to excessive copper deposition in the body, which severely impacts the liver.” Dr Varghese reveals that when he met Aishwarya’s family during her pre-transplant tests, they had been sleeping in the corridors of their hometown hospital because they could not afford to rent a room for the child in a private hospital.

Some years ago, Dr Varghese says, many such families would simply resign themselves to the death of the child, either because of the high costs of the transplant surgery itself or because of the difficult course of post-transplant care that patients required. Today, however, Aishwarya is fully recovered and back in school, dreaming of becoming a nurse herself one day.

And it’s not just Aishwarya — in the last year alone, doctors at Gleneagles Global Health City have given a second chance at life to many children from low-income families. “Further, some children whose parents could afford the treatment on their own were also able to get a liver transplant and will now lead their lives normally,” says Dr Rajanikanth Patcha V, Clinical Lead, Liver Transplant & HPB Surgery.

Becoming a major liver transplant centre

Dr Mettu Srinivas Reddy, Director, Department of Liver Transplant & HPB Surgery, explains that Indian hospitals were many decades late in developing liver transplant capabilities. Thus, while more developed countries were performing a few thousand liver transplants every year by the late 1990s and early 2000s, India only began to achieve comparable transplant levels by around 2010.

In earlier decades, new developments in transplants also all came from Western nations. However, he says, we are now more self-sufficient in terms of knowledge and skills thanks to pioneering surgeons who helped transfer the knowledge from global frontrunners to India. In this, they have been ably aided by hospitals which run strong multidisciplinary efforts to constantly innovate on surgical techniques and maximise patient care.  

“I went abroad to learn. Similarly, most of my colleagues here, have qualifications from Western universities. But, if you look at the next generation of transplant specialists, none of them have qualifications from abroad. All of them are trained here,” observes Dr Patcha.

It is the development of such skills and knowledge that has helped Gleneagles Global Health City to grow one of the largest paediatric liver transplant programs in the world, with 50 transplant surgeries in the last year. Of these, several have dealt with rare liver conditions, for which there have been only a handful of transplants across the world. What’s more, the hospital has also maintained a perfect record for the last two years, with zero deaths among paediatric transplant patients.

The A-Z of liver transplant

While Gleneagles Global Health City, Chennai has an enviable global standing as one of the best paediatric liver transplant programs in the world, by no means is it limited to transplants in children, with about 15% of the cases being complex geriatric cases. “We have done some of the toughest transplants in the world here,” says Dr Patcha.

“We have done transplants even in patients over 70 years of age,” Dr Joy points out. “Sometimes even the patients and their family feel that they are too old for a transplant, but we do fitness tests and show them that it will be worthwhile,” says Dr Joy, adding with laughter, “I have had families come and complain later that their old father is too active after the transplant.”

“The hospital has a skill and talented team, thanks to the sheer number and complexity of cases we have done so far,” says Dr Reddy. The hospital also is the pioneer in India in certain types of transplants, like the ABO-incompatible liver transplant, where an emergency transplant is done even when the donor and recipient have different blood groups. “The process requires more skill and technique, as we have to prepare the recipient body to accept a different blood group,” Dr Reddy explains.

Government’s pioneering role

One of the major differences between countries like the US or UK and India has been the proportion of cadaver versus live donor transplants. India has traditionally been a hub for live donor transplants, where relatives or well-wishers donate a part of their liver for the patient.

However, one of the unique aspects of Gleneagles Global Health City is its comprehensive transplant program, combining both cadaver donor and live donor liver transplants. Such a comprehensive program has been possible because of the state’s pioneering role in encouraging cadaver donation.

Tamil Nadu was instrumental in the passage of laws regarding organ donation in India. The state has also worked to create a transparent and efficient system for organ donation with minimum disturbance to donors’ families. With campaigns by celebrities, the state has also been highly successful in spreading awareness among the public about the importance of organ donation. Finally, the state has also shown great coordination by agencies such as the police for the formation of green corridors and so on.

“I have seen important government officials from several other states come here so that they can learn from our experience. Already, several states follow the system that TN has pioneered,” says Dr Varghese.

One of the most significant forms of support offered by the government has been the inclusion of liver transplantation under the Chief Minister’s Comprehensive Health Insurance Scheme. It is only thanks to this scheme that Aishwarya and scores of others have been able to get a surgery that their families could not even dream of affording.

Gifting a life to children

Dr Varghese says that there is more for the government to do, particularly in terms of further expanding funding for transplants.

For the present, however, he continues to relive the joy of seeing a child receive the gift of life. “Aishwarya wants to become a nurse. One child wants to become an aeronautical engineer. Another wants to become a famous movie star like Vijay. If you had seen them before their surgeries, you would not believe that these were the same lively children with grand dreams for their future,” says Dr Varghese.

This article was created by TNM Brand Studio in association with Gleneagles Global Health City, Chennai.