Successful Liver Transplantation in India: A Case Study

The liver transplant surgery is a very complicated type of surgical operation; it requires the removal of a diseased liver and replacing it with a healthy new liver obtained from either a living donor or deceased donor. Usually people who are recommended to receive a liver transplant are patients that have end-stage liver disease due to conditions such as advanced cirrhosis, active hepatitis B or C, liver cancer, and some genetic disorders (due to uncommon / rare disorders). The path taken by Mr Azhar Iqbal, a Pakistani citizen aged 54 years, illustrates the difficulties he had in finding a liver transplant to provide him with good health.

Introduction

Mr Azhar was diagnosed with liver cirrhosis due to the hepatitis C virus. On approximately April 19, 2018, Mr Azhar was diagnosed with liver cancer (hepatocellular carcinoma (HCC)). After doing all the local treatments available and only finding partial success, his son Bilal Ahmed contacted MediGence to see what other options may exist for his dad's care since the local hospitals had limited treatment options and were not able to provide enough information for his family to decide as a group. Due to the complexity of the health care system and the diagnosis of HCC, Mr. Azhar and his family did not know who they should be asking for help and turned to MediGence for professional guidance, and sent all of Mr. Azhar's medical records to us for assistance.

After looking over the updated documents, specialists in India recommended a structured treatment plan. The family was informed that the overall goal would be to have a liver transplant, but first, he would need to undergo an interim treatment called transarterial chemoembolization (TACE) to shrink his tumor before he could be safely operated on. Based on directions from MediGence, Mr. Azhar and his family did all of their travel arrangements, hospital coordination, and visa processing with smooth efficiency.

Travel period

Mr. Azhar traveled to India with his wife, daughter (who was the donor), and brother. Upon his arrival, Mr. Azhar was evaluated further with advanced imaging to establish how widespread his tumors were. Fortunately, Mr. Azhar did not have any cancerous growths invading the adjacent critical structures, therefore he was eligible to move on in the treatment stage. Within a short time after being admitted to the hospital, Mr. Azhar underwent TACE and demonstrated an excellent response to this treatment, evidenced by the size of his tumor having changed noticeably.

Treatment Details

After this improvement, the transplant team was able to reconfirm Mr. Azhar's suitability for donation and to begin assessing his daughter as a donor. After thorough testing of both Mr. Azhar and his daughter's forms of blood work, as well as receipt of approval from their corresponding transplant committees, the period of waiting for surgery was underway for this family. The liver transplant surgery went well, and as with most of the intensive-care transfers, both he and his donor were assessed closely in the intensive care unit post-operatively.

Once the improvement had been achieved, the transplant team did another evaluation of his status and began a donor evaluation. The Committee approved the possibility to proceed with surgery after extensive testing, and therefore scheduled the surgery to be done following the completion of necessary tests. The surgery was successful and both the donor and Mr. Azhar were monitored closely in the ICU following their respective surgeries.

Post-treatment

The donor had a good recovery course and was discharged after a few days. Mr. Azhar required more time in the ICU than the donor before being transferred to a regular room. They both had good post-operative recoveries, and neither had significant complications during their hospitalizations. Later biopsy tests validated that Mr. Azhar has another early-stage cancer and additional medication will be provided in order to reduce the chances of having new cancer in the future.

After Mr. Azhar was discharged from the hospital, he continued recovering with the supervision of his physician. As he received this supervision he was able to start resuming normal activities, eat a healthy diet, and participate in light physical activity, such as walking. His daughter had a good recovery as well and had stable vital signs upon discharge.

Conclusion

This case demonstrates that with appropriate medical intervention, proper planning, and superior medical care, the outcomes can be improved in complex cases compared to if only one of these support systems were available. Patients, such as Mr. Azhar, can benefit from having access to state-of-the-art medical care and have successful operations and ultimately lead healthier lives.