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Posted at: Feb 11, 2018, 1:43 AM; last updated: Feb 11, 2018, 1:43 AM (IST)

DR. SAVIOUR

Mohit Khanna in Chandigarh
Organ donation involves law and delicate surgery. A few days back, experts at PGI Chandigarh achieved a first: they performed simultaneous kidney and liver transplant. But, more than anything else, doctors thank the parents of the teenage daughter declared brain dead for agreeing to organ donation even as they mourned the death

Mohit Khanna in Chandigarh

A tragedy is never a tragedy until it tears you apart to the point of no-return. In medical sciences, there are no dead-ends. That’s what Prof Rajesh Chhabra, Dr Lileswar Kaman and many of their colleagues at PGI Chandigarh thought when they found a teenage daughter of a migrant couple from Bihar struggling for life. The girl had met with an accident on Jan 24 and was rushed to the PGI the next day. The following week was an agonizing wait for neurosurgeon Prof Chhabra — until he found the girl ‘brain-dead’ — an indication of legal death. “I told the parents your child could still give life to many others. This was the most positive way of telling them that she was no more, legally.” The parents were hysterical with grief. “Yet they allowed us to make her live on in others,” recalls Prof Chhabra. 

“People come to us for treatment, not to hear that the patient will not survive. Declaring someone clinically brain dead is a tough call,” says Prof Chhabra. He followed the standard procedure of organ donation. What followed on Feb 2 became historic for the Post Graduate Institute of Medical Education & Research (PGIMER) Chandigarh. 

A team of top doctors decided to ask general surgeon, Prof Arunanshu Behera, and transplant expert, Prof Ashish Sharma, to start the simultaneous complex liver-kidney transplant surgery on a 40-year-old patient (name withheld). Since Prof Sharma had to be out of town, the task fell on Dr Dipesh Benjamin's shoulders. 

The PGI's Nehru Hospital turned into a war room, with five teams from neurology, nephrology, hepatology, anaesthesia and cardiology discussing the modalities of the operation. Dr Kaman was planning to join his two sons and wife for a dinner. No way. The next 13 hours meant life and death. For doctors, as Dr Kaman puts it, it was a relay race.

“Tension begins to mount as these are complex surgeries. Each minute counts. We rushed to the Operation Theatre (OT). The mission: extract the liver from the brain dead person. It took us three hours of nerve-racking procedure. A little mistake, and the liver would be of no use,” recalls Dr Kaman. In the meantime, the matching recipient was shifted to the OT. 

“This process is quite painstaking as weaving the arteries should be done immaculately. Any mistake, and you are doomed,” says Dr Kaman. The complete liver transplant stretched on for 10 hours. 

Over to the kidney transplant, the same day. Dr Dipesh Benjamin, additional professor, was busy with a live kidney transplant when he received a call about the accident victim being declared brain dead. As Prof Ashish Sharma, the man behind the success of cadaver transplant was unavailable, the entire responsibility fell on Dr Dipesh. His senior Prof Sarabpreet Singh told him that it was perhaps the first time in his medical career that they were to perform a simultaneous surgery. 

It was 5am when the kidney extraction from the donor began. Dr Dipesh was to perform three more surgeries in the next 12 hours. “There were three back-to-back surgeries: one for extraction and another for transplanting it on two recipients. Not only was it physically exhausting, it was also a test of skill and team work,” says Dr Dipesh. 

He came out of the OT at noon. The task was not yet over. The recipient's condition had to be monitored. It again took four hours to conclude that the transplant was successful. Now, the simultaneous operation got underway on the 40-year-old man. “It took us another two hours,” says Dr Dipesh. The team got out of the OT around 7pm. 

Dr Dipesh is all praise for his senior Prof Sarabpreet. “He was there all the time and guided me all through,” says Dr Dipesh. Dr Kaman, too, thanks his senior Prof Arunanshu Behera and his colleague Dr Divya Dahiya. “Team work is important for such surgeries. If one doctor gets tired, the other takes over to continue the operation,” says Dr Kaman.

How did they take so much of stress? “What we see the whole day is sickness and suffering. We start our day when our children are sleeping and reach home when they are in bed. But we chose this life. We have a social responsibility. And if we will fail in our duty, then the society will suffer,” says Dr Kaman.

The 40-year-old recipient of the liver and kidney continues to be under watch. That's where prayers begin. 

 

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