Ruby Hall has been at the forefront in delivering high quality care in organ transplant

Dr Sheetal Dhadphale Mahajani, Hepatologist, Liver Transplant Physician & In-Charge, Department of Liver Transplant, Ruby Hall Cinic, throws light on the evolution of liver transplantation techniques and how technology is playing an integral role to bring in better quality and affordability

Can you elaborate on how much has the liver transplantation technique evolved since 1960’s?

Liver transplant is the treatment offered to patients suffering from end stage liver disease across the globe. The first liver transplant was done by Late Dr Thomas Starzl in 1963. It took good six to seven years before it was regularly offered to the patients in the US/ UK. It was in 1993 when the first transplant was conducted in India. Subsequently, in the 20th century, it was available to Indian patients. However, this treatment modality was available only to patients residing in the metros, mainly Chennai, Delhi, Hyderabad, Bengaluru and Mumbai.

There was a huge demand for this procedure in Pune and rest of Maharashtra. Ruby Hall Clinic, Pune was able to bring this treatment to Pune in 2013 and set up a liver transplant programme of international repute for patients residing in Pune and rest of Maharashtra apart from Mumbai.

• First successful liver transplant was conducted in January 2013
• First combined liver and kidney transplant was conducted in March 2013
• First adult to adult living donor transplant was conducted in May 2016
• Liver transplant surgery without using any blood products

What is the role of technology in the field of liver transplantation? How has it changed in recent times?

The understanding of the process of transplant surgery, post-operative management and long-term management has remarkably changed. Some of the surgical techniques have changed for example no venovenous bypass is needed now. The surgical technique has refined so much that the time incurred is really less compared to before, the blood loss is minimised, anaesthesia has changed. The blood component requirement has gone down significantly. Surgical innovation has allowed split transplants, adult donor left lobe transplants. The risk to the living donor has minimised significantly. The recovery post transplant is very fast, patients can go home on an average in seven to ten days. The immunosuppression medicines are more safe and effective.

In the coming five years, What changes do you predict in this field?

In the next five years, our centre will evolve as country’s advance care giving centre for all liver disease patients and liver transplants. We wish to take the deceased donor programme to another level. More complicated surgeries of split transplants and domino transplants will be routinely done. More research will be done on hepatocyte transplants and liver support devices.

How can the affordability be improved?

The increasing number will definitely bring down the cost. Drugs and disposables can have subsidy so that cost can go down. The transplant facility can be made available in the government set up so that it will be available for the economically challenged group.

Can drone technology, green corridors aid in bringing about more timely and effective transplants?

Intercity and inside a city transport of organs gets facilitated by creating green corridors. Traffic police play a crucial role in minimising the delays in transfer of organs. Newer technology like drones have a lot of scope in improving organ transport.

How has Ruby Hall been at the forefront in delivering high quality care in liver transplants?

Ruby Hall has been at the forefront in delivering high quality care in organ transplant. We are ahead of all the hospitals in Pune in promoting and initiating organ donations. We have received government of India – NOTTO best transplant award. When it comes to the innovations and nuances in medical technology ,Ruby Hall has been always leading. We have been helping the needy patients who require transplants though the social work department and help them raise the funds.

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