PROF. SIBAL AND LIVER TRANSPLANT

Prof Sibal helped set up the first successful liver transplant program in India in 1998 at Apollo Hospitals, Delhi. In 2012, 1200 solid organ transplants in children and adults (840 kidney and 360 liver) were performed. The Apollo Transplant Program thus became the first transplant program in the world to perform more than 1000 transplants in a year and Apollo Delhi the busiest transplant centre in the world by performing 813 transplants (269 liver, 544 kidney). The Apollo Transplant Program remained the busiest program in the world in 2013 by performing 1456 transplants (390 liver, 1066 kidney) and Apollo Delhi the busiest centre with 952 transplants (283 liver, 669 kidney). The year 2014 saw continuing growth of the program with 1547 (422 Liver and 1125 Kidney) transplants being conducted across the Group, with Delhi performing 1065 (304 Liver and 761 Kidney) transplants. Thus, Apollo Delhi continued to remain the busiest solid organ transplant centre in the world for the 3rd consecutive year.

More than 2800 Liver Transplants were performed in the Apollo Group in the year 2015 – 2016.

PEDIATRIC LIVER TRANSPLANT

Pediatric liver transplant is a surgical procedure performed to replace a diseased liver with a healthy liver from either a deceased or living donor. As one of the largest and most complex organs in your body, the liver plays an essential role in your quality of life. The Apollo liver care program is committed to the comprehensive and lifelong care of your liver illness.

The multidisciplinary team offers advanced procedures in hepatology, medical oncology, liver transplantation, interventional radiology, and radiation oncology (including CyberKnife therapy) to provide you with a full range of personalized patient care.

Since the program began in 1998, our pediatric liver transplant team has achieved liver survival rates comparable to the best published outcome and developed new clinical techniques.

ABOUT LIVER TRANSPLANT

The liver is a large, meaty organ that sits on the right side of the belly. Weighing about 1.5 Kg, the liver is reddish-brown in color and feels rubbery to the touch. Normally you can’t feel the liver, because it’s protected by the rib cage.

The liver has two large sections, called the right and the left lobes. The gallbladder sits under the liver, along with parts of the pancreas and intestines. The liver and these organs work together to digest, absorb, and process food.

The liver’s main job is to filter the blood coming from the digestive tract, before passing it to the rest of the body. The liver also detoxifies chemicals and metabolizes drugs. As it does so, the liver secretes bile that ends up back in the intestines. The liver also makes proteins important for blood clotting and other

The liver is a vital organ present in human being and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion. The liver is necessary for survival; there is currently no way to compensate for the absence of liver function long term, although liver dialysis can be used short term.

This organ plays a major role in metabolism and has a number of functions in the body, including glycogen storage, decomposition of red blood cells, plasma protein synthesis, harmone production, and detoxification. It lies below the diaphragm in the abdominal-pelvic region of the abdomen. It produces bile, an alkaline compound which aids in digestion via the emulsification oflipids. The liver’s highly specialized tissue regulates a wide variety of high-volume biochemical reactions, including the synthesis and breakdown of small and complex molecules, many of which are necessary for normal vital functions.

Testimonials

It was a wonderful experience in Apollo Hospital during the liver transplant of my son. Initially I was very apprehensive regarding this procedure, as there was scarcity of alternatives we went ahead with the procedure. After the transplant was done, I was very happy regarding the case and procedure. I would like to thank Dr. Anupam Sibal and their team to give a new life to my son. I would also like to thank the nursing staff and all the member of Apollo hospital who took wonderful care of my son.
Antonio
I was shocked when my son was diagnosed with liver disease and needed liver transplant. We were not prepared for it initially because it had high risk and also require huge financials. Dr. Anupam Sibal counselled us and finally the liver transplant was done and my son got a new life. We are on regular follow up and he is leading a normal life like any other kid.
Paramvir
“It was a very difficult & tough time when we came to know that we need to go for the liver transplant,However due to the complete
explanation by the doctors at Apollo we could understand that its worth going for it , though it would cost us a lot on money”
“During the transplant, though ofcourse it was a tough time & we didnt know about the outcome, we believed in the team at Apollo
we remained calm & positive.The experience was very good with doctors replying & explaining any doubts or questions which came to our
mind.The whole staff was friendly & made our stay so comfortable during the transplant”.
“Again due to a very good follow up & concern by the doctors our son recovered & is now leading a normal life.We are very thankful to
Apollo & their humanitarian approach with special mention of Dr Anupam Sibal,Dr Nishant Wadhwa,Dr Subhash Gupta & their team who
made the whole experience look so easy”
Vikas Tuli
I wanted my son to lead a normal life when he grew up. At the age of 9 month his condition started deteriorating. We were told that he might need a liver transplant later in his life but this soon it was not expected. I trusted the team of Dr. Anupam Sibal for the treatment. My son did very well during the course of hospital stage. I would like to thank the nursing staff and all the people who were involved during and after the procedure.
Yusuf
I went to him with my son Kanav Arora – aged 9 years in the month of November 2016. Kanav was not going to school for the last 2 months due to constant complaints of stomach ache, vomiting and constant motions, after every one hour. We got all his tests done, showed him to various doctors but everything turned out to be fine, all test reports were ok and no doctor was able to diagnose the exact problem faced by my son. We were so worried for his studies and his future and didn’t know what to do. Then one friend of mine in media advised me to go to Prof Anupam Sibal.
Prof Sibal turned out to be an angel for us. He is God’s gift to mankind. He heard the background fully and gave us a patient hearing. He spent good 20 minutes with us in going through all the past reports of Kanav. He understood and diagnosed the problem and concluded that it has just gone into my son’s mind that whenever he enters the school or thinks about it, he feels like vomiting and going to washroom.
Moreover, we found Dr. Sibal very confident about his profession and he didn’t seem to struggle to diagnose the problem and identified the exact cause of the problem faced by my son.
The best part was that he asked us to buy some sweet tablets and give it to Kanav and tell him to take these tablets whenever he develops stomach ache or feel vomiting. That worked wonder for us and my son. He started keeping those tablets in his pocket and started telling me that Dr. Sibal’s medicine is very effective, he no more feels frequent motions, vomiting and pains since the time he has started taking Dr. Sibal’s medicine.
It clearly turned out to be that my son developed a fear and anxiety in his mind which was to be eradicated by some way which only Prof. Anupam Sibal did. He is the best Pediatrician I have ever seen. He deserves to hold so many accolades and ranks which he is holding.
May God bless him and give him long life so that he keeps on helping people in need!”
Bhupesh Arora
Respected Doctor,
I am extremely sorry to late for write few lines about experience go through pre & after Liver Transplant. Actually I have no words to explain the whole events. Hence I will try to express few words share with you.
“…In the year 2008 I have faced a hard challenge in my life when my new born baby became sick with a liver problem.
My agony & anxiety reached highest level, I feel a trauma covered me and windows of hopes seem closed. I was advised by Dr. Amitava Pahari & Dr. Abhijit Chowdhury they advised me to go Indraprashtha Apollo Hospital for LIVER TRANSTPLANT. This is first time I heard this medical term. My baby’s condition becomes deteriorated so without wasting much time, I reached Delhi.
I was keeping trust on my Almighty to get rid of this trauma and I saw there was a glimpse of hope at the end of the tunnel.
I am unable to explain my feelings for your friendly co operation, dedication and warm hospitality, during TRANSPLANATION. Special thanks to Dr Anupam Sibbal, Dr. Nameet, and Dr. Deepa. It’s seems to me that Almighty sent these Angels for my son.
Even at present when I face any problem I always found your strong co-operation. I don’t know the exact language which can express my feelings, I shall never forget that every act which blurred the line between professionalism and hospitality.”

Munmun Dubey

FAQ

A. Liver enlargement is usually an indicator of liver disease, although there are usually no symptoms associated with a slightly enlarged liver (hepatomegaly). Symptoms of a grossly enlarged liver include abdominal discomfort or “feeling full.”

Liver transplantation is the surgery to remove a diseased liver and replace it with a healthy one.

There are two sources: cadaveric and living donors.

• Cadaveric donors are individuals whose organs have been made available after brain death. As few cadaveric donations take place in India, living related liver transplantation is the only feasible option in our country. For living related transplants, a relative (usually parents) with a compatible blood type donates a portion of their liver to the child. Fortunately, the liver of the donor is able to grow back to full size in 812 weeks.
• Living liver donors should be healthy adults, with a near normal body mass index (not obese) who have the ability to understand the procedure. The donor should have no medical, emotional, or psychological condition that could potentially increase the risk of this surgery.

TThis consist of checking all the body systems with regards to optimal function and presence of unexpected disease. Your child’s immunization records will be reviewed. Following transplantation, some vaccines cannot be given and others may not be as effective.

A detailed nutritional assessment will also be performed. Several tests will be performed:

• Laboratory blood and urine tests.
• Electrocardiogram (ECG) and a chest X-ray.
• CT ofthe liver and blood vessels

The advantage of living related donor transplant is that the procedure can be scheduled effectively so that it works best for the donor and recipient. The disadvantage is that there is a very small risk of complications to the donor. Out of the 40 pediatric living related liver transplants performed at our center, there has been no significant complication in the donor population.
Most donors are hospitalized for 7-10 days after surgery. The incision staples are usually removed about 7-10 days postoperatively.
The recovery time for this type of surgery varies, but most donors are advised that they will require up to 3 months for complete recovery of normal health and activity.
A typical liver transplant can last from 8-12 hours. The surgery for the donor lasts approximately 5-6 hours.
There are risks with transplant surgery just as with any major surgery. Some immediate complications can include bleeding and blood clotting problems, respiratory problems and malfunction of the donor liver. Long term complications include rejection (when the child’s immune system does not accept the new liver) and infection. Fortunately, most of these complications are treatable.
After your child’s surgery, he/she will be taken to transplant ICU where he/she will stay for a week. After your child is transferred out of ICU to the pediatric floor, the length of stay will depend on how quickly he/she recovers. Average length of hospital stay is about 3 weeks.
Your child will take 2 major types of medications in addition to multivitamins and health supplements to prevent rejection. If your child misses a dose, you need to contact our team immediately.
Initially your child has to come to the transplant clinic twice a week for laboratory work up and physical examination or as frequently advised by our team. As recovery progresses, these visits become less frequent.
Your child will be looked after by the primary pediatrician who will be supported by our team. Reports will be communicated to us via e-mail or fax.
For the first six weeks after surgery, your child should avoid strenuous exercises.
Most patients can return to a normal or near-normal lifestyle six months after a successful liver transplant. Recipients should avoid exposure to people with infections. Maintaining a balanced diet and staying on prescribed medications are vital to stay healthy. Children can attend school and participate in sports and other age-appropriate activities and can have a normal married life with no fertility issues.
Our centre performed the first successful pediatric liver transplant in India in 1998. Our survival rate in the 241 liver transplants (215 adult and 26 pediatrics) performed in the last 3 years is 90%. Survival rates vary from centre to centre around the world. Our results are comparable to the most well established centers from across the world.
A pediatric liver transplant at our center costs between 12 to 15 lakhs, which is roughly one-tenth of what it would cost in the West. Subsequently, a patient requires Rs.8-10,000 month for lifetime immunosuppression.