by Suman Gupta
The team at Global Hospitals, Parel, Mumbai, successfully conducted a Living Donor Intestine transplant with a Sentinel Graft to give a second lease of life to a 9-year-old Kazakhstan boy. Dr Gaurav Chaubal along with his team of doctors performed a 14 hour complex procedure on the patient who was diagnosed with Midgut volvulus followed by Resection of both small and large intestine leading to short bowel syndrome on parenteral nutrition.
Patient Bekarys Zhumabek, was diagnosed with midgut volvulus (condition where the intestines twist upon themselves) in October 2022 when the clinical team decided to go ahead with surgically resecting the part of the small intestine along with appendix. Followed by this, the patient had complications and was immediately taken up for surgery where a significant position of his small intestine and another portion of large intestine was removed leading to a condition called Short Gut Syndrome. The patient was put on TPN since then and he started losing weight. He was referred to Global Hospitals Mumbai in December 2022.
Dr Lalit Verma, Senior Consultant Paediatric Gastroenterologist at Global Hospitals, Parel, Mumbai said, “Bekarys was referred to us as he had exhausted all treatment options in his country. He had already lost significant weight and had a high stoma output. We counselled the family about Living Donor Intestine Transplant and his maternal uncle came forward for organ donation. All requisite permissions from Statutory authorities were sought and he was optimised medically simultaneously. As he was prone to multiple infections, we had a multidisciplinary team meeting before finalising on the date of his surgery. He underwent a Living Donor Intestinal Transplant on the 30th January 2023 and has recovered very well.”
Dr Gaurav Chaubal, Director of Liver, Pancreas, Intestine Transplant Programme and Hepato-Pancreato- Biliary surgery at Global Hospitals, Parel, Mumbai said, “Bekarys’s case was extremely complex as he was extremely malnourished and had multiple infections when he presented to us. After optimising him, we has a detailed multi-disciplinary team discussion where the challenges and options were discussed before finally proceeding with the. As a kid, we did not want him to be subjected to frequent invasive protocol biopsies and hence had Dr Nilesh Satbhai, HOD & Senior Consultant, Plastic Surgery, to implant a free flap graft from his uncle’s thigh on his thigh. This remote free flap graft allows for non-invasive remote monitoring of early rejection. This is the first time this has been attempted in a living donor transplant in India. The surgery was complex and addition of free flap grafting had the surgery lasting for over 14 hours after which the recipient was extubated on table and shifted to transplant ICU for further management. The recipient is recovering well, off TPN and is eating orally well.”
“We are grateful to Dr Gaurav Chaubal and his team for giving our child’s life back. Seeing him lose weight and not eat anything orally, I was devastated as any child of his age dreams of eating everything. Also, the lines for TPN had to be carefully monitored and any infection could become dangerous for my child’s life. This surgery will allow my child to return back to normalcy and for that we will forever be grateful to the clinical team and the hospital” said the patient’s mother Shynargul Nassipkaliyeva.
“The year 2022, all the 3 Intestinal Transplants done in India were done in our hospital as per NOTTO statistics. Till date India has seen about 24 transplants, 4 being Living donors and the rest Deceased donors. Western India has seen 11 Intestine Transplants with 3 Living donor and 8 deceased donors. All three Living donor Intestinal Transplants have been done by Dr Gaurav Chaubal. The team is poised to deliver on the “Heal in India” mission and provide clinical excellence and value to not only domestic but International Recipients as well. The clinical team is the first in India to setup a Living Donor Intestine Transplant program and with this surgery, the bar of clinical excellence has been further raised with addition of Sentinel Graft procedure, it truly is a proud moment for the entire team at our hospital to see the Child getting his normal life back,” concluded Dr Vivek Talaulikar, COO – IHH Healthcare India
