यकृत माइलस्टोन

पुण्यातील 9-वर्षांच्या मुलीचे आयुष्य वाचविण्यासाठी यकृत देणग्या
सह्याद्री रुग्णालयातील यकृताच्या अपयशासाठी पुण्याचे प्रथम जिवंत रक्तदाते यकृत प्रत्यारोपण

रुग्णाला 9 वर्षांची, मुलगी होती. ती तिच्या नातेवाईकांबरोबर वेळ घालवण्यासाठी मुंबईला गेली होती. तेथे त्यांनी अशक्तपणा आणि गरीब भूकची तक्रार केली. तिला एका स्थानिक रुग्णालयात नेण्यात आले, जिथे तिला कावीळ असल्याचे सिद्ध झाले होते. पालकांनी लगेच त्यांना पुण्यात आणले होते जेथे ते बालरोगतज्ञांच्या देखरेखीखाली होते. सुरुवातीच्या वैद्यकीय व्यवस्थापनानंतर, ती सुधारली आणि डिस्चार्ज झाली. तथापि, ती लवकरच निमुळता होत गेली आणि पालकांनी तिला लगेच रुग्णालयात नेले. पुनरावृत्तीच्या चाचण्यांवर आधी बिलीरुबिन वाढला जो स्पष्टपणे उच्च पातळीपर्यंत पोहचला होता. रक्ताच्या थरांचा मापदंड देखील असामान्य होण्यास सुरुवात झाली होती. योग्य वैद्यकीय व्यवस्थापन चालू ठेवण्यात आले आणि एखाद्या गॅस्ट्रोएन्टेरोलॉजिस्टची मते शोधून काढली गेली की हे हेपेटायटीस नसले तर काही अधिक म्हणजे तीव्र लिव्हर फेल्यूअर. लगेचच सह्याद्री रुग्णालयाचे लिव्हर ट्रान्सप्लान्ट टीम मते मागविण्यात आली. डॉक्टरांनी लगेच जाऊन रुग्णाला तपासणी केली. तिच्याकडे नक्कीच लिव्हर ट्रिपलॅटनेशनची निकृष्ट कामगिरी नव्हती. आईवडिलांची आणि उपचार करणार्या डॉक्टरांबरोबर मुलांच्या स्थितीची तपशीलवार चर्चा झाली आणि रक्त चाचणीचा त्रास अधिक झाल्यास त्यांना लिव्हर प्रत्यारोपणाची गरज भासू शकते. अशा प्रकारच्या रुग्णांचे व्यवस्थापन यव्हर्स्ट प्रत्यारोपणासाठी आवश्यक असलेल्या आवश्यक असलेल्या केंद्रांकडे चांगले व्यवस्थापन म्हणून, पुढील व्यवस्थापनांसाठी मुलाला सह्याद्री रुग्णालये, डेक्कन येथे हलविण्यात आले होते.

सह्याद्री हॉस्पिटलमध्ये स्थलांतर केल्यानंतर, आवश्यक वैद्यकीय व्यवस्थापन चालू राहिले आणि मुलांच्या प्रगती प्रमाणे पालकांना सतत अद्ययावत केले गेले. तथापि, यकृताचे कार्य अधिक बिघडले आणि 12/06/2016 रोजी रक्तच्या अहवालातून स्पष्ट होते की तिला यकृत प्रत्यारोपणाची आवश्यकता होती. आईवडिलांची मुलांची स्थिती आणि तातडीने लिव्हर ट्रान्सप्लान्टची गरज लक्षात घेऊन अद्ययावत केले गेले. जर एक योग्य मस्तिष्क मृत दाता उपलब्ध असेल तर रुग्ण जवाहिरे कॅडेट लिव्हर ट्रान्सप्लान्टसाठी ZTCC सह सूचीबद्ध होते. त्याचबरोबर, कुटुंबाला थेट संबंधीत डोनर लिव्हर ट्रान्सप्लान्टचाही पर्याय देण्यात आला. कुटुंब यकृत-संबंधित लिव्हर प्रत्यारोपणासाठी पुढे आले आणि आईचे संभाव्य यकृत दाता म्हणून मूल्यमापन केले गेले. दुर्दैवाने, सुरुवातीच्या चाचण्यांमधे, तिच्या यकृताला फार मेदाचे आढळून आले होते आणि म्हणून तिचा संभाव्य यकृता देणारा म्हणून त्याचे मूल्यांकन केले गेले नाही. वडिलांनी लगेच स्वेच्छेने, त्याचे मूल्यांकन केले गेले आणि यकृताचे देणगीसाठी तंदुरुस्त असल्याचे आढळले. आवश्यक कायदेशीर कागदपत्रे 14/06/2016 रोजी पूर्ण झाली आणि 15/06/2016 साठी शस्त्रक्रिया आखण्यात आली.

15/06/2016 रोजी नियोजित केलेल्या शल्यक्रियेनुसार तिला शस्त्रक्रिया करून तसेच नंतर पोस्टऑपरेटिव्हने पुनर्प्राप्त केले. दाता (वडील) वसूल करण्यात आला आणि त्याला 21/06/2016 रोजी (पोोड 6) सोडण्यात आले. मुलाला देखील प्रत्यारोपणाच्या रूपात चांगले काम मिळाले. ती व्यवस्थित बरी झाली आणि तिला 25/06/2016 रोजी सोडण्यात आले. सध्या ती 1 महिन्याचे पोस्ट ट्रान्सप्लान्ट आहे, तिचे यकृत कार्य सामान्य आहे आणि ती चांगली करत आहे आणि दात्या (वडिला) परत काम करत आहे.

साडेतीन तासांत 210 किलोमिटर

पुणे: नाशिकमधील एक 67 वर्षीय मृतांची मृत्यूनंतर यमग्नोलीचे पुतळा 210 किलोमीटर्सने भरून पुण्याला 50 वर्षांपर्यंतचे आयुष्य वाचविण्यासाठी सोमवारी केवळ तीन ते अडीच तासांत पुण्यात आणले गेले. माणूस हा अंग एम्बुलेंसमध्ये सह्याद्री रुग्णालयात, डेक्कन शाखेत पाठवला होता. हे एक वर्षापेक्षा अधिक काळ ट्रिगर यकृताच्या आजारापासून ग्रस्त असलेल्या प्राप्तकर्त्यामध्ये बसविले जाणार आहे. दोन शहरांमधील रस्ते प्रवास, जे सहसा सहा तास लागतात, जवळजवळ अर्धा वेळेत डॉक्टर, वाहतूक पोलिस, जिल्हा प्रशासन आणि सहायक कर्मचारी यांच्या समन्वयित प्रयत्नांमधून पूर्ण होते. सोमवारी दुपारी 7.30 च्या सुमारास पुण्याजवळ पोहचल्यानंतर त्या प्रत्यारोपणाची प्रक्रिया सुरू झाली. शस्त्रक्रिया चार ते सहा तास घेते आणि दाबाच्या वेळेपर्यंत चालत राहते. डेक्कन शाखेच्या सह्याद्री रुग्णालयाचे वरिष्ठ व्यवस्थापक (ऑपरेशन) सोहम भातावडेकर म्हणाले, “हे गेल्या तीन महिन्यांत आमच्या हॉस्पिटलमध्ये 13 व्या यकृताचे प्रत्यारोपण आहे.” 26 जूनच्या रात्री दात्याला इंट्राकेनियल हॅरामेज (डोकेच्या आत रक्तस्त्राव) झाला होता आणि त्याला नाशिकच्या सह्याद्री रुग्णालयात दाखल केले होते. त्यांनी उपचारांना प्रतिसाद दिला नाही आणि दुसऱ्या दिवशी मेंदूला मृत घोषित केले. त्यांच्या नातेवाईकांनी त्यांच्या अंगणवाडीसाठी सल्ला दिला. “तथापि, नाशिकमधील सह्याद्री रुग्णालयात ऑक्स पुनर्प्राप्तीसाठी एक नियुक्त केंद्र नसल्यामुळे, दाता ऋषिकेश रुग्णालयात हलविण्यात आला. क्षेत्रीय प्रत्यारोपण समन्वय समितीच्या (जीएसटीसीसी) नियमानुसार, देणगी यकृत पुण्यात सह्याद्री हॉस्पिटल, डेक्कन शाखेत लवकरच वाटप करण्यात आली, “भातवडकर म्हणाले. सोमवारी सकाळी 11 वाजता पुण्यातील डॉक्टरांनी अंगणवाडीसाठी धाव घेतली. दुपारी चार वाजता, कापणी केलेल्या यकृतसह डॉक्टरांच्या टीमने पुणे आणि नाशिकच्या वाहतूक पोलिसांनी आयोजित केलेल्या हिरव्या कॉरिडॉरमार्फत त्यांचे प्रवास सुरू केले.

प्रत्यारोपण ऍनेस्थेटिस्ट मनीष पाठक यांनी सांगितले की, प्राप्तकर्ता गैरवर्तनातील स्टेटोहेपॅटायटीस (फेटी लिव्हर) संबंधित क्रॉनिक लिवर सिरोसिसमुळे ग्रस्त होता आणि यकृताचे प्रत्यारोपण आवश्यक होते. लिव्हर प्रत्यारोपण चिकित्सक बिपीन विभुते व प्रशांत राव हे शस्त्रक्रियेत सहभागी होते. लिव्हरव्यतिरिक्त दात्याचे त्वचा, डोळे आणि मूत्रपिंडदेखील कापणी होते. मूत्रपिंडांना नाशिकमध्ये दोन रुग्णांना फायदा होईल तर इतर अवयवांनी त्वचा आणि डोळा बँकांना दान केले आहे.

Sahyadri Hospitals witnesses its First Green Corridoor, from Nashik to Pune (May 16)

A Liver and a Kidney of a Brain Dead Patient in Nashik transported to Sahyadri Speciality Hospital, Deccan Gymkhana via Green Corridor in record 3.25 hrs. Usually it takes around 6.5 hours to travel this distance. It’s was first of its kind green corridor on Nashik-Pune highway & Sahyadri Hospital’s first intercity Organ transfer. The liver of a brain-dead 55-year-old woman was brought to Sahyadri Speciality Hospital Deccan Gymkhana for transplant on 10th May and was transplanted in 49 years old patient suffering from chronic liver disease.

One of its kind rare & Complex Liver Surgery performed first time in Pune (Apr 16)

A 24-year-old boy, who met with an accident was suffering from internal bleeding in body that had resulted in inflation in the belly. Local doctors immediately shifted to Sahyadri Speciality Hospital, Decccan Gymkhana for further treatment.

At Sahyadri Hospitals, after examining the critical condition of the boy, the Liver Team immediate advised surgery. It was observed that there was heavy bleeding in the arteries above the liver, which are connected to the heart, and in the arteries below the liver, which are connected to legs. Doctors performed a two-hour-surgery to repair the arteries.

As a result of this successful surgery, bleeding could be stopped, but the boy was still experiencing other medical difficulties. It was found that the veins inside the liver were also damaged. Doctors performed another surgery wherein they removed the damaged part of the liver, and could temporarily stop the bleeding through stitches.

The bleeding continued even after two surgeries. Hence, Doctor decided to perform third surgery. This time in order to completely stop bleeding and possibility of gangrene, doctors removed approximately 30 to 40 % of damaged part of the boy’s liver, and the bleeding could be stopped completely.

During the third and last surgery liver team realized that the boy had only one kidney in his body, on the right side and that too was badly damaged. Consequently, the boy took longer period to recover. After few months he recovered well. This type of surgery is unique and it is performed for the first time in Pune.

Father donates liver to save 9 year old daughter’s life in Pune’s (Aug 16)

In Aug 16, a complex liver transplantation surgery on a nine-year-old girl from Pune was performed by Sahyadri’s Liver Team. This was a case of Pune’s First Living Donor Liver Transplant for Acute Liver Failure. Previously, there had been few Living donor transplants in Pune, though for chronic liver diseases. In case of ALF (Acute Liver Failure), this was the first instance, in Pune. In such cases, the major challenge is immediate availability of a Liver Transplant Surgeons. In this case, the liver transplant done for ALF was a life-saving procedure. Father of the 9 year old girl donated his liver to save life of his daughter. After the successful surgery of liver transplant, the girl child and her father both have recovered well, post one month of the transplant.

81 year old’s liver makes for a healthy Liver Transplant (Oct 16)

A healthy 81-year-old woman with no history of diseases and morbidities, became the oldest donor from the city after donating her liver. The organ was given to a 56-year-old patient who was diagnosed with liver cirrhosis and cancer, and also had a tumour that measured 5.6 cms. The patient’s circumstances pressed for an organ transplant within a month’s time as the mortality rate was quite high.

In a first, recipient of a transplant donates organ (Jan 17)

In the first such instance in the country and the second in the world, the liver of a 42-year-old brain-dead woman, who was a kidney transplant recipient two years ago, was donated and successfully transplanted into a 66-year-old liver cirrhotic patient in Jan 17. What makes the case unusual, say experts, is that the woman’s liver was found fit to be harvested and transplanted despite she having been on immunosuppressive drugs for the last two years since her kidney transplant. The liver transplant, charted a new course in the field of organ donation as transplant recipients can now be recognised as potential donors on being declared brain-dead.

3 year old weighing only 10.2 kg undergoes liver transplant (Jan 17)

Liver Team @ Sahyadri Hospitals successfully performed a liver transplant on a 3-year-old boy weighing 10.2 kg, making the child one of the lowest-weight patients to undergo the procedure. Congenital liver cirrhosis is rarely seen in children. This was a challenging case as the child weighed only 10.2kg and was just three years old. The surgery lasted for 12 hours. The father and son were discharged under healthy conditions after surgery. The Surgeons took 20% of the liver approximately 185g from the father and transplanted it successfully into the three-year-old. Both their livers regenerated to normal size within six to twelve weeks.

Fastracking Liver Transplants

Fastracking Liver Transplants: 3rd day discharge after liver transplant
Sahyadri Hospitals’ has always believed in constantly innovating treatments to ensure the best care possible to all patients. The hospital recently conducted a liver transplant on a 67 year old male suffering from end stage liver cirrhosis with liver cancer. With the newer, internationally approved measures and meticulous pre – operative and post – operative procedures, the patient was able to be discharged on the third day after the surgery. This ensured that the cost of the surgery was brought down considerably as well. fast tracking liver transplants, where normally a transplant patient is discharged in 15-20 days, at Sahyadri we have fastracked the surgery and are discharging within 7-8 days.Recently we have discharges one liver transplant patient in record minimum 3 days, which might be the fastest liver transplant surgery..

Sahyadri Hospitals perform eight organ transplant surgeries in a month for the first time in Pune ( may 2016)

Among the eight organ transplant surgeries, five were liver transplant surgeries and 3 surgeries were performed for kidney transplant. Sahyadri Hospitals performed eight organ transplant surgeries in a month for the first time in Pune. This includes five liver transplant surgeries and three kidney transplant surgeries. Many times when diseases related with liver and kidney grow, organ transplant surgery is the only option to treat such patiants, as it can give new lease of life to these patiants. Hence these surgeries performed at Sahyadri Hospitals would go a long way in creating public awareness about importance of organ transplant.

Consumption of alcohol or excessive consumption of medicines can severely damage the liver. Not allowing natural drainage of urine and storing it in the body unnaturally can also put excessive strain on the liver. However when a person suffers from severe liver diseases such as acute liver failure, chronic liver cirrhosis, transplant surgery is the only option; but according to the need liver or kidney is not available. Therefore, the eight organ transplant surgeries done at Sahyadri hospitals is an important event in medical (healthcare) sector of Pune.

Talking on this occasion, Liver expert at Sahyadri hospitals Dr. Bipin Vibhute said, “Eight organ transplant surgeries in a month have been done for the first time in Pune and these surgeries were performed at Sahyadri Hospitals, which is very important to create awareness about importance of organ donation. We at Sahyadri Hospitals have recently launched new state of the art organ transplant center and in such a short period of time we have got very good response. Two aspects played a key role in these organ transplant surgeries, first the families of brain dead patients decided to donate organs of the brain dead patient and secondly our world class team of transplant surgeons.”

He further said, “Their is lack of awareness about organ donation and organ transplant in our society. These surgeries performed at Sahyadri Hospitals would play a vital role in creating awareness about organ donation and transplant surgeries.”

Rare feat at Sahyadri Hospitals, Liver Transplant patient discharged on 3rd day after surgery

Pune, 23rd October 2017 – Sahyadri Hospitals’ has always believed in constantly innovating treatments to ensure the best care possible to all patients. The hospital recently conducted a liver transplant on a male patient who was in his early sixties and suffering from end stage liver cirrhosis with liver cancer. With the newer, internationally approved measures and meticulous pre – operative and post – operative procedures, the patient was able to be discharged on the third day after the surgery. This ensured that the cost of the surgery was brought down considerably as well.
Liver transplants are usually quite lengthy. However, by using cutting edge world class transplant facilities and procedures, Sahyadri Hospitals’ Liver Transplant Team made sure that the patient was very well prepared physically, mentally and nutritionally prior to the surgery. Sahyadri Hospitals were thus able to shorten the duration of the patient’s stay in hospital.
Dr. Bipin Vibhute, Liver & Multi-organ Transplant & Hepatobiliary surgeon, Sahyadri Hospitals said, “Liver transplant is among the most expensive surgical procedures being performed. Our vision is to make clinical care patient centric & affordable without compromising on its quality so that it can benefit many more people in India. We believe that Fast Tracking is the way to go so that we can reduce the hospital stay and hence the cost of transplant. Using our Fast Tracking surgery we could discharge most of our patients (approx. 90%) on day 5 of transplant Surgery.”
The surgery was completed in 4 hours. The surgery was performed by a team comprising Multi-organ Transplant surgeons – Dr Bipin Vibhute, Dr Sharan Narute; Dr Dinesh Zirpe, Transplant Anaesthetist, Dr Manish Pathak, Hepatologist & Gastroenterologist, Dr. Sandeep Kulkarni, Asst. Surgeon, Dr. Abhijeet Mane, Transplant coordinators – Mr Arun Ashokan & Mr Rahul Tambe & Medical Social Worker – Mrs Sharmila Padhye. The team also included Liver Transplant Surgeons – Dr Anurag Shrimal & Dr Gaurav Gupta.
Besides careful selection of the donor and finding a good quality organ for the patient, measures were also taken to ensure that the risk of potential infection is lowered. It was also equally essential to ensure that minimal blood products were used along with steps such as early extubation and removal of lines, early mobilization, early oral feeding and optimal immunosuppression.
Within just 4 hours of the surgery, the patient was put on normal liquids such as tea and coffee, instead of only water which is usually the case at this stage. The very next day after surgery, he was also made to walk and even consume soft solids. The lines attached to the patient were also removed on the second day itself. All these steps helped fast track the patient’s recovery process and on the third day of his operation, he was successfully discharged.
Dr. Manish Phatak, Transplant Anesthetist, Sahyadri Hospitals said, “In this case, we believed that he would recover fastest when at home. We ensured that progress reports were sent to us twice a day. The pre surgery protocols and post-operative care for the patient that were put in place made it possible for him to be discharged soon after the surgery.  With our well-equipped hospital, latest technology and internationally approved procedures it is becoming easy for us to ensure fast and safe treatments for our patients.”
Sahyadri Hospitals is one of the best known and reputed hospitals for quaternary care and is especially well known for its expertise in organ transplants. They are well equipped with international medical protocols that allow almost all their transplant patients to be discharged within 6-7 days as compared to the usual 15-20 days.