Global Hospitals one of the fastest growing chain of tertiary care, multi-super specialty and multi-organ transplant in India, has yet again achieved a rare feat in liver surgery.

1. Global Hospital Successfully Performs First Dual Lobe Liver Transplant
In Western India
Sister and uncle turn saviors for 31 year old
Mumbai, February 05, 2015: Global Hospitals - one of the fastest growing chain
of tertiary care, multi-super specialty and multi-organ transplant in India, has yet
again achieved a rare feat in liver surgery. The expert team of doctors in Global
Hospital led by Prof. Mohamed Rela and Dr. Ravi Mohanka performed first
ever Dual Lobe Liver Transplant in Western India on a 31 year old male, Mr.
Satish Sonawane who was suffering from End Stage Liver Cirrhosis.
Mr. Sonawane, a resident of Jalgaon, was admitted at Global Hospitals with
swollen feet and fluid accumulated in the abdomen and around the lungs. Also, he
was breathless and had persistent cough. His tests revealed that he had advanced
liver cirrhosis with a very high bilirubin and high risk of bleeding. He was advised
liver transplant for which he underwent tests, was found to be suitable and was
listed for a cadaveric liver transplant. However, his liver disease was worsening
and waiting for a cadaveric liver transplant did not seem to be a feasible option. He
was therefore advised a living donor transplant with one of the family members
donating part of their liver for his transplant. Since he was overweight, he needed a
large liver for a successful transplant. He lost weight from 95 to 80 kgs for the
operation.
Two family members, his sister, 29 and uncle, 48, underwent tests for liver
donation, but both of them were found to have a small liver for his requirement,
despite his reduced weight, and therefore were not suitable as donors for his
transplant and therefore waiting for a cadaveric transplant seemed to be the only
option.
Meanwhile, on serial follow-up, he was found to repeatedly accumulate fluid in his
lungs which made him breathless and required oxygen for even daily activities and
his clotting abilities were severely impaired which put him at high risk for serious
bleeding in the internal organs. He was hospitalized for almost 2 months prior to
his surgery because it was unsafe for him to go to his hometown.

2. He was therefore advised a dual lobe transplant, which is like doing 2 liver
transplants on one patient where both donors would donate part of their livers for
his transplant and he would get enough liver for a successful transplant.
All the three surgeries were done in three different operation theatres
simultaneously involving 9 surgeons, 5 anesthetists and 20 operation room staff.
The surgery of the patient lasted for 15 hours starting from 6 am in the morning. It
involved removing his old liver which was severely diseased and transplanting 2
liver lobes, the right lobe harvested from his sister on the right side and the part of
left lobe taken from his uncle on the left side and joining all the blood vessels and
bile ducts to his own blood vessels and bile duct. Repeated ultrasounds were
performed during the surgery to make sure that all the tiny vessels had good blood
flow in them. He received 6 units of blood for the operation and none of the donors
required any blood products.
Both the donors remained in the ICU for 1 day and 5 – 7 days in the hospital. The
recipient was weaned off the ventilator the next day in the ICU, was shifted to the
ward out of ICU on 5th
day and was discharged 15 days after transplant with a well
functioning liver.
Prof. Mohamed Rela, Group Director, Institute of Liver Diseases Hepato-
Pancreato-Biliary Surgery and Transplantation, Global Hospitals, said, “Dual lobe
liver transplant is a complex procedure which requires two donors with healthy
functioning livers and one recipient. The entire Global Hospitals group has
successfully completed over 900 liver transplants, out of which this is the first of
its kind in Western India.”
Dr. Samir Shah, Head of Department of Hepatology, Liver Intensive Care &
Transplant Hepatology, Global Hospital, Mumbai, added, “Cirrhosis is the last
stage of chronic progressive liver disease. It not only causes portal hypertension,
nutritional deficiency, jaundice but also prevents the liver from functioning
normally. Hepatitis infection and alcoholism are some of the major causes for this
condition; however it can also be caused by other illnesses.”
Dr. Ravi Mohanka, Chief Surgeon and Head of Department of Hepato-Pancreato-
Biliary Surgery and Liver Transplantation, Global Hospital, Mumbai, said, “In

3. cases like these where the small size of the donor’s liver becomes a challenge, the
technique of dual lobe liver transplant is quite useful. The success of this procedure
is a breakthrough, for many more patients with liver failure can be offered a life
saving transplant in the future.”