New Delhi, April 22
A week after the Post-Graduate Institute of Medical Sciences and Research, Chandigarh, conducted the first-ever liver transplant in its history, recipient of the donated liver is in an extremely critical state after developing several post-operative complications.

The Tribune has learnt that 44-year-old Vijay Khurana from Saharanpur, Uttar Pradesh, who underwent liver transplant at the PGI, Chandigarh, on April 15, has suffered intra-ventricular haemorrhage (brain haemorrhage) and has been put on ventilator after he stopped responding. He is being monitored at the intensive care unit (ICU) of the Advanced Cardiac Centre at the PGI.

The patient’s platelet count has plummeted to dangerously low levels at 50, 000, the normal range being 1,50,000 to 4,50,000.

“The patient’s condition is critical although the surgery went off well and his lungs are functioning properly. It was a major surgery where post-operative aspects were very significant,” Dr Yogesh Chawla, Head of the Hepatology Department and coordinator for the first cadaveric (where the liver is received from a brain dead patient) liver transplant at the PGI, today told The Tribune. Dr Chawla is among the three finalists in the race for appointment as the new PGI Director.

Lead surgeon in the operation, Dr Arunanshu Behera, speaking exclusively to The Tribune, said the patient had been doing well over the first five days after the surgery, but had developed serious cerebral-vascular complications now. “Such complications occur in 3 per cent cases and are very unfortunate,” he said. The surgeon insisted that there were no technical or surgery-related issues and all graphs of the patient were fine, and so was his liver.

“This problem could have arisen due to a pre-existing complication in the brain that we didn’t know about. We are examining the patient to determine the source and are in touch with experts at the King’s College, London, and the Army’s Research and Referral Hospital in New Delhi whose team was here to help us for the surgery,” Dr Behera said. The question is why in such a major transplant surgery, all preexisting conditions were not ruled out and excluded.

That apart, it has also come to light that while the organ from the donor - a brain dead accident victim - was removed at the Renal Transplant Operation Theatre in the Nehru Block at the PGI, the transplant was done at the Cardiothoracic OT in the Advanced Cardiac Centre. The two are located at some distance, though Dr Behera said there was no question of any infection as international protocols were strictly followed. “In London, they transport the liver long distances. In cadaveric transplants, such transportation is normal. It is only in live liver transplants that the removal of the organ and the surgery much both be done in the same OT,” he said.

Asked why the patient was being kept at the ICU of the cardiac centre and not at the liver ICU, the surgeon said they wanted the “cleanest OT of the PGI for the first-ever liver transplant”.