Referral Center for Liver Transplants - 15th November 2013

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Referral Center for Liver Transplants - 15th November 2013

13th Nov 2013

MIOT International takes immense pleasure in inviting the press fraternity to share the fact that true to the reputation of being a highly preferred referral hospital for complex Liver and Pancreatic diseases, MIOT has proved again that it has the ability to accomplish the mission failed elsewhere.
Of course, it is the technology & surgeons’ expertise that helps MIOT stay class apart. Our approach towards medicine starts with care and extends till the usage of most advanced technology that enhances the performance of our experienced team.

Today we present you with three circumstances where the patients with severe, life threatening Liver and pancreatic conditions were brought to MIOT International with very minimal hope among their family members. We sincerely hope that this meet will convey the significance of choosing the right center at the crucial moment and how a referral center could be the life-saver.

Case 1

Mr. A, 40 years gentleman from Viruthachalam was presented to an outside hospital in Chennai with 1 month history of weakness, weight loss and vague abdominal pain. On evaluation in the outside hospital, he was detected to have a 20 x 15 cm tumor in the right portion of the liver. He was taken up for surgical removal of the tumor. After ligation of the blood supply to the right portion of the liver, the surgeons in the outside hospital were unable to proceed with the surgery due to heavy bleeding. So the surgery was abandoned and the patient was transferred on a ventilator to MIOT Hospitals in an emergency situation on the night of the surgery.

In MIOT Hospitals, after initial stabilization, the patient was taken up for surgery. The massive tumor was seen to be infiltrating the diaphragm (the muscular partition between the chest and abdomen) and the major blood vessels inside the liver. The experienced MIOT Hospitals liver team was successful in removing the tumor (weighing 2.6 Kg) affected right portion of the liver along with the affected portion of the diaphragm without affecting the blood supply to the remaining left portion of the liver after a daring 4 hour long surgery. After the surgery, the patient was taken care of in the liver ICU and subsequently transferred to the liver ward and is recovering well.

Case 2

Mr. B, 56 year old diabetic for 20 years consulted a specialist at his home town for his symptoms of loss of weight and fatigue. He was evaluated and was detected to have a large liver tumor. The tumor was inoperable due to its multi-focality and cirrhotic change of rest of the liver. He was not a transplant candidate because of the size of the tumor and was informed that “nothing could be done”.

He came to MIOT hospital for second opinion. The team of doctors at MIOT hospitals formulated a plan for his management. He underwent a full course of stereotactic body radiation therapy (SBRT). Scan after radiotherapy showed that the tumor shrunk in size, which made him a transplant candidate. He was evaluated in detail and was deemed fit for the liver transplant and was listed for cadaver liver transplant as there was no suitable live donor in the family. Availability of suitable organ is unpredictable and can take long time, which can cause spread of the tumor in patients with liver cancer. To buy time patient underwent transarterial chemoembolisation(TACE), which delivers high dose chemotherapeutic agent to the tumor, sparing rest of the liver.

4 weeks later patient was called for a liver transplant. After thorough evaluation to confirm no metastasis, the liver was offered to the patient. He underwent uneventful liver transplant . His post operative recovery was uneventful and he was discharged from the hospital after 2 weeks. He is doing well in the follow up period.

Case 3

This 47 yr old Tamil Nadu government employee, father of two kids, reported to his work in the secretariat as usual on that morning. He was feeling a little uneasy but kept trying to get on with his usual work. A cup of coffee or the soda would not help. By the afternoon he was feeling some heaviness in his upper abdomen and was dizzier. He had to report sick and came back home. The consultation in a major corporate hospital was taken in the evening and was admitted for further evaluation. The blood tests and CT scan done showed a large tumor in his belly engulfing multiple organs like duodenum, pancreas, gall bladder, liver, large intestine and possible blood vessels of the right kidney. The specialist in that hospital reviewed the scan images and deemed it as inoperable, or rather too much to try in their hospital.

The specialist referred the patient for higher level care to MIOT Hospital. At MIOT he was reassessed and the patient and the family was assured that the case was not a ‘ given up’ one and an attempt at cure would be made. Careful pre-operative preparation including proper assessment for heart and lungs were made. Bowels were cleansed with special solutions anticipating bowel resection. Arrangements were made for something unusual called ‘auto-transplantation’ of the kidneys, just in case the kidney blood vessels needed to be removed along with the tumor: this involves removing ones kidney outside the body, infusing it with ice cold special solution to keep it alive outside the body, clearing it of all the tumor tissue and attaching new blood vessels by a surgery outside the body and then replacing it back into one’s body. The surgery was performed on him and in a 4 hour long surgery the tumor, which was arising from the head of pancreas was removed by a complicated procedure called ‘Whipple’s procedure’ along with the involved portion of large intestine, gall bladder , portion of adrenal gland and liver. Using meticulous surgical technique the tumor was freed from the kidney blood vessels without resorting to ‘auto-transplantation’. The patient had intensive care monitoring, special nutrition and intensive rehabilitation in the post-operative period.

Luckily the biopsy report of the removed specimen confirmed that the tumor was not only completely cleared but also of a certain type called \”gastrointestinal stromal tumor (GIST)\”, which has a very good prognosis. This patient was discharged after 10 days after surgery in a healthy condition. After discharge, our medical oncologist stepped in to treat him with special type of chemotherapy which does not require conventional admissions and infusions and one with very little of the dreaded side effects like hair fall -‘Imatinib’ which he could take at home for the next one year. The patient is doing very well two months after surgery now and has rejoined his government duties.

This case illustrates the success of excellent surgical skills, team work and multi-disciplinary approach for treatment of pancreatic cancers.

Events: Press Meet
Location: MIOT Hospitals
Date: 15th November 2013

  • Referral Center for Liver Transplants - 15th November 2013