30 year old Ponnar is back on his feet after undergoing possibly Asia’s first en bloc heart and liver transplant surgery at Apollo Hospitals.

K.P Ponnar (30) who has a master’s degree in Engineering was brought to Apollo Hospitals in March with symptoms of liver and heart failure caused by high pressure in a vein connecting the heart to the liver. It took six months to find an appropriate donor liver-heart match. An exceptional student who completed his masters in engineering and a gold medallist, Ponnar, at 22 years of age, started noticing swelling in his abdomen, shortness of breath and found that he was turning yellow.

This was diagnosed as cirrhosis of the liver, leading to liver failure. He was advised a liver transplant, which his family was ready to get done for the young man. “However, when he presented himself for liver transplant, it was discovered that Ponnar had a congenital condition called Ebstein’s anomaly – a failure of the right side of the heart to develop properly, which was the cause of the liver failure,” said Dr Paul Ramesh, consultant cardiothoracic surgeon, Apollo Hospitals. This left Ponnar with just one option – a combined heart and liver transplant.

The procedure involved surgery of the thoracic cavity (for the heart) as well as the abdominal cavity (for the liver), making it highly risky. The advantage of an en bloc surgery is that it reduces the amount of time organs spent outside the body, thereby improving the outcome and also reducing the amount of toxins secreted from the liver that could affect the heart if the organs were implanted one after the other.

The surgery cost Rs. 43 lakhs but it is only 1/30th of the cost of the same surgery in the U.S which would cost Rs. 12 crores.

After about six months of waiting for an organ from April, Mr.Ponnar’s chance came through on October 14. Thanks to the family of a brain dead victim, a heart and liver were obtained together and four teams of surgeons, nurses, technicians and others worked simultaneously – two teams removing the heart and liver from the donor and two teams preparing the recipient – for the procedure.

After eight hours of synchronised working together, the surgery was completed. The heart began beating, and the liver began functioning. J. Amalorpavanathan, member secretary, Transplant Authority of Tamil Nadu, called this a “commando surgery” and lauded the hospital for its effort. He also said the authority would ensure the highest quality of outcomes and ethical conduct in all transplants performed.

He underwent the combined heart and liver transplant on October 14 and was discharged within a week after the surgery. Mr.Ponnar, who is on the road to recovery,is thankful to his doctors and nurses who helped complete the rare and risky procedure successfully.

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Original Post: The Hindu, Times of India

Image Credits: The Hindu

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