In a short span of one decade this department has not only become a center of excellence, but has established high standards for Liver transplant surgery for the first time in the public sector university hospitals in India. Ours is the only centre to have established a successful liver transplant program for both adult and pediatrics. Being a high volume center for complex hepato-pancreato-biliary surgeries, the department has dedicated and trained professionals, together with state of the art infrastructure. Our results are at par with the best international centers and hence attract patients from pan India and other countries of the world. Department’s commitment to training and research is reflected by its strong M.Ch. program which is one the most sought after super-specialty training programs in the country. An active research programme in the department is evident by publications in high impact journals.
Department is being increasingly recognized in both patient and in medical community as a destination for high-quality patient care. A total of 655 liver transplants have been performed till date for both Adult and Pediatric. The program has grown in strength with around a hundred transplants being performed every year for the last four consecutive years. About 15% of live donor liver transplants are emergency surgeries which is very unique and rare by international standards for major organ program.
Live donor liver transplant
Department has established live donor transplant program with results comparable to the world’s best centers despite operating upon sicker patients. Complex cases such as variant anatomy, portal vein thrombosis, patients with organ failures are being increasingly performed. New protocols for ABO-incompatible transplant has been established with comparable results. Live donor liver transplant for acute liver failure are being increasingly performed and the results are steadily improving. The experience of liver transplant for acute liver failure was published this year which received a special editorial and was well appreciated by the transplant community. Live donor outcome has been excellent with no donor mortality in around 580 cases performed by the current team and a major complication rate of less than 2%. Although a majority of our patients are fellow countrymen but because of increasing recognition patients are refreed from other countries such as Afghanistan, Pakistan, Nepal, Bhutan, Russia, Uzbekistan, Kazakhstan, Myanmar, and Iraq.
Pediatric liver transplant
A unique endeavour of the department is the liver transplant program for children which has seen an increasing trend. Inspite of the complexity involved in the operation and post-operative care our surgeons have efficiently managed to deliver good results comparable to best in the world. Pediatric liver transplant is 10% of our transplant and till date a total of 81 pediatric liver transplants have been performed. Majority of the children were acute liver failure needing emergency transplant the youngest such been 5 months old. Perioperative survival is 76% in ALF and 80% in CLD. We have started performing reduced and hyper reduced (mono segment) live donor grafts which have made it possible to perform liver transplant in infants with very low body weight. In addition ABO-incompatible liver transplants for children’s have been carried out.
Deceased donor liver transplant
We are one of the largest DDLT program in north India. Department has set a new trend of interstate organ transportation in the country. Majority of the organs were retrieved from distant cities such as Jaipur, Indore, Lucknow, Patna, and Chandigarh. Most of the livers were marginal but even then the team managed to deliver good results. We are committed to towards cadaveric organ transplantation in other public sector hospitals. Towards this end, we have trained teams from other institutes like SMS Jaipur, JIPMER Pondicherry, KGMC Lucknow, IGIMS Patna, SGPGI Lucknow, and RML Hospital Delhi. We have also started liver transplant program successfully at SMS Jaipur.
Major HPB resections
The department has become one of the high volume referral centers for complex resections for HPB malignancy. Major liver resections for cancers in the setting of chronic liver disease are routinely performed and results have been published. Extended hepatectomy with vascular resection for hilar cholangiocarcinoma which is one the most complex surgeries is increasingly being performed with good results. Complex pancreaticoduodenectomy for pancreatic cancer requiring vascular resections is commonly performed. Pediatric complex HPB surgery such as Kasai portoenterostomy and major liver resections for tumors are consistently performed.
Department is very active in Academics and Research as evidenced by publications in high impact journals. Both clinical and Basic science research is actively performed together with multiple clinical trials. Department set a new trend by presenting multiple clinical audits in the Institute’s academic meeting. The residents are actively involved in academic research and have presented in various international and national conferences.
A decade of milestones
|First live donor liver transplant||2010|
|First pediatric liver transplant||2011|
|First deceased donor liver transplant||2012|
|First ABO incompatible liver transplant||2015|
|Completing 100 liver transplant||2013|
|Completing 300 liver transplant||2016|
|Completing 600 liver transplant||2019|
|Start of MCh course||2010|
|Increase of MCh seats from 2 to 3||2012|
|Increase of MCh seats from 3 to 6||2019|
|Dr. Shridhar Vasantrao Sasturkar||Associate Professor|
|Dr.Ragini Kilambi||Assistant Professor|
|Dr. Nilesh Patil||Assistant Professor|
|Dr. Nihar Mohapatra||Assistant Professor|
|Dr. Sahil Gupta, Dr. Vivek R, Dr. Venkatesh BS, Dr. Tharun Gattu, Dr. Dinesh Bharati, Dr. Sanyam Santosh Falari, Dr. AnubhabhPanwar, Dr. Bharat Nair, Dr. Anish Gupta, Dr. DhananjaySaxena, Dr. Dharmender Dangi, Dr. Parthiban|
|KuldeepVarshney, Sunil Kumar, Neeraj Kaushik, Ravi Chauhan, Pushpendra Kumar, Kamaljit Singh, Mahesh Pal Singh, Mahipal Yadav, Shailender Kumar|
|Sanjay Joshi, Amom Beda Devi, T.Prameshwari Devi, Debola Devi, Sandeep Jhajharia, ThailunaDengmai, Smitha Thomas, Mohan Sharma, H.Taunthang, Omila, JishaBabu, Manju, Sarita Devi, Sandhya, Adanai, Neha Bhatt|
Fig: Year wise numbers of live donor (LDLT) and dead donor (DDLT) liver transplant
Fig. 2 Year wise numbers of Adult vs Pediatrics Liver tranpslant