Sister travels from US to give the greatest gift of life to her brother

Sister travels from US to give the greatest gift of life to her brother

Patient Review

  • Patient’s Name: Mr. Suresh Devani
  • Patient’s Age: 36
  • Patient’s Gender: male

Symptoms

  • Multiple infections with worsening Liver cirrhosis

Case Presentation

Doctors at Fortis Hospital Mulund performed a unique Liver transplantation surgery when a sister travelled from the USA, despite international travel restrictions, to donate a part of her liver and save her brother’s life. The transplant was essential as the patient was suffering from Liver Cirrhosis for the past one year. 

The procedure was successfully conducted by Dr. Gaurav Gupta, Consultant & Chief Surgeon, Dept. of Liver Transplant and HPB Surgery, Fortis Hospital, Mulund, and his team. 

Detailed Description :

36-year-old Mumbai resident Suresh Devani was diagnosed with Liver Cirrhosis in June 2020 and had been in & out of the hospital for one year. He had multiple infections, and his condition was deteriorating rapidly. The only way of saving and improving the quality of his life was a Liver transplant. However, during the pandemic, the number of organ donations saw a great dip. 

Suresh’s wife had offered to donate a part of her Liver, but she wasn’t a right match for the transplant. When Suresh’s USA-based sister heard about his condition, she immediately stepped in to volunteer and donate. Due to the pandemic, getting air travel permission was a big task. In fact, for several months, international travel was disrupted entirely, and many countries had stopped flights to India.

Moreover, the living organ donation norms in India are strict when it comes to donors from foreign countries. These regulations are in place to avoid organ trafficking. But this was a special case; it was about saving a life.

“This was a one-of-its-kind case as we learnt how love and determination can help overcome all obstacles. When we understood that the patient’s sister Sumita Gajera was willing to donate, she was evaluated and was found to be a good match for her brother. The process to get all the required permissions for the donor to travel and the donation to happen was quite painstaking, but the sister was determined to save her brother. This was a unique situation where the donor is an American citizen, and the recipient is an Indian. Also, this was the only hope we had to save the patient as Suresh was in a critical condition. Every passing day without a transplant would worsen his condition. We made concerted efforts to get all permissions for Sunita’s travel, despite the lockdown and restrictions. After getting all the permission for transplant were in order, Sunita Gajera was allowed to travel and gift a new life to her brother”. 

Dr. Gupta and his team helped Suresh’s sister with the necessary documentation to seek permission from the US embassy and the FBI. Documents required to get permission from the US Embassy, Director of Medical Education and Research (DMER), were expedited to enable the transplant procedure.

From the Doctor’s desk :

“This instance teaches us that living continents away does not weaken relationships. It also stands as a golden example of furthering the cause of Organ donation. Around 5 lakh people in India need to undergo lifesaving organ transplants each year. 

Many patients die due to the lack of availability of donors for transplants. Therefore, the need for understanding the significance and impact of organ donation is even more critical,” says Dr Gaurav Gupta, Consultant & Chief Surgeon, Dept. of Liver Transplant and HPB Surgery, Fortis Hospital Mulund.

Treatment and prognosis

  • Liver Transplant

Physical Examination & Tests

  • Liver Cirrhosis

Feedback

“We visited multiple hospitals and consulted many doctors. However, there was just one response that the surgery is too risky. When we met with Dr. Gaurav Gupta, he explained the procedure in detail, highlighted the risk, and gave us a glimmer of hope that the surgery could succeed. All staff and doctors were helpful and accommodating. My sister and I are both perfectly fine, three months after the operation, and living a normal life,” expressed a happy Suresh Devani. With a big smile and moist eyes, an emotional Sunita Gajera shared, “My brother is very dear to me, and when I found that the only way to save him was a transplant, I couldn’t wait any longer. Due to the pandemic-related restrictions, getting permissions was quite hassling, but Fortis helped me with most documentation. I am very grateful to the team of doctors who helped save my brother’s life. Today, he lives a healthy life, and I am glad that I could gift him a part of my Liver; our bond has strengthened even more now.” After the transplant, both the donor and the recipient are recovering well. The siblings celebrated Raksha Bandhan together this year.

Relevant Questions

Q. What can potentially cause damage liver?
 
The 3 main causes of liver damage are: Obesity, undiagnosed hepatitis infection and alcohol misuse. There are some other factors that lead to liver damage. That is,
  • Too Much Vitamin A From Supplements
  • Excess intake of Soft Drinks
  • Too much sugar

Read more


Q. My brother is hospitalized in Nair hospital since last 15days because of alcoholic liver infection, not getting improvement .. So i want to consult with you.

If a patient has alcohol-related liver injury generally treatment depends upon the degree of liver injury. some of the patients will recover after alcohol-related liver injury but in case of severe alcoholic hepatitis, liver transplant may be needed. 

If you want to know more, you can refer the article on Alcohol Liver Disease.

Read more


Q. My wife has issue with abdomen pain & according to Dr the lever is fatty We have done USG of upper & lower abdomen & it shows bit enlargement of lever What shall we do next

If on USG liver is fatty, the Patient should undergo some more blood tests to find the cause and degree of fatty liver. We should also check whether this fatty liver is causing hepatitis or not. Treatment will depend upon finding of these tests. I will suggest you to consult a liver specialist and then further treatment can be started.

Q. I have had high chronic liver enzymes for the past 10 years, and in this time i visited several doctors, some of them diagnosed my condition to be gilbert syndrome. My bilurbin range is 2 to 5 as both direct and indirect, whereas elevated Alt range is 60 to 100, and my Alp remains within the normal range. Hcv pcr is negative, hbv is also negative, wilson disease is negative, and no hemochromatiis has been detected. I had got my ultrasound done in January this year (2021), everything was normal then and my mrcp was fine too. For the past few months my upper right part of the abdomen has been aching, but that happens only when i walk, otherwise i don’t experience any pain at all. Can i know what is the cause of high alt and bilurbin? Do i have some issue related to liver or is it something else?

Gilbert syndrome does not generally cause high Liver enzymes (AST and ALT), it can cause a rise in bilirubin. Secondly, Gilbert syndrome causes only indirect bilirubin to be high and it doesn’t cause pain in the abdomen. Some of ur symptoms don’t match with Gilbert syndrome. Any rise in liver enzymes needs to be thoroughly evaluated. I will suggest you to consult a liver specialist and get evaluated.

Q. I have fever and is also experiencing fatigue. i got my blood tests done and the reports showed raised LFTs, but everything else is fine. there is no cough or shortness of breath, is this something to worry about? What is the cause?

Raised LFT can be due to various reasons. Different values in LFT signify different problems. Plus clinical examination will be helpful. You should see a doctor consultation along with a detailed check-up.

A patient suffering from ascites treated with liver transplant

A patient suffering from ascites treated with liver transplant

Patient Review

  • Patient’s Name: Mr. Swamy
  • Patient’s Age: 47
  • Patient’s Gender: male

Symptoms

  • Fluid overload
  • Ascites
  • Infections
  • Coagulopathy

Case Presentation

A 59-year-old male named Mr Swamy, a decompensated cirrhosis patient suffering from ascites, fluid overload, infections, and coagulopathy, consulted Dr Gaurav Gupta for a liver transplant. Mr Swamy was unable to breathe due to fluid overload when he arrived at the OPD. He weighed 120 kgs, and the majority of his excess weight was due to fluid overload. 

Dr. Gaurav Gupta is a skilled liver transplant surgeon in Mumbai. He has performed more than 500 liver transplants in Mumbai. Moreover, Dr Gaurav Gupta is a certified ASTS abdominal organ transplant surgeon.

liver transplant is a complex procedure that necessitates a multidisciplinary and comprehensive approach. End-stage liver disease and cancer patients who want to rehabilitate and restore their health as much as possible can benefit from a liver transplant.

It is critical to remember that cirrhotic liver patients have a reduced level of immunity. Infections plague these people constantly. Furthermore, the presence of the COVID-19 complicates things.

Mrs. Swamy, the patient’s wife, agreed to donate a portion of her liver to him. Mr Swamy had a fever, cough, and trouble breathing during the early investigation and was COVID positive. He was admitted to the hospital for two weeks to recover from the same. On the other hand, his wife and son were also COVID positive, but they recovered well in two weeks.

Mr. Swamy began to experience serious cirrhosis complications, and waiting too long for a transplant would have put him at risk. In such severe conditions, liver transplant surgery is postponed for six to eight weeks. Furthermore, Mr Swamy’s health insurance was set to expire in four weeks, leaving Dr Gupta with no choice except to perform the high-risk liver transplant surgery.

Dr Gupta went over the risks of performing an early liver transplant surgery with the patient, donor, and entire family. Dr Gupta performed the transplant with the approval of the family. Dr Gupta took all necessary precautions before the procedure. Now, he is glad to see the patient doing so well following the transplant.

Treatment and prognosis

  • Liver Transplant

Physical Examination & Tests

  • Pre-operative tests required for liver transplantation
  • RT-PCR test for COVID-19 diagnosis

Feedback

This is what the patient, Mr. Swamy, said, “Dr. Gaurav Gupta and his entire staff were extremely supportive during this tough time for our family. When I was running out of time due to the diagnosis of COVID and the expiry date of my medical insurance, I had given up hope. Dr. Gaurav Gupta and his team gave me hope. After our COVID-19 recovery, they conducted a liver transplant within four weeks. After the transplant, my extra weight was reduced, and now I am 80kgs. My wife and I have entirely recovered. I am speechless when it comes to expressing my gratitude to the entire team.”

Relevant Questions

Q. My wife has issue with abdomen pain & according to Dr the lever is fatty We have done USG of upper & lower abdomen & it shows bit enlargement of lever What shall we do next
 
If on USG liver is fatty, the Patient should undergo some more blood tests to find the cause and degree of fatty liver. We should also check whether this fatty liver is causing hepatitis or not. Treatment will depend upon finding of these tests. I will suggest you to consult a liver specialist and then further treatment can be started.

Q. I have fever and is also experiencing fatigue. i got my blood tests done and the reports showed raised LFTs, but everything else is fine. there is no cough or shortness of breath, is this something to worry about? What is the cause?

Raised LFT can be due to various reasons. Different values in LFT signify different problems. Plus clinical examination will be helpful. You should see a doctor consultation along with a detailed check-up.

Q. What can potentially cause damage liver?

The 3 main causes of liver damage are: Obesity, undiagnosed hepatitis infection and alcohol misuse. There are some other factors that lead to liver damage. That is,
  • Too Much Vitamin A From Supplements
  • Excess intake of Soft Drinks
  • Too much sugar

Read more


Q. My brother is hospitalized in Nair hospital since last 15days because of alcoholic liver infection, not getting improvement .. So i want to consult with you.

If a patient has alcohol-related liver injury generally treatment depends upon the degree of liver injury. some of the patients will recover after alcohol-related liver injury but in case of severe alcoholic hepatitis, liver transplant may be needed. 

If you want to know more, you can refer the article on Alcohol Liver Disease.

Read more


Q. I have had high chronic liver enzymes for the past 10 years, and in this time i visited several doctors, some of them diagnosed my condition to be gilbert syndrome. My bilurbin range is 2 to 5 as both direct and indirect, whereas elevated Alt range is 60 to 100, and my Alp remains within the normal range. Hcv pcr is negative, hbv is also negative, wilson disease is negative, and no hemochromatiis has been detected. I had got my ultrasound done in January this year (2021), everything was normal then and my mrcp was fine too. For the past few months my upper right part of the abdomen has been aching, but that happens only when i walk, otherwise i don’t experience any pain at all. Can i know what is the cause of high alt and bilurbin? Do i have some issue related to liver or is it something else?

Gilbert syndrome does not generally cause high Liver enzymes (AST and ALT), it can cause a rise in bilirubin. Secondly, Gilbert syndrome causes only indirect bilirubin to be high and it doesn’t cause pain in the abdomen. Some of ur symptoms don’t match with Gilbert syndrome. Any rise in liver enzymes needs to be thoroughly evaluated. I will suggest you to consult a liver specialist and get evaluated.

Budd-Chiari Syndrome Disorder

Budd-Chiari Syndrome Disorder

Details of the Patient

  • Patient’s Name: Unknown
  • Patient’s Age: 13
  • Patient’s Gender: male

Symptoms shown by the Patient

  • ● Huge Splenic Aneurysm (around 7 cm)
  • ● Multiple episodes of upper GI bleeding in last 5-6 years
  • ● Had developed cirrhosis and has huge collaterals
  • ● Due to such spleen, he has developed symptoms of hypersplenism (low platelet count, Low Hemoglobin, and low white cell count)

An Overview of the Case

Master X was diagnosed with Budd Chiari syndrome at age six years. He had multiple episodes of upper GI bleeding in the last 5-6 years. He had developed cirrhosis and had huge collaterals (veins that can bleed). 

The patient had a huge spleen reaching up to his right side. The size of the spleen was 27 cm. Due to such a large spleen, he developed symptoms of hypersplenism. like –

  • Low platelet count
  • Low Hemoglobin
  • Low white cell count

The large splenic aneurysm was a serious reason to worry. Any rupture of splenic aneurysm can be catastrophic. Because of collaterals, low platelet count, and such a big aneurysm, operating was a technical challenge.

Luckily, the patient was able to tolerate the surgery very well. The excision of the aneurysm and spleen went very well without any blood loss. The weight of the spleen was more than 2.5 Kg. 

Treatment Provided to the Patient

  • surgery

Medical Tests Performed

  • Routine CT scan
  • Blood platelet count

Feedback from the Patient

The surgery saved the life of Master X. He became fit in few days right after the surgery. Now, after the complete recovery, he can lead a healthy life. His parents were also pleased with the treatment.

Rare AB+ to B+ Living Donor Liver Transplant

Rare AB+ to B+ Living Donor Liver Transplant

Details of the Patient

  • Patient’s Name: Mr. Gajanan Thamke
  • Patient’s Gender: male

Symptoms shown by the Patient

  • Coagulopathy
  • Ascites

An Overview of the Case

Mr. Gajanan Thamke visited Dr. Gaurav Gupta with symptoms of coagulopathy and ascites. After diagnosis, Dr. Gaurav and his team concluded that Mr. Gajanan has Non-alcoholic steatohepatitis (NASH) and he would require an immediate liver transplant. The patient’s blood group was B+, so liver donation can only be done by family members with a B+ or O+ blood group. 

 

Unfortunately, none of the family members of Mr. Gajanan suited the blood group requirement. Dr. Gaurav and his team decided to wait in case a suitable liver donor could be found. However, time was running out for Mr. Gajanan, his condition was getting worse. He needed frequent ascitic tapping and his kidney was getting injured.

Dr. Gaurav Gupta, one of the best liver transplant surgeon in Mumbai and his team had a frank discussion with Mr. Gajanan and his family stating that there was not much time left and he required a liver transplant urgently. The team discussed with patient about the possibility of ABO incompatible liver transplant, where a transplant is performed from any blood group donor. The patient’s 23 year old daughter – Ms. Jayshree had an AB+ blood group which was incompatible. After some CT scans and tests, Jayshree was found suitable for the liver transplant. 

So, Dr. Gaurav decided to proceed with utmost precaution as such transplants are at risk of developing biliary complications. The doctor decided to modify the surgical procedure by making changes in how they would cut and join the bile duct.

Medical Tests Performed

  • Tests

Feedback from the Patient

This feedback is from the patient Mr. Gajanan: “During this difficult period for our family, Dr. Gaurav Gupta and his whole staff were very helpful. I had given up hope when I was running out of time and we could not find a suitable donor. Yet Dr. Gaurav Gupta and the rest of the team gave me new hope. I am doing a lot better after my liver transplant, and I have no words to express my gratitude to the entire team.”

Relevant Questions

Q. Hello, I’m a 49-year-old male whose platelet count has dropped to 27000 in the last several months. Gastroenterologists use sonography and endoscopy to detect compensated liver cirrhosis. I’m curious about the long-term effects and what kind of diet I should follow. Thanks
 
If your doctor has told you that you have compensated cirrhosis, this means you are in the early stages of the disease. The cause of cirrhosis in such patients must be thoroughly investigated. These individuals must also be monitored by liver experts on a frequent basis in order to diagnose and treat issues when they emerge. These individuals must also adhere to a rigorous liver-related diet. Diets are usually changed and tailored to the specific needs of each patient. I hope this answers your question, and please contact me if you have any other questions!

Q. My brother is hospitalized in Nair hospital since last 15days because of alcoholic liver infection, not getting improvement .. So i want to consult with you.

If a patient has alcohol-related liver injury generally treatment depends upon the degree of liver injury. some of the patients will recover after alcohol-related liver injury but in case of severe alcoholic hepatitis, liver transplant may be needed. 

If you want to know more, you can refer the article on Alcohol Liver Disease.

Read more


Q. My wife has issue with abdomen pain & according to Dr the lever is fatty We have done USG of upper & lower abdomen & it shows bit enlargement of lever What shall we do next

If on USG liver is fatty, the Patient should undergo some more blood tests to find the cause and degree of fatty liver. We should also check whether this fatty liver is causing hepatitis or not. Treatment will depend upon finding of these tests. I will suggest you to consult a liver specialist and then further treatment can be started.

Q. What can potentially cause damage liver?

The 3 main causes of liver damage are: Obesity, undiagnosed hepatitis infection and alcohol misuse. There are some other factors that lead to liver damage. That is,
  • Too Much Vitamin A From Supplements
  • Excess intake of Soft Drinks
  • Too much sugar

Read more


Q. I have had high chronic liver enzymes for the past 10 years, and in this time i visited several doctors, some of them diagnosed my condition to be gilbert syndrome. My bilurbin range is 2 to 5 as both direct and indirect, whereas elevated Alt range is 60 to 100, and my Alp remains within the normal range. Hcv pcr is negative, hbv is also negative, wilson disease is negative, and no hemochromatiis has been detected. I had got my ultrasound done in January this year (2021), everything was normal then and my mrcp was fine too. For the past few months my upper right part of the abdomen has been aching, but that happens only when i walk, otherwise i don’t experience any pain at all. Can i know what is the cause of high alt and bilurbin? Do i have some issue related to liver or is it something else?

Gilbert syndrome does not generally cause high Liver enzymes (AST and ALT), it can cause a rise in bilirubin. Secondly, Gilbert syndrome causes only indirect bilirubin to be high and it doesn’t cause pain in the abdomen. Some of ur symptoms don’t match with Gilbert syndrome. Any rise in liver enzymes needs to be thoroughly evaluated. I will suggest you to consult a liver specialist and get evaluated.

9 Months Old Baby with Biliary Atresia

9 Months Old Baby with Biliary Atresia

Details of the Patient

  • Patient’s Name: Piyush
  • Patient’s Age: 9
  • Patient’s Gender: male

Symptoms shown by the Patient

  • Jaundice

An Overview of the Case

At a private hospital in Kolkata, the Kundu family of Raipur was blessed with a baby boy, Piyush. However, the baby was diagnosed with jaundice shortly after birth. Doctors at the hospital ran tests and determined that the baby had Biliary Atresia, a condition in which the bile ducts around and inside the liver are scarred and blocked. The doctors determined that the baby needed a liver transplant as a lifesaving procedure.

The family was informed about the procedure. The baby’s mother agreed to a liver transplant in Mumbai, and the patient was transferred to Mulund’s Fortis Hospital to the pediatric ICU. After evaluation, it was found that the patient was having jaundice and a chest infection. The baby was severely underweight and had developed liver failure signs and symptoms. The patient was cared for by a pediatric intensivist team in the PICU.

Antibiotics, physiotherapy, and dietary supplements were used to treat the patient over the next two weeks. Aggressive optimization was done to improve the baby’s chances of a successful Liver Transplant. The patient’s grandmother was examined by a team led by Dr. Gaurav Gupta, who determined that she was a good candidate for liver donation. The patient underwent a liver transplant surgery which, although demanding, went smoothly. Postoperatively baby has a smooth recovery.

Even though it was difficult to manage the patient as he was a baby, the concentrated efforts of Dr. Gaurav Gupta and the entire team ensured that the patient recovered smoothly without any complications.

Medical Tests Performed

  • Tests

Feedback from the Patient

This feedback is from the patient Piyush’s mother “Dr. Gaurav Gupta and the entire team were very supportive during this trying time for our family. When Piyush was diagnosed with biliary atresia, I had lost all hope. But, Dr. Gaurav Gupta and the entire team were a new light of hope for me. My child Piyush has recovered after the liver transplant, and I have no words to express my gratitude to the entire team.”

Relevant Questions

 

Q. I have had high chronic liver enzymes for the past 10 years, and in this time i visited several doctors, some of them diagnosed my condition to be gilbert syndrome. My bilurbin range is 2 to 5 as both direct and indirect, whereas elevated Alt range is 60 to 100, and my Alp remains within the normal range. Hcv pcr is negative, hbv is also negative, wilson disease is negative, and no hemochromatiis has been detected. I had got my ultrasound done in January this year (2021), everything was normal then and my mrcp was fine too. For the past few months my upper right part of the abdomen has been aching, but that happens only when i walk, otherwise i don’t experience any pain at all. Can i know what is the cause of high alt and bilurbin? Do i have some issue related to liver or is it something else?

 

Gilbert syndrome does not generally cause high Liver enzymes (AST and ALT), it can cause a rise in bilirubin. Secondly, Gilbert syndrome causes only indirect bilirubin to be high and it doesn’t cause pain in the abdomen. Some of ur symptoms don’t match with Gilbert syndrome. Any rise in liver enzymes needs to be thoroughly evaluated. I will suggest you to consult a liver specialist and get evaluated.

Read more


Q. What can potentially cause damage liver?

 

The 3 main causes of liver damage are: Obesity, undiagnosed hepatitis infection and alcohol misuse. There are some other factors that lead to liver damage. That is,

  • Too Much Vitamin A From Supplements
  • Excess intake of Soft Drinks
  • Too much sugar

Read more