Hepato Pancreato Biliary And Liver Transplant Surgery

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.

Departmental Achievements

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.

Academic achievements

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.