CHENNAI: Two hospitals in Coimbatore collaboratively performed the country’s first inter-hospital swap liver transplant on two patients suffering from end-stage liver disease. The complex procedure was executed between GEM Hospital and Sri Ramakrishna Hospital in Coimbatore.

The patients, a 59-year-old man from Salem admitted in GEM and a 53-year-old man from Tirupur in Sri Ramakrishna, were both in need of liver transplants. Their wives were willing to donate, but blood group incompatibility ruled out direct donation.

In a rare stroke of opportunity, doctors identified that a ‘swap transplant — where the wife of each patient gives to the other, was the only viable solution. And the surgery was simultaneously performed at both the hospitals on July 3.

Unlike conventional living donor liver transplantation, where a relative donates directly to the patient, a swap transplant enables patients who do not have a compatible donor within their own family to exchange donors with another family in a similar situation. Both surgeries were performed under the Chief Minister’s health insurance scheme. By enabling a compatible swap, the financial burden on patients was reduced.

On the day of the transplant, both hospitals performed the surgeries simultaneously in two different operation theatres located 5 km apart. Real-time video feeds were established to monitor surgical progress and co-ordinate liver retrieval and transplantation. Ambulances equipped with cold chain systems were kept on standby, but both donors and recipients remained in their respective hospitals throughout.

"This required navigating a host of legal, ethical, and logistical challenges. We had to obtain special clearance from the Tamil Nadu State Transplant Authority to transport the organ from one hospital to the other. We also had to ensure synchronised surgeries and establish a real-time communication protocol between both hospitals,” said Dr C Palanivelu, founder and chairman of GEM hospitals.