Patient had rare, complex live donor intestine transplant surgery, the first in Singapore; Dr Gaurav Chaubal, with two prior surgeries, was invited
Dr Gaurav Chaubal (second from left) with other doctors
A city-based doctor made the way for the first living donor intestine transplant surgery in Singapore. The patient, a 7-year-old girl, was born with rare intestinal pseudo-obstruction or the inability of the muscles to contract by birth as well as multiple liver complications, but couldn’t undergo the surgery due to lack of clinical expertise in the country. Dr Gaurav Chaubal from Global Hospital, who has successfully operated two such cases prior to this, was contacted and flown into the country for the surgery, giving the child a new lease of life.
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The 7-year-old had been unable to eat since birth and was put on Total Parenteral Nutrition, which involves the management of macro and micronutrients, fluids, and electrolytes via the central vein. Her health deteriorated further and the only option left was an intestine transplant. As part of the surgery on March 26, 150 cms of terminal ileum—the most distal segment of the small intestine—was resected from the girl’s father and was transplanted into her after removing the dysfunctional bowel. Doctors said that the transplanted bowels looked healthy a day after the surgery.
Dr Chaubal, director of liver, pancreas, intestine transplant programme and HPB surgery at Global Hospital, Parel, said, “Intestinal transplants are complex and rare worldwide. This is the first time such a transplant has been performed in Singapore. They don’t have expertise in living donor intestinal transplants. I have already done two such transplants in Mumbai, which was published in the American Journal of Transplantation. I have done a fellowship at Duke University in the US. So they approached my programme director and called me for the operation. As per our experience, living donors can safely donate around 30-40 per cent of their intestines.”
As this is a complex surgery, meticulous planning was done before it and both the recipient and donor had to undergo a number of tests to ascertain immunological match. The transplant is a result of international collaboration between SingHealth’s transplant division, Duke University’s abdominal transplants division, and Dr Chaubal. Post-surgery, both father and daughter are doing fine.
Dr Debra Sudan, director of abdominal transplant surgery at Duke University Hospital, USA, and the primary surgeon for the transplant, said, “For this young girl, complications of parenteral nutrition were life threatening and her only hope for long-term survival and improved quality of life was intestine transplantation. Thankfully, her father was able to donate a portion of his intestine and both the surgeries went very well. Both are recovering very well and we have every expectation that she will do well with this living donor intestine transplant.”
The last time an intestine transplant was attempted in Singapore was the case of Nirbhaya, who was raped and brutally assaulted in New Delhi. However, she succumbed to the injuries while waiting for a transplant.
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