Complex Liver Transplant at Kamineni Hospitals brings new ray of hope into life of 49-year-old Patient

Surgeons at Kamineni Hospitals, LB Nagar, Hyderabad, performed a
Complex Cadaver Liver Transplant surgery on a 49-year-old patient, who was suffering from
Primary Biliary Cirrhosis with autoimmune hepatitis since October 2021. He was brought to the
hospital with complaints of tiredness, general weakness, and later, Pedal oedema. After performing
certain tests, doctors diagnosed that the patient’s Model for End-stage Liver Disease (MELD)
score was 19, which was a clear indication for liver transplantation.
The patient, Dinesh Agarwwal, resident of New Delhi, was aware that the hospital had a
competent transplant team and well-equipped transplant OT and ICU capable of dealing with
difficult cases. Besides, Kamineni Hospitals’ former patient Sanjay Agarwal had recommended
him about the successful liver transplant surgeries done by the hospital’s surgeons.
“Primary biliary cirrhosis (PBC) is a rare ailment with overlap autoimmune hepatitis (AIH). The patient
already had low MELD score, and so we immediately looked for donors for immediate liver
transplant surgery. AIH with PBC is rare and has a predisposition for genetic inheritance due to which
daughter cannot be a donor and wife belongs to different blood group, so the donor was O +ve whereas
recipient is A +ve as patient has Decompensated chronic liver disease stage requiring serial transfusions
and ascetic tapping which lead him to undergo liver transplantation,” said Dr. Rajasekhar Perumalla,
Senior Hepato Biliary and Liver Transplant Surgeon, and Director – Hepatobiliary & Transplant
Surgery, Kamineni Hospitals, Hyderabad.
“We faced challenges while performing surgery as the patient had previous history of subcute
bacterial peritonitis, extensive vascular interloop and perihepatic adhesions issues which were addressed
by meticulous dissection with the help of the senior most surgeon and judicious use of blood and blood
products. Post-surgery the patient was managed well and discharged on the 10th day,” Dr. Rajasekhar
added.
The surgery was conducted by Dr. Rajashekar Perumalla, Senior Hepato Biliary and Liver
Transplant Surgeon, Dr Srinivas, Dr Paramesh, Dr Verma along with Dr. Lal Meher Pradeep, Senior
Anaesthetist – Liver Transplant, and Dr. Shravan, Senior Anaesthetist – Liver Transplant. All these
doctors have been treating such difficult cases for the past 20 years with negligible mortality
and morbidity.

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