Centre of Organ Transplant
Centre of Organ Transplant
The Centre for Transplantation at Jupiter comprises of a team of highly ranked surgeons and specialists who provide care for people who need transplants of the liver, kidney, pancreas, bone marrow and corneas as treatment for complex or rare end-stage disorders. Our multi-disciplinary team consists of hepatologists, nephrologists, transplant surgeons, intensivists, anesthesiologists, gastroenterologists and dedicated nursing staff.
Jupiter Hospital has prominent adult and pediatric transplant programs in the city, having performed more than 500 transplants till date. The integrated teams of specialists bring fresh, innovative approaches, offering patients answers to complicated medical needs.
Liver transplant: Liver transplant, also known as hepatic transplant, is a surgical procedure that aims at replacing the damaged or diseased liver of a person or a portion of it and replacing the same with a healthy lobe taken from a suitable donor. Liver transplant is usually the last resort of treatment when other options fail to give the desired results.
Kidney transplant: Kidney transplant is also referred to as renal transplant. The procedure involves the surgical replacement of the diseased or non-functional kidneys of a patient with a healthy one taken from a suitable donor. Kidney transplant is usually recommended when the patient does not show considerable improvement with medication and dialysis.
Pancreas transplant: Pancreas transplant is a surgical procedure in which the diseased pancreas of a person is replaced with healthy ones taken from a deceased donor. The procedure is usually performed to treat Type 1 diabetes. The procedure may also be performed along with a kidney transplant to alleviate serious complications triggered by diabetes.
Small intestine transplant: Small intestine transplant or small bowel transplant is an invasive procedure which involves the replacement of the diseased or non-functional portion of the small intestine with a healthy portion taken from a suitable donor. The procedure is usually performed to save the life of patients suffering from irreversible intestinal failure.
Wide Outreach: Transplant experts from Jupiter provides consultation at multiple locations in Mumbai, Pune and other parts of Maharashtra, Madhya Pradesh and Gujarat.
Experience: Our transplant surgeons have a cumulative experience of over 1000 transplants after intensive trainings received in international institutes.
Outstanding outcomes: Transplant recipients at Jupiter Hospital experience excellent outcomes which compare favourably to leading centres worldwide.
Comprehensive care: All the specialists, tests and procedures that a patient needs, are available at the same location, where integrated teams coordinate every step from start to finish.
An institution of milestones:
- Mumbai’s first pancreas transplant
- First adult dual lobe liver transplant in Western Maharashtra
- First small intestinal transplant of Western India.
- Pediatric liver transplants in infants using mono segment grafts.
- Performed more than 250 liver transplants.
The team in Jupiter performed the first pancreas transplant in Mumbai. Over the last year the team performed over 60 liver transplant surgeries and over 50 complex hepatobiliary surgeries.
This includes distinguished milestones such as paediatric liver transplant for a child weighing only 7.8kgs to using a liver from a cadaveric donor aged 82 years. More than 250 patients have been cared for inpatient for critical liver ailments and several thousand have been seen in clinics/OPDs.This will be the highlighted banner.
Personalized approach: Our doctors determine the safest and most effective approach for every challenge that patients face, and apply this knowledge to obtain the best possible outcomes.
Detailed follow-up practice: The team of physicians monitors patients closely so that each patient gets the care he or she needs when it's needed.
Whole-process support: A dedicated and experienced transplant coordinator is available to help answer questions and provide support before and after transplantation.
Surgeries & Procedures
All you need to know about Transplant
Surgeries & Procedures:
We seek to provide seamless surgical care to our patients and some of the procedures done routinely by the team are:
- Living Donor Liver transplantation
- Living Donor Kidney transplantation
- Pancreas transplantation
- Small bowel transplantation
- Deceased Donor transplantation
- Paediatric Liver Transplantation
- Surgery for Liver cancer
- Surgery for bile duct cancers
- Surgery for pancreatic cancer
- Surgery for acute/chronic pancreatitis
- Laparoscopic / Open live donor Nephrectomy
- Vascular Access procedures for Haemodialysis
- Continuous Ambulatory Peritoneal Dialysis
Services provided for the treatment of liver ailments such as
- Viral Hepatitis (Hepatitis B, C)
- Fatty Liver disease
- Liver Cirrhosis & all related complications
- Alcohol related liver disease
- Autoimmune liver diseases
- Liver cancers
- Biliary/Pancreatic diseases
- Acute Liver failure
- Acute on chronic liver failure
- Critically ill Liver patients
Normal liver vs. liver cirrhosis
Liver failure may happen quickly or over a longer period of time. Liver failure that occurs quickly, in a matter of weeks, is called acute liver failure (fulminant hepatic failure).
Chronic liver failure may be caused by a variety of conditions. The most common cause of chronic liver failure is scarring of the liver (cirrhosis), a process in which scar tissue replaces normal liver tissue and impairs liver function. Cirrhosis is the most frequently cited reason for a liver transplant.
Major causes of cirrhosis leading to liver failure and liver transplant include:
- Hepatitis B and C.
- Alcoholic liver disease.
- Nonalcoholic fatty liver disease.
- Genetic diseases affecting the liver (including hemochromatosis and Wilson's disease).
- Diseases that affect the bile ducts (the tubes that carry bile away from the liver), such as primary biliary cirrhosis, primary sclerosing cholangitis and biliary atresia. Biliary atresia is the most common reason for liver transplant among children.
Liver transplant is usually reserved as a treatment option for people who have significant complications due to end-stage chronic liver disease and acute liver failure.
Normal Kidney vs. Kidney Failure
When your kidneys lose this filtering ability, harmful levels of fluid and waste accumulate in your body, which can raise your blood pressure and result in kidney failure (end-stage kidney disease). End-stage renal disease occurs when the kidneys have lost about 90% of their ability to function normally.
Common causes of end-stage kidney disease include:
- Chronic, uncontrolled high blood pressure
- Chronic glomerulonephritis — an inflammation and eventual scarring of the tiny filters within your kidneys (glomeruli)
- Polycystic kidney disease
People with end-stage renal disease need to have waste removed from their bloodstream via a machine (dialysis) or a kidney transplant to stay alive.
At Jupiter, a team of surgeons, physician, transplant nurses, intensivists, social workers and other health professionals take care of you before, during and after transplant.
Transplants can be carried out only after an array of compatibility tests between the patient and the donor. We are equipped with all the latest technology to do such immunological tests for transplantation. We have trained pathologists to provide support for the accurate diagnosis of rejection and renal pathology.
Having all of these subspecialized expertise in a single place, focused on you, means that you're not just getting one opinion — your care is discussed among the team, your test results are available quickly, appointments are scheduled in coordination, and your transplant care team works together to determine what's best for you.
1. Choosing a transplant center
If your doctor recommends a liver / kidney transplant, you may be referred to a transplant center. You're also free to select a transplant center on your own or choose a center from your insurance company's list of preferred providers.
When you're considering transplant centers, you may want to:
- Learn about the number and type of transplants the center performs each year
- Ask about the transplant center's liver transplant survival rates
- Understand the costs that will be incurred before, during and after your transplant. Costs will include tests, organ procurement, surgery, hospital stays, and medicines required during treatment
- Assess the center's commitment to keeping up with the latest transplant technology and techniques, which indicates that the program is growing
A thorough evaluation is necessary to determine whether you are eligible for a transplant.
The goals of the evaluation process are to determine whether you:
- Are healthy enough to have surgery and tolerate lifelong post-transplant medications
- Have any medical conditions that would interfere with transplant success
- Are willing and able to take medications as directed and follow the suggestions of the transplant team
- Specific tests, procedures and consultations you may undergo include:
- Laboratory tests, including blood and urine tests to assess the health of your organs, including your liver
- Imaging tests, such as an ultrasound
- Heart tests to determine the health of your cardiovascular system
- A general health exam, including routine cancer screening tests, to evaluate your overall health
- Nutrition counseling with dietitians who assess your nutritional status and make recommendations regarding nutritional intake before and after transplant
- Psychological evaluation to assess and treat any underlying issues, such as depression or anxiety, and determine whether you fully understand the risks of a transplant
- Meetings with social workers who assess your support network to determine whether you have friends or family to help care for you after transplant
- Addiction counselling to help people with alcohol, drug or tobacco addictions to quit
- Financial counselling to help you understand the cost of a transplant and post-transplant care and to determine what costs are covered by insurance.
Once these tests and consultations are completed, the transplant center's selection committee meets to discuss your situation. It determines whether a transplant is the best treatment for you and whether you're healthy enough to undergo a transplant.
If the answer to both questions is yes, then you're placed on the transplant waiting list.
3. The wait for a new liver
The wait for a donor liver can vary greatly. Some people wait days, while other wait months or may never receive a deceased-donor liver. As you wait for a new liver, your doctor will treat the complications of your liver failure to make you as comfortable as possible.
In India, the number of people waiting for a liver/ kidney transplant greatly exceeds the number of available deceased-donor livers.
The human liver regenerates and returns to its normal size shortly after surgical removal of part of the organ. This makes living-donor liver transplant an alternative to waiting for a deceased-donor liver to become available.
In case of a living-donor kidney transplant, only one donated kidney is needed to replace two failed kidneys, which makes living-donor kidney transplant an alternative to deceased-donor kidney transplant.
A living-donor transplant is determined primarily by identification of a living donor who is healthy and able to safely undergo a major surgical procedure and is also the right size and blood type. Most living liver donors are close family members.
Living-donor transplants have good results, just as transplants using livers from deceased donors. But finding a good living donor match is difficult due to restrictions on the donor's age, blood type, size and health. Your transplant team can discuss the benefits and risks with you and the potential donor.
The transplant coordinator will help you enrol the name of patient in ZTCC (Zonal Transplant Committee) for deceased donor transplant. This list is arranged according to blood groups and the date at which patient is registered.
Once your name is enrolled in list, you need to keep close follow up with doctors.
If you're waiting for a organ, make sure the transplant team knows how to reach you at all times. Keep your packed hospital bag handy, and make arrangements for transportation to the transplant center in advance.
If you're notified that an organ from a deceased donor is available, you'll be asked to come to the hospital immediately. Your health care team will admit you to the hospital, and you'll undergo an exam to make sure you're healthy enough for the surgery.
The transplant surgery is done using general anesthesia, so you'll be unaware during the procedure.
The transplant surgeon makes a long incision across your abdomen to access your organs.
The location and size of your incision varies according to your surgeon's approach and your own anatomy.
The surgeon disconnects your organ’s blood supply and the bile ducts and then removes the diseased liver. The donor organ is then placed in your body, and blood vessels and bile ducts are reattached. Surgery can take up to 12 hours, depending on your situation.
Once your new organ is in place, the surgeon uses stitches and staples to close the surgical incision. You're then taken to the intensive care unit to begin recovery.
If you're receiving an organ from a living donor, surgeons will transplant a portion of the donor's liver / one kidney in your body.
Surgeons first operate on the donor, removing the portion of the liver/ one kidney for transplant. Then surgeons remove your diseased organ and place the donated organ/ portion in your body. They then connect your blood vessels and bile ducts to the new organ.
In case of liver, the transplanted portion in your body and the portion left behind in the donor's body regenerate rapidly, reaching normal volume within a couple months.
After a liver transplant, doctors will test your organ function often and monitor you for signs of complications.You can expect to:
- Possibly stay in the intensive care unit for a few days. Doctors and nurses will monitor your condition to watch for signs of complications. They'll also test your organ function frequently for signs that your new organ is working.
- Spend 5 to 10 days in the hospital. Once you're stable, you're taken to a transplant recovery area to continue recuperating.
- Have frequent checkups as you continue recovering at home. Your transplant team designs a checkup schedule for you. You may undergo blood tests a few times each week at first and then less often over time.
- Take medications for the rest of your life. You'll take a number of medications after your transplant, many for the rest of your life. Drugs called immunosuppressant help keep your immune system from attacking your new organ. Other drugs help reduce the risk of other complications after your transplant.
Expect six months or more recovery time before you'll feel fully healed after your transplant surgery. You may be able to resume normal activities or go back to work a few months after surgery. How long it takes you to recover may depend on how ill you were before your transplant.
It's normal to feel anxious or overwhelmed while waiting for a transplant or to have fears about rejection, returning to work or other issues after a transplant. Seeking the support of friends and family members can help you cope during this stressful time.
Your transplant team at Jupiter can also assist you with other useful resources and coping strategies throughout the transplant process.
Eating a well-balanced diet is especially important after liver transplant to help you recover and keep you healthy. Your transplant team includes a nutrition specialist (dietitian) who can discuss your nutrition and diet needs and answer any questions you have after your transplant.
To prevent damaging your new liver, it's important to avoid alcohol. Do not drink alcoholic beverages or use alcohol in cooking.
Your dietitian's recommendations after kidney transplant may include these steps:
- Eat at least five servings of fruits and vegetables each day
- Have enough fiber in your daily diet
- Choose whole grain foods over processed ones
- Drink low-fat or fat-free dairy products, which is important to maintain optimal calcium and phosphorus levels
- Eat lean meats, poultry and fish
- Follow food safety guidelines
- Stay hydrated by drinking adequate water and other fluids each day
Exercise and physical activity should be a regular part of your life after a transplant to continue improving your overall physical and mental health.