Man in Asia’s first combo heart, liver transplant

A 30-year-old Indian man, Ponnar, has become the first Asian to undergo a combined heart and liver transplant in a single surgery, say officials at India’s Apollo Hospital. Ponnar, described by his doctors as a quiet-spoken young man from Tiruchengode in the Indian state of Tamilnadu, needed the surgeries after he started “noticing swelling in […]

A 30-year-old Indian man, Ponnar, has become the first Asian to undergo a combined heart and liver transplant in a single surgery, say officials at India’s Apollo Hospital.
Ponnar, described by his doctors as a quiet-spoken young man from Tiruchengode in the Indian state of Tamilnadu, needed the surgeries after he started “noticing swelling in his abdomen, shortness of breath and found that he was turning yellow,” according to a hospital statement.
Ponnar had been 22 then, but he was diagnosed with cirrhosis of the liver, leading to liver failure and needed a transplant.
His family was behind him but when he went to hospital to get his new liver, doctors found he had a congenital condition called Ebsteins anomaly – a failure of the right side of the heart to develop properly.
They concluded the anomaly was the cause of Ponnar’s liver failure.
“With the heart not functioning in an efficient manner, there was high back pressure on the liver causing destruction of the liver cells leading to jaundice and cirrhosis,” recalls Dr. Paul Ramesh, consultant cardiothoracic surgeon at Apollo in Chennai, India.
His doctors decided on an en-bloc combined heart and liver transplant, a rare and risky procedure which has only been done in a handful of centres around the world, but never before in Asia.
They forwent other options to stage the transplant-doing heart first, then liver as a second after recovery-or sequence it, doing both as independent procedures in the same surgery under one anaesthesia.
In the en-bloc option, both the heart and liver are considered a single entity.
“Additionally, the transplant team had to take into consideration the risk of excessive bleeding in the case of simultaneous transplant and the risk of accumulated toxins in the liver, attacking the heart, if the two organs were transplanted separately,” explained Ramesh.
Ponnar waited six months for an organ donor until his surgery in October, and left hospital a week later. His trust encouraged his medical team to push the boundaries of clinical science a notch higher, his doctors have said.
“Over a decade of experience in solid organ transplants has enabled us with the skills and expertise needed to carry out a complex and demanding procedure like this,” said Ramesh.
“Our successful heart transplants and liver transplants performed individually, gave us the foundation, strength and operational excellence.”
His doctors confirm Ponnar’s skin tone has lost its yellow hue and he’s on his road to recovery.
“With the trauma of over 8 years firmly behind him, Ponnar is all set to realize his hopes and dreams,” the hospital said in a statement.
“The surgery is a result of days of meticulous planning by both our cardiac and liver transplant team,” said Dr Prathap Reddy, founder of Apollo Hospitals.
“The collaborative efforts taken by both the transplant teams to analyse, strategize and orchestra the whole surgery is laudable.”