In a first of its kind, a cadaver liver travelled by road from Chennai to Coimbatore was transplanted almost 27 hours after it was harvested. The organ, harvested at 11 am at Vijaya Hospital was connected to the perfusion machine (OrganOx) in the evening. It was then left Chennai at 9.30 p.m. and reached Coimbatore’s PSG Hospital at 9 a.m, the next day. By 2.15 p.m., the liver got reperfused in the recipient.
When the 56-year trauma patient’s family came forward to donate the liver, several patients were on the waiting list. A few centres in Chennai rejected the organ because of its sub-optimal quality but a patient in Coimbatore agreed to receive it.
The patient who agreed to receive the liver was a 65-year-old woman who had suffered liver cirrhosis. Dr S. Swaminathan, the liver transplant surgeon at PSG Hospital, Coimbatore, said he held discussions with his patient. ‘The surgery went smoothly and the patient was stable,’ he added.
“We tried last week to transport a liver. But the machine could not be transported by flight as it is battery operated and the logistics were not favourable. So we couldn’t use the liver and it was discarded,” Dr Swaminathan said. He also added, “This time, we took a chance. The machine was transported by ambulance. It is a logistical nightmare. But when the liver is on the machine, we can preserve it for a longer time. We preserved it for almost 18 hours in the machine. Before that, it was in ice for about eight hours.”
The machine is commonly used in America and Europe. But, the prohibitive cost has prevented Indian doctors from using the machine, says Dr Swaminathan.
Subith Kumar, Chief Executive Officer of Duraent Lifesciences, which transported the OrganOx Metra machine and the liver, said there were several firsts to this transplant. The patient was told about all the risks. “She has been waiting with us for six months and doesn’t have much time. If we put off transplant for too long, the tumour will progress, making her unfit for transplantation,” the surgeon said.
“The liver was on the machine for more than 17 hours, a record for India,” he said.
Once after extracting, the liver was transported in ice to RPS Hospital in Kolathur for cannulation. Then, it was it was transported in an ambulance to a hospital, which is 500 km away, with the vehicle taking only four stops in ten hours to evaluate the various parameters of liver function.

Image Credits: The Hindu

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